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Cited by 94Child Welfare and AdoptionChild and Adolescent Psychosocial and Emotional DevelopmentEarly Childhood Education and Development

The effects of early foster care intervention on attention biases in previously institutionalized children in Romania

Open access
Troller‐Renfree, Sonya, McDermott, Jennifer Martin, Nelson, Charles A., Zeanah, Charles H., Fox, Nathan A.·2015·Developmental Science
DOI 10.1111/desc.12261PMC PMC4447605
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Abstract

Children raised in institutions experience psychosocial deprivation that can negatively impact attention skills and emotion regulation, which subsequently may influence behavioral regulation and social relationships. The current study examined visual attention biases in 8‐year‐old children who were part of the Bucharest Early Intervention Project ( BEIP ). Relations among attention biases and concurrent social outcomes were also investigated. In early childhood, 136 children abandoned at birth or shortly thereafter into institutional care were randomized to receive a high‐quality foster care intervention or care‐as‐usual within the context of the Bucharest Early Intervention Project ( BEIP ). At 8 years of age, 50 care‐as‐usual, 55 foster care, and 52 community controls performed a behavioral dot‐probe task, and indices of attention biases to threat and positive stimuli were calculated. Concurrent data on social behavior were collected. Children placed into the foster care intervention had a significant attention bias toward positive stimuli, while children who received care‐as‐usual had a significant bias toward threat. Children in the foster care intervention had a significantly larger positive bias when compared to the care‐as‐usual group. A positive bias was related to more social engagement, more prosocial behavior, less externalizing disorders, and less emotionally withdrawn behavior. The magnitude of positive bias was predicted by age of placement into foster care among children with a history of institutionalization. An attention bias towards positive stimuli was associated with reduced risk for behavioral problems amongst children who experienced early psychosocial deprivation. Research assessing attention biases in children experiencing early environmental stress may refine our understanding of the mechanisms underlying risk for later psychiatric and social disorders and inform prevention efforts.

Integrity signals

Registry

Crossref · 10.1111/desc.12261

Cites

44 of 44 references verified0 citation errors · 0 not checkable

Statistics

20 tests recomputed · 0 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

0 of 34 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In ever-institutionalized children, greater positive attention bias was correlated with fewer externalizing problems.

    “Results indicate that a positive bias was correlated with fewer externalizing problems (r (85) = −.226, p = .035)”
    Quote in the paperSubstantial claim
  • Findingown data

    Children assigned to the foster care intervention showed a significant attention bias toward positive stimuli.

    “Children placed into the foster care intervention had a significant attention bias toward positive stimuli”
    Quote in the paperSubstantial claim
  • Findingown data

    The group by bias interaction was marginally significant.

    “A marginally significant group by bias interaction emerged (F (1, 93) = 3.158. p = .079).”
    Quote in the paperSubstantial claim
  • Findingown data

    In the never-institutionalized group, attention bias scores for threatening faces did not differ significantly from zero.

    “or threat bias (t (49) = −.481, p =.632).”
    • Also stated in: § Discussion · plain
      “the typically developing community sample showed no positive or threat biases”
    Quote in the paperSubstantial claim
  • Findingown data

    Positive attention bias was associated with fewer externalizing disorders.

    “A positive bias was related to more social engagement, more prosocial behavior, less externalizing disorders, and less emotionally withdrawn behavior.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 16
  • May combine two claims. 13

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Institutionally reared international adoptees have deficits in identifying facial expressions and in matching happy, sad, and fearful faces relative to non-adopted controls.

    “Wismer Fries and Pollak (2004) reported that internationally adopted children who had spent some portion of their early years in an institution had deficits in identifying facial expressions as well as matching happy, sad, and fearful faces when compared to non-adopted controls.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Wismer Fries and Pollak (2004)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    A threat-avoidance bias is associated with greater physical abuse severity and psychiatric diagnosis.

    “Pine and colleagues (2005) found attention bias away from threat was associated with severity of physical abuse and diagnosis of psychiatric disorders.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Pine et al., 2005

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The coding team independently coded 20% of videos after establishing reliability on five practice videos.

    “After establishing reliability on 5 practice videos, the coding team independently coded twenty percent of all videos to achieve reliability (intra-class correlations, or ICCs).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Average inter-rater reliability across tasks and codes was .93 for Social Engagement and .91 for Task Orientation.

