Effects of Therapeutic Interventions for Foster Children on Behavioral Problems, Caregiver Attachment, and Stress Regulatory Neural Systems PHILIP A. FISHER, a,b MEGAN R. GUNNAR, c MARY DOZIER, d JACQUELINE BRUCE, a AND KATHERINE C. PEARS a a Oregon Social Learning Center, Eugene, Oregon, USA b Center for Research to Practice, Eugene, Oregon, USA c University of Minnesota, Minneapolis, Minnesota, USA d University of Delaware, Newark, Delaware, USA ABSTRACT: 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 under- lying 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 place- ment, 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. KEYWORDS: adrenocorticotropic hormone (ACTH); cortisol; hypo- thalamic-pituitary-adrenal (HPA) axis; stress; stress hyporesponsive pe- riod (SHRP) Address for correspondence: Dr. Philip A. Fisher, Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401-4928. Voice: 541-485-2711; fax: 541-485-7087. e-mail: philf@oslc.org Ann. N.Y. Acad. Sci. 1094: 215–225 (2006). C  2006 New York Academy of Sciences. doi: 10.1196/annals.1376.023 215