title: Motor outcomes in children exposed to early psychosocial deprivation.
abstract: OBJECTIVE
  To determine the effect of psychosocial deprivation early in life on motor development, assess the impact of a foster care intervention on improving motor development, and assess the association between motor and cognitive outcomes in children with a history of institutional care.
  
  
  METHODS
  In a randomized controlled trial, children living in Romanian institutions were randomly assigned to care as usual in the institution or placed in family-centered foster care as part of the Bucharest Early Intervention Project. The average age at placement into foster care was 23 months. At age 8 years, the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Short Form (BOT2-SF) was applied to assess the motor proficiency of children in both groups, as well as a never-institutionalized group from the Romanian community.
  
  
  RESULTS
  Children in the never-institutionalized group did significantly better on the BOT2-SF than children who had ever been institutionalized (P < .001). There was no significant difference in performance between children in the care as usual group and the foster care group. This finding also held true for all individual items on the BOT2-SF except sit-ups. Regression analyses revealed that the between-group and within-group differences in BOT2-SF scores were largely mediated by IQ.
  
  
  CONCLUSIONS
  Early deprivation had a negative effect on motor development that was not resolved by placement in foster care. This effect was predominantly mediated by IQ. This study highlights the importance of monitoring for and addressing motor delays in children with a history of institutionalization, particularly those children with low IQ.
authors.affiliation: Department of Neurology, Boston Children's Hospital/Harvard Medical School, Boston, MA; Laboratories of Cognitive Neuroscience, Boston Children's Hospital/Harvard Medical School, Boston, MA. Electronic address: April.Levin@childrens.harvard.edu.
authors.forename: April R
authors.initials: AR
authors.lastname: Levin
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Zeanah
authors.affiliation: Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD.
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Fox
authors.affiliation: Laboratories of Cognitive Neuroscience, Boston Children's Hospital/Harvard Medical School, Boston, MA; Center on the Developing Child at Harvard University, Cambridge, MA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Nelson
mesh_terms: D002648:Child; D002657:Child Development / Q000502:physiology*; D002674:Child, Institutionalized / Q000523:psychology*; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005581:Foster Home Care / Q000523:psychology*; D006801:Humans; D007223:Infant; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D011610:Psychosocial Deprivation; D012189:Retrospective Studies; D012383:Romania
keywords: BEIP; BOT2-SF; Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Short Form; Bucharest Early Intervention Project; WISC-IV; Wechsler Intelligence Scale for Children–Fourth Edition