Parenting a Child with Prenatal Exposure

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What are the long-term impacts of prenatal alcohol and drug exposure and how can we parent these kids to help them thrive. In this episode, we talk with Dr. Mona Delahooke, a clinical child psychologist and the author of Beyond Behaviors: Using Brain Science and Compassion to Understand and Solve Children’s Behavioral Challenges.
In this episode, we cover:
Long term impact of prenatal alcohol and drug exposure: Research has found that most drugs that are commonly abused easily cross the placenta and can affect fetal brain development. In utero exposures to drugs and alcohol thus can have long-lasting implications for brain development resulting in behavioral challenges and mental and physical health implication. Some things to consider:

• The amount of drugs and alcohol used by the mom and the timing in the pregnancy matter, although this is information that is seldom available to adoptive or foster parents.
• Very often children are exposed to more than one substance in utero. For example, it is not uncommon for a pregnant woman who is drinking alcohol to also use drugs.
• Untreated drug abuse/addiction often coincides with poor nutrition and prenatal care, which increases the risk further for pre-natal and post-natal trauma with potentially lifelong impacts.

It helps to begin with understanding how alcohol and drugs exposure in pregnancy can affect the child not just in infancy but throughout their life.

• Alcohol
  Fetal Alcohol Spectrum Disorders (FASDs) is characterized with a broad range of deficits. Children with FASD may not have the facial dysmorphology and other physical abnormalities associated with Fetal Alcohol Syndrome (FAS).
• FASDs currently represent the leading cause of mental retardation in North America.
• Of all the substances of abuse (including cocaine, heroin, and methamphetamines), alcohol produces by far the most serious neurobehavioral effects in the child and into adulthood.
• Alcohol exposure can cause a host of cognitive and behavioral impairments, including:
  • Low to average IQs (IQ can range from mental retardation to normal)
  • Poor executive functioning skills
  • Poor information processing skills
  • Lack of social and communication skills
  • Lack of appropriate initiative
  • Discrepancy between their behavioral age and their chronological age (i.e., acting younger than they are)
  • Difficulty with abstract concepts, such as time and money
  • Poor judgment
  • Failure to consider consequences of actions. Doesn’t learn from mistakes.
  • Poor concentration and attention
  • Social withdrawal
• Other drugs: Methamphetamines, Amphetamines (speed and also some of the medications used to treat ADHD), 