Children and Youth Services Review: 'Early specialized foster care, developmental outcomes and home salivary cortisol patterns in prenatally substance-exposed infants'.

D'Angiulli, Amedeo ; Sullivan, Richard

This article looks at whether good early foster care can compensate for the early deficits associated with prenatal drug exposure. It reports on a study which investigated possible associations between developmental outcomes of prenatally substance-exposed infants and early specialised foster care. The participants were volunteer foster families and 22 infants from the Vancouver Coastal Safe Babies programme; this specialised care programme included selective recruitment of foster parents, training and support for foster infant retention. Subdivided in two gestational groups (preterm and full-term), the infants were assessed at home using BDI-2 Screening Test to determine their development in cognitive and social domains. Salivary cortisol was sampled three times (awakening, morning and evening) on two different days to determine the infants' basal cortisol patterns. No evidence of clinically significant atypical development was found in either the pre-term or full-term group. The pre-term group had consistently lower mean cortisol levels than the full-term group but when the mean cortisol concentrations were corrected for number of months spent in foster care, the differences between pre-term and full-term groups were no longer significant. From a perspective of clinical significance, these results suggest that stable, committed and specialised early foster care may be associated with 'better than expected' developmental outcomes in prenatally substance-exposed infants.

32:3, pp 460-65, March 2010