Background information notes that children born to substance-abusing women face many risks that can impede optimal developmental outcome. These risks include both potential neurological and organic sequelae of intrauterine substance exposure, as well as additional risk factors in their postnatal environment. Foster care placement is a common occurrence among this population. In this study, 27 children placed through a church-based, foster-care program were observed. All but one of the children were African-American, and nearly half (48 percent) had been placed shortly after birth. The children ranged in age from 1 to 29 months. Home environment and caregiver-child interaction were assessed with the HOME Inventory and the Nursing Child Assessment Feeding and Teaching Scales. Children were also given physical, neurological, and developmental assessments (mean age = 11.7 months). Although the majority of the children scored within normal limits on developmental testing, 28 percent were considered at risk for cognitive delay, and over half exhibited suspect or abnormal neurological signs. Many were believed to be at further risk because of poor home environment and/or caregiving. As Ruff et al. (1990) indicate in their commentary on foster care, policy-makers must recast the role of foster care to include not only physical maintenance, but also techniques to achieve positive developmental outcomes for the children. 6 tables and 42 references