Effects of therapeutic interventions for foster children on behavioral problems, caregiver attachment, and stress regulatory neural systems

Ann N Y Acad Sci. 2006 Dec:1094:215-25. doi: 10.1196/annals.1376.023.


Young children in foster care are exposed to high levels of stress. These experiences place foster children at risk for poor social, academic, and mental heath outcomes. The role of adverse events in stimulating neurobiological stress responses presumably plays a role in shaping neural systems that contribute to these problems. Systematic and developmentally well-timed interventions might have the potential to change developmental trajectories and promote resilience. Moreover, understanding how specific dimensions of early adversity affect underlying stress response systems and how alterations in these systems are related to later psychosocial outcomes might facilitate more precise and targeted interventions. Data are drawn from two ongoing randomized trials involving foster infants/toddlers and preschoolers. Consistent with prior animal models of early adversity, these studies have shown that early adversity-particularly neglect, younger age at first foster placement, and higher number of placements-is associated with altered hypothalamic-pituitary-adrenal (HPA) axis function. The interventions under investigation have produced evidence that it is possible to impact many areas that have been negatively affected by early stress, including HPA axis activity, behavior, and attachment to caregivers.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adaptation, Psychological
  • Animals
  • Caregivers / psychology*
  • Child
  • Child Behavior Disorders / therapy*
  • Child, Preschool
  • Foster Home Care / psychology*
  • Humans
  • Hydrocortisone / analysis
  • Hypothalamo-Hypophyseal System / physiopathology*
  • Object Attachment*
  • Pituitary-Adrenal System / physiopathology*
  • Stress, Psychological / physiopathology*


  • Hydrocortisone