    “Average reliability (ICCs) across the two tasks and all codes was .93 for Social Engagement and .91 for Task Orientation.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Nine additional participants were excluded from HBQ analyses because teachers did not respond.

    “An additional nine participants (5 CAUG, 3 FCG, 1 NIG) were excluded from all analyses using the HBQ due to teacher non-response.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Three foster care participants did not complete the peer interaction tasks and were excluded from analyses using the Social Engagement and Task Orientation composites.

    “Three participants (all FCG) did not complete the peer interaction tasks and were excluded from all analyses using the Social Engagement and Task Orientation composites.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Children with less than 60% accuracy on the dot-probe task were excluded from analysis.

    “To verify capacity to complete the dot-probe task, children who had less than 60% accuracy (Pérez-Edgar et al., 2011) were excluded from analysis (7 CAUG, 3 FCG, 2 NIG)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Pérez-Edgar et al., 2011

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Intent-to-treat analysis permits direct comparison of the intervention and control groups in the BEIP randomized trial.

    “The intent-to-treat approach allows direct assessment of the BEIP randomized clinical trial by comparing the intervention group (FCG) and the control group (CAUG).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Children with early psychosocial deprivation show enhanced neural processing of fearful faces and reduced neural responses to happy faces compared with non-institutionalized peers.

    “Parker and Nelson (2005) demonstrated that children who experienced early psychosocial deprivation had enhanced neural processing when viewing fearful faces, but reduced neural amplitudes when processing happy faces when compared to non-institutionalized peers”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Parker and Nelson (2005)

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Longer exposure to adversity and later removal from adverse environments are linked to greater impairment in attention and social competence.

    “Across numerous studies, both longer periods of adversity and later age of removal from adverse environments have been associated with greater impairment in attention skills and social competence”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Colvert et al., 2008

      Not checked in the free run.

    • cites Pollak et al., 2010

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Attention biases determine which parts of the environment are selected and processed.

    “Attention biases act as “gate keepers,” influencing which aspects of the environment are selected and processed”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Crick, 1994

      Not checked in the free run.

    • cites Pérez-Edgar et al., 2011

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Children with a threat attention bias tend to have more anxiety, social avoidance, and poorer emotion regulation than children without such a bias.

    “Children who display an attention bias to threat (commonly measured by faster reaction times to an angry facial expression) tend to have more anxiety symptoms (Vasey, el-Hag, & Daleiden, 1996), social avoidance (Mogg, Philippot, & Bradley, 2004), and poorer emotion regulation (Cisler & Koster, 2010) compared to children without threat biases.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Vasey, el-Hag, & Daleiden, 1996

      Not checked in the free run.

    • cites Mogg, Philippot, & Bradley, 2004

      Not checked in the free run.

    • cites Cisler & Koster, 2010

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Children raised in institutional settings face severe psychosocial deprivation and show negative outcomes across cognitive, behavioral, and social domains.

    “Children raised in institutional settings experience severe psychosocial deprivation and display a myriad of negative developmental outcomes in cognitive, behavioral, and social domains”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Nelson, Fox, & Zeanah, 2014

      Not checked in the free run.

    • cites Reeb-Sutherland, Fox, Nelson, & Zeanah, 2009

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Videotapes were event-coded in 30-second epochs by Romanian research assistants who were unaware of group assignment.

    “Videotapes were event-coded in 30-second epochs by teams of Romanian research assistants who were blind to group assignment.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The constellation of anxiety, social avoidance, and poor emotion regulation has been previously identified in institutionalized children.

    “This constellation of behaviors has been previously identified in institutionalized children (Tottenham et al., 2010; Wismer Fries & Pollak, 2004; Zeanah et al., 2009).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Tottenham et al., 2010

      Not checked in the free run.

    • cites Wismer Fries & Pollak, 2004

      Not checked in the free run.

    • cites Zeanah et al., 2009

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Social data and attention biases were measured at the same time point, so temporal precedence cannot be determined.

    “Additionally, all social data reported in the current study were measured at the same time point as the attention biases and thus it is not possible to determine whether positive attention biases precede, follow, or develop concurrently with adaptive social profiles.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Biases away from threatening stimuli have also been reported in maltreated children.

    “However it is important to note that biases away from threatening stimuli also have been reported in maltreated children (e.g., Pine et al., 2005)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Pine et al., 2005

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In Taylor et al. (2011), participants who developed a positive bias showed less anxiety and more positive emotionality under stress than those who did not.

