Adaptive functioning at age 18 years following severe early deprivation: Results of a randomized controlled trial

In the present study, we examined adaptive functioning data from the Bucharest Early Intervention Project, a randomized controlled trial of foster care as an alternative to institutional care following exposure to severe psychosocial deprivation. Adaptive functioning refers to the skills individuals need to meet age-appropriate social and practical demands required for independent functioning. These abilities are essential for successful navigation of daily life and can be impacted by early adversity. We report data from 134 children (55% female) assessed in early adulthood (M_age = 18.9 years). Adaptive functioning was assessed via the Vineland Adaptive Behavior Scales (Vineland). We found that 16 years after randomization occurred, those who had been randomized to the foster care group (FCG) had significantly higher scores in adaptive functioning, including communication and socialization skills, compared to those in care as usual group (CAUG). Further, when examining age equivalences (i.e., individual's adaptive functioning by representing their functional level in terms of age milestones), individuals in the FCG had higher age equivalences compared to those in the CAUG. Mediation analyses revealed that caregiving quality partially mediated the association between the intent-to-treat group (i.e., CAUG vs. FCG) and adaptive functioning, with higher caregiving quality associated with higher levels of adaptive functioning. Similarly, caregiving quality mediated the association when comparing the never-institutionalized group to the ever-institutionalized group (CAUG + FCG) and adaptive functioning. These findings underscore the positive impact of nurturing environments on children's adaptive functioning and indicate that early investment in family care as an alternative to institutional care leads to better adaptive functioning during the transition to adulthood. (PsycInfo Database Record (c) 2026 APA, all rights reserved).