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Effects of Early Deprivation 205scribed in Zeanah et al. (2003) and Smyke et al. (2006), explaining variance overand above what was accounted for by large between-group (institutionalized vs.never-institutionalized) differences (Smyke et al., 2004). Among institutionalizedchildren, quality of caregiving was related to signs of attachment disorder and toa more fully developed attachment to the caregiver. Quality of caregiving alsowas the only significant factor associated with an institutionalized child havingan organized (as opposed to disorganized or unclassifiable) attachment. 3At follow-up, infants and toddlers randomized into foster care were observedto use speechlike vocalizations and to exhibit more positive interactions withcaregivers significantly more frequently than children who had been randomizedto continued institutional care (Smyke et al., 2004). This pattern of findings, bothin the NICHD child care studies (see NICHD Early Child Care Research Network,1996, 2003, 2005) and in the findings from the infant and toddler BEIP, suggestthat quality of the caregiving environment, as measured by the ORCE, is an importantconstruct in understanding child outcome. Examples of inadequate caregivinginclude being less available to the child or interacting less with the child.To illustrate differences in our institutionalized versus never-institutionalizedchildren, we are sampling five different domains, including attachment, cognitivedevelopment (i.e., Bayley scores), EEG power, ERPs to facial recognition ofemotion, and psychiatric disorders. Note that because both data collection and dataanalysis is ongoing, only an overview of these findings will be discussed (herethe reader is encouraged to consult our existing published data).Mental age: At baseline, there were substantial differences in the institutionalizedgroup and the never-institutionalized group. Mean scores on the BayleyMental Development Index (MDI) were 103 in the never-institutionalized group(virtually identical to the population mean of the US of 100) and 65 in the institutionalizedgroup (Smyke et al., 2003). The latter score was inflated because thelowest score assigned on the Bayley is < 50. All children who received this scorewere assigned a score of 49. Following randomization, children in foster caredemonstrated more significant gains in MDI scores than children in the institutiongroup, although they did not attain levels of the never-institutionalized groupat any follow-up point (Smyke et al., 2004).To examine the effects of foster care on developmental status, we comparedthe data from our IG to our foster care group (FCG) at 42 months of age. As can beseen in figure 9-1, the Developmental Quotient (roughly comparable to full scaleIQ) of the Bayley improved significantly for those placed in foster care, but onlymodestly for those who remained in the institution.Attachment: At baseline, institutionalized children had substantially more disorganized(including nonattached) attachment than children raised with their parents(78% vs. 22%; for discussion, see Zeanah et al., 2005). Furthermore, 100%of never-institutionalized children were coded blindly as having fully developedattachments to their mothers, whereas only 3% of institutionalized children were