    “For instance, in a study by Taylor and colleagues (2011), participants who developed a positive bias showed less anxiety and more positive emotionality when confronted with a stressful situation than participants who did not develop a positive bias.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Taylor and colleagues (2011)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Timing and type of maltreatment may produce different attention bias profiles.

    “suggesting that timing and type of maltreatment may produce different attention bias profiles.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The present study does not identify the precise mechanism linking positive biases to adaptive outcomes.

    “While the present study does not identify the precise mechanism linking positive biases to adaptive outcomes”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Threat biases may be particularly maladaptive for institutionalized and maltreated children because they are associated with psychiatric and social outcomes and because they exacerbate stress.

    “Threat biases may be particularly maladaptive for institutionalized and maltreated children not only because of their association with psychiatric and social outcomes, but also because threat biases have been shown to exacerbate the effects of stress (Derryberry & Reed, 2002; Ellenbogen et al., 2002; Paunovic et al., 2002).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Derryberry & Reed, 2002

      Not checked in the free run.

    • cites Ellenbogen et al., 2002

      Not checked in the free run.

    • cites Paunovic et al., 2002

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    Children placed into government foster care were placed over a wide range of ages and were not randomly assigned.

    “It is important to note that children placed into government foster care were placed into foster care over a wide range of ages and were not randomly assigned.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In Frewen et al. (2008), participants with a positive/rewarding bias were less likely to have psychiatric disorders than those with a threat bias.

    “Additionally, a meta-analysis by Frewen and colleagues (2008) showed that participants with a bias towards positive/rewarding stimuli were less likely to have psychiatric disorders than those with biases towards threatening stimuli.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Frewen and colleagues (2008)

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The BEIP foster care intervention may reduce attention bias to threat and increase positive bias.

    “Data from the current study suggest that the BEIP foster care intervention may reduce attention bias to threat and increase a positive bias.”
    Quote in the paperSubstantial claim
24 of 24

  • The paper relies on this without support.

    Few studies have identified the mechanisms linking institutional care to cognitive and social outcomes.

    “few studies have identified the mechanisms underlying these outcomes”

  • The paper relies on this without support.

    No published studies have examined how institutional care affects attentional biases.

    “While no published studies have addressed the influence of institutional care on attentional biases”

  • The paper relies on this without support.

    The foster care intervention in BEIP was high quality.

    “randomized to receive a high-quality foster care intervention or care-as-usual”

  • The paper relies on this without support.

    Institutionalization has negative effects on cognitive, social, and adaptive behavioral outcomes.

    “Multiple studies from a variety of groups describe the negative effects of institutionalization on cognitive, social, and adaptive behavioral outcomes.”

  • The paper relies on this without support.

    Few studies have investigated the relations among positive attention biases, social outcomes, and psychopathology.

    “Few studies have investigated the relations among positive attention biases to social outcomes and psychopathology.”

  • The paper relies on this without support.

    Positive attention biases have received little research focus up to this point.

    “First, positive attention biases have received little research focus up to this point.”

  • The paper relies on this without support.

    Positive affect is associated with all of the positive outcomes found in the present study.

    “In turn, positive affect has been associated with all of the positive outcomes found in the present study.”

  • The paper relies on this without support.

    Positive biases have not been previously reported in maltreated children.

    “Although positive biases have not been previously reported in maltreated children”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value: F (1, 93) = .640, p = .462

    Minor

    The paper reports p = .462 here; recomputing from the test statistic and its degrees of freedom gives p = .426. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .462 · recomputed p = .426

  • Inconsistent p-value: r (89) = .244, p = .023

    Minor

    The paper reports p = .023 here; recomputing from the test statistic and its degrees of freedom gives p = .020 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .023 · recomputed p = .020

  • Inconsistent p-value: F (1,142) = 2.341, p = .100

    Minor

    The paper reports p = .1 here; recomputing from the test statistic and its degrees of freedom gives p = .128. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .1 · recomputed p = .128

3 of 3

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upF(1, 142) = 2.341reported p = .1 · recomputed p = .128

    “F (1,142) = 2.341, p = .100”

  • Doesn’t add upF(1, 93) = 0.64reported p = .462 · recomputed p = .426

    “F (1, 93) = .640, p = .462”

  • Doesn’t add upr(89) = 0.244reported p = .023 · recomputed p = .020

    “r (89) = .244, p = .023”

  • Consistentχ²(2) = 4.297reported p = .117 · recomputed p = .117

    “χ2(2, N = 157) = 4.297, p = .117”

  • ConsistentF(1, 142) = 0.083reported p = .774 · recomputed p = .774

    “F (1,142) = .083, p = .774”

  • ConsistentF(2, 142) = 2.268reported p = .107 · recomputed p = .107

    “F (2,142) = 2.268, p = .107”

  • Consistentt(42) = 2.204reported p = .033 · recomputed p = .033

    “t (42) = 2.204, p = .033”

  • Consistentt(42) = -0.485reported p = .63 · recomputed p = .630

    “t (42) = −.485, p = .630”

  • Consistentt(49) = 3.56reported p = .001 · recomputed p < .001

    “t (49) = 3.560, p = .001”

  • Consistentt(49) = 1.385reported p = .172 · recomputed p = .172

    “t (49) = 1.385, p = .172”

  • Consistentt(49) = 0.655reported p = .515 · recomputed p = .516

    “t (49) = .655, p = .515”

  • Consistentt(49) = -0.481reported p = .632 · recomputed p = .633

    “t (49) = −.481, p = .632”

  • ConsistentF(1, 93) = 1.665reported p = .2 · recomputed p = .200

    “F (1, 93) = 1.665, p = .200”

  • ConsistentF(1, 93) = 5.122reported p = .026 · recomputed p = .026

    “F (1, 93) = 5.122, p = .026”

  • ConsistentF(1, 93) = 0.31reported p = .579 · recomputed p = .579

    “F (1, 93) = .310, p = .579”

  • ConsistentF(1, 93) = 0.394reported p = .532 · recomputed p = .532

    “F (1, 93) = .394, p = .532”

  • Consistentr(85) = -0.226reported p = .035 · recomputed p = .035

    “r (85) = −.226, p = .035”

  • Consistentr(90) = 0.209reported p = .045 · recomputed p = .046

    “r (90) = .209, p = .045”

  • Consistentr(93) = -0.303reported p = .003 · recomputed p = .003

    “r (93) = −.303, p = .003”

  • Consistentt(68) = -2.005reported p = .049 · recomputed p = .049

    “t (68) = −2.005, p = .049”

20 of 20

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Three-group test reports one group degree of freedom

    Minor

    The analysis compares three groups, so its group main effect should have two numerator degrees of freedom. The reported test instead gives one; the interaction from the same analysis gives two.

  • Foster-care t-tests imply a smaller sample than reported

    Minor

    The reported final foster-care sample contains 52 children, but both one-sample t-tests give 49 degrees of freedom, implying 50 observations. No further exclusion for these tests is stated.

2 of 2

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Cited by

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Related

Authors
Troller‐Renfree, S., McDermott, J. M., Nelson, C. A., Zeanah, C. H., & Fox, N. A.
Affiliations
  • University of Maryland, College Park (US)
  • University of Massachusetts Amherst (US)
  • Boston Children's Hospital (US)
  • Tulane University (US)
Corresponding author
Troller‐Renfree, Sonya
ORCID
Venue
Developmental Science
Publisher
Wiley
Published
2014-11-28
Volume
18
Issue
5
Pages
713-722
ISSN
  • 1363-755X (ISSN-L)
  • 1467-7687
DOI
10.1111/desc.12261
PMC
PMC4447605
OpenAlex
W2055631928
Cited by
94
References
44
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 6 · 2022: 6 · 2021: 8 · 2020: 38 · 2019: 4 · 2018: 6 · 2017: 12 · 2016: 7 · 2015: 2
FWCI
19.55
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Developmental Science (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • John D. and Catherine T. MacArthur Foundation
  • National Institute of Mental Health (1RO1MH091363)
  • National Science Foundation
  • Binder Family Foundation
Topics
  • Social Sciences › Safety Research › Child Welfare and Adoption
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Education › Early Childhood Education and Development
Keywords
foster care, institutionalized children, attentional bias, Bucharest Early Intervention Project, psychosocial deprivation, early childhood, threat bias, positive bias, social engagement, prosocial behavior, externalizing disorders, emotional withdrawal, behavioral problems
MeSH terms
Peer Influence, Analysis of Variance, Attention, Mental Disorders, Child, Child Development, Child, Institutionalized, Emotions, Female, Follow-Up Studies, Foster Home Care, Humans, Male, Psychosocial Deprivation, Surveys and Questionnaires, Romania, Bias, Early Intervention, Educational

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