Developmental outcomes of infants adopted from foster care: Predictive associations from perinatal and preplacement risk factors

Infants adopted domestically from foster care often present with prenatal substance exposure and risky birth outcomes such as prematurity and low birthweight. Because few longitudinal studies of foster-adoptive infants exist, it is unclear how these preplacement risk factors influence development over time. The present study examined associations between perinatal risk factors and developmental outcomes among an ethnically/racially diverse sample of 97 infants in foster care (56% boys) placed into adoptive homes at ages 0-19 months. Relative to population norms, foster-adoptive infants showed comparable cognitive but lower language and motor functioning at baseline and 1-year follow-up. Age-adjusted language scores significantly improved 1 year following placement, consistent with a developmental catch-up effect. Low birthweight uniquely predicted lower language scores at baseline, but this association was no longer significant at follow-up. Prenatal substance exposure was associated with lower baseline cognitive scores, but only for infants placed after 6 months of age. In contrast, infants with low birthweight and later placement age (>12 months) showed the most accelerated motor development. Sex differences emerged at follow-up when predicting motor and language outcomes, suggesting potential sex-specific pathways of risk. Overall, results support adoption as an early intervention that may buffer vulnerability to perinatal risk on development.