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The intersection of infant substance exposure, foster care placement & child welfare policy

Abigail Novak1, Colleen K Gutman2, Vitoria De Francisco Lopes1

  • 1Department of Criminal Justice & Legal Studies, University of Mississippi, Oxford, MS, USA.

Child Protection and Practice
|September 8, 2025
PubMed

Insights

Out-of-home placement for infants exposed to substances may harm development. Child welfare systems should consider alternatives to out-of-home placement to improve outcomes for these vulnerable children.

Area of Science:

  • Child Development
  • Public Health Policy
  • Social Work

Background:

  • Fetal exposure laws often mandate child welfare system involvement for substance-exposed infants.
  • Research on the developmental consequences of child welfare system involvement for these infants is limited.

Purpose of the Study:

  • To examine the impact of out-of-home placement on substance-exposed infants at 18 and 36 months.
  • To assess the association between early out-of-home placement and developmental outcomes.

Main Methods:

  • Utilized data from the National Survey of Child and Adolescent Well-being II (NSCAWII).
  • Analyzed a sample of infants (<1 year) referred for substance exposure between Feb 2008-April 2009.
  • Employed propensity score weighting to evaluate the effects of out-of-home placement.

Main Results:

  • Out-of-home placement for substance-exposed infants was associated with increased risk of negative developmental outcomes.
  • Compared to in-home care, out-of-home placement showed potential detriments in attachment, behavior, and development at 18 and 36 months.

Conclusions:

  • Social workers and practitioners should explore alternatives to out-of-home placement for substance-exposed infants.
  • Policies guiding testing and placement decisions may improve developmental trajectories for these children.

Keywords:
Child abuseChild welfareSubstance exposure

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