[17] At the turn of the twentieth century, Henry Dwight Chapin, M.D., initiated reforms in institutional care for infants and in the foster home movement.

Both nurseries became vested in the evolution of how unwanted infants were managed, from institutions-based methods to what is considered a more humane treatment that recognized their worth and value to society.

Social work techniques in adoption were developed, best practices were introduced to the public and prevailing cultural attitudes were addressed.

Respected public figures of the time, such as Margaret A. Mead, M.D., joined their efforts in tackling cultural attitudes towards adoption.

Throughout the 1950s, eminent women such as First Lady Eleanor Roosevelt, Mrs. Hubert Thomas Delany,[27] Mrs. Ralph J. Bunche, Marian Anderson, and Mrs. Jackie Robinson helped to promote Spence-Chapin's recruitment of African-American adoptive families.

This includes genetic conditions such as spina bifida, sickle cell anemia and Down Syndrome, but it can also be developmental delays or a result of prenatal substance or HIV/AIDS exposure.

The knowledge base in adoption and child welfare was an area that the organization's Board of Directors envisioned dedicated support for.

A unique service is the Interim Care Provider Program, which trains volunteer caregivers in nurturing infants during the first few weeks after birth.

[33][34][35] Caregivers are trained to care properly for newborns, which includes taking them to medical appointments, and providing round-the-clock feedings and diaper changes.

2016 Recognition as an Adoption-Friendly Workplace by Dave Thomas Foundation for Adoption[38] 2018 Spence-Chapin was recognized as an Innovator in LGBTQ Inclusion by the Human Rights Campaign.