Foster care intervention protects cognitive control skills in young adults exposed to institutional rearing

Prior work from the Bucharest Early Intervention Project (BEIP) suggests that institutional care impairs cognitive control, whereas foster care may help preserve these skills. However, it remains unclear whether these effects persist into adulthood. We examined EEG data from a flanker task administered at BEIP's 22-year follow-up. Participants (N = 127; Age: M = 23.5 years, SD = 1.0, range = 21.4-25.6; 61% Romanian ethnicity) were initially enrolled during childhood while in institutional care in Bucharest, Romania and included individuals randomized to remain in institutional care (CAUG; n = 42; 50% female) or transition to foster care (FCG; n = 46; 54% female), along with never-institutionalized controls (NIG; n = 39; 67% female). At the 22-year follow-up, young adults in the FCG showed event-related potential (ERP) markers of performance monitoring comparable to the NIG but different from the CAUG (η2_p = 0.06). In contrast, the CAUG showed convergent evidence of disrupted cognitive control, including poorer behavioral performance and altered neural responses across ERP and time-frequency measures relative to the NIG. These neural disruptions were associated with lower IQ and elevated mental health symptoms. Overall, results highlight enduring effects of early caregiving on cognitive control in adulthood.