C11 Children and Families

Prenatal Exposure: What happens to babies whose mother's are addicted... to opiates (heroin, oxycontin, vicoden, etc)?

- Babies whose mothers are dependent on opiates have more medical problems compared to other babies. Opiates can cross the placenta and an unborn baby can become dependent on the drug if the mother is a regular user. - Babies of opiate-dependent mothers can suffer withdrawal symptoms after they are born. They are often born premature and under-developed and suffer from breathing problems and infections in the first few weeks of life. If their mother is HIV positive, they may also be born with HIV. However, suddenly stopping opiate use during a pregnancy can precipitate miscarriage or premature labor. - Mothers who take opiates while their baby is in utero can increase a newborns risk of SIDS (sudden infant death syndrome) significantly.

Implications for Intervention

- CDC suggest that school connectedness is a significant protective factor that can help insulate children from substance abuse and a range of maladaptive behaviors. - The protective factors include: 1. Having adult support 2. Belonging to a positive peer group 3. Having a commitment to education 4. Having positive perceptions of the school environment

Implications for Interventions

- Difficult to treat a person with cognitive impairment resulting from in utero exposure to alcohol - Often the most difficult step is the acceptance that the area(s) of deficit result in an inability to carry out certain life functions. - Individual interventions focus on the person's strengths using simple strategies to provide routine, repetition, and structure. - Interventions can not stop -Dynamic Case Management (DCM) should be used; Expands intra-agency case management to interagency case management pulling together and providing services from a number of agencies to collaborate and create a single case management plan.

Prenatal Exposure: What happens to babies whose mother's are addicted... to alcohol?

- Fetal Alcohol Spectrum Disorders (FASD) 1. Fetal Alcohol Syndrome (FAS; .05%-2.0%/1000 births) 2. Partial Fetal Alcohol Syndrome (pFAS) 3. Alcohol-related birth defects (ARBD) 4. Alcohol-related neurodevelopmental disorder (ARND)

How much alcohol is too much?

- No evidence exists that can determine how much alcohol ingestion will produce birth defects. Individual women process alcohol differently. Other factors vary the results, too, such as the age of the mother, the timing and regularity of the alcohol ingestion, and whether the has eaten any food while drinking. - Although full-blown FAS is the result of chronic alcohol use during pregnancy, ARND may occur with only occasional use or binge drinking. - Prevention is the key: FAS can be completely prevented by not drinking any alcohol during pregnancy.

Prenatal Exposure: What happens to babies whose mother's are addicted... to methamphetamines?

- We simply do not have enough research to say currently - Due to the idiosyncratic nature of the drug's manufacturing process (i.e. changes to ingredients and processing) it is difficult for researchers to pinpoint specific chemicals responsible for effects.

Alcohol is a __________. What does this mean?

-Solvent; capable of dissolving something, causing a solution -Alcohol influences the cells of developing brain resulting in cognitive defects -Range of outcomes labeled in the FASD (Fetal Alcohol Spectrum Disorders); doesn't officially include "PAE" or prenatal alcohol exposure

Prenatal Exposure: What happens to babies whose mother's are addicted... to cocaine?

-All pregnant women using cocaine have a 3-5% chance of having a baby with a birth defect -Cocaine is a local anesthetic and a powerful stimulant of the CNS -Researchers have not determined just how much cocaine it takes to cause birth defects and other adverse outcomes for an exposed baby. It is recommended that cocaine, in any amount or any form, be avoided during pregnancy. -Cocaine by-products stay in the urine of a pregnant woman for 30 hours and for 2 to 7 days in the newborn after the drug is used. -Cocaine crosses the placenta and enters the baby's circulation and can be found in the urine and hair of the baby. -Cocaine has been found in breast milk. Some infants show signs of cocaine intoxication following nursing. Based on these reports, an infant should not be given breast milk following cocaine use by the mother. -Can cause miscarriages -Cocaine appears in the semen and may reduce the number of sperm or increase the number of abnormal sperm. This can result in fertility problems. Cocaine binds to sperm. Authors of one study suggested that delivery of cocaine by the sperm to the egg might be associated with developmental problems. No birth defects have been identified as a direct result of paternal exposure to cocaine. However, the safest approach is for a man to avoid cocaine use three months prior to conception when sperm are developing.

What 2 types of AOD exposure occur for children?

-Prenatal; use of tobacco, alcohol, and other drugs affects the fetus; some problems may remain even if mother discontinues use or child is raised in a non-using setting -Interpersonal; can affect a child's social and psychological development through adulthood; effects vary depending on ind/environmental differences like age of exposure, progression of use, characteristics of child/user, family dynamics, external events; some children can even develop a resilience and do not develop problems; therefore you cannot expect similarities

Interpersonal Exposure

-Research by Kroll finds children's lives are effected in 6 overarching areas; 1. Denial, 2. Distortion and secrecy, 3. Attachment-seperation and loss, 4. Family functioning-conflict & breakdown 5. Violence, abuse, and living with fear 6. Role reversal, confusion and child as caretaker -Although impacts on children are not always severe, the possibility exists that parental drug abuse may be a significant factor in adolescent suicide attempts

Fetal Alcohol Syndrome (FAS) Signs and Symptoms

-low birth weight, -small head circumference, -failure to thrive, developmental delay, organ dysfunction, -facial abnormalities (small eye opening, flattened cheekbones, underdeveloped philtrum-groove between nose and upper lip) -epilepsy -poor coordination/fine motor skills, socialization skills (difficulty building and maintaining friendships and relating to groups) -lack of imagination or curiosity -learning difficulties (poor memory, inability to understand concepts like time and money, poor language comprehension, poor problem-solving skills) -behavioral problems (hyperactivity, inability to concentrate, social withdrawal, stubbornness, impulsiveness, and anxiety)

What is Neonatal Abstinence Syndrome?

-potentially occurs when a pregnant woman ingests addictive substances, even prescription, and becomes chemically addicted. If so, the unborn child does as well -Use continued throughout pregnancy= mom and baby addicted at birth -if medical professionals don't know, withdrawal symptoms may go unnoticed and treatment delayed -NAS depends on drug used, how much, stage of pregnancy, etc - Symptoms can be present 1-3 days or 5-10 days after birth -NAS symptoms same as mother's

Prenatal Exposure: What happens to babies whose mother's are addicted... to cigarettes?

Infant Health Problems; -Low birth weight -Intrauterine growth restricting -Sudden infant death syndrome (SIDS) Childhood and Beyond Health Problems; -Reduced lung function, respiratory illnesses like asthma, infections like pneumonia **All made worse by secondhand smoke exposure

What is NAS?

Neonatal Abstinence Syndrome

What is prenatal exposure?

Passing of drugs through the human placenta or breast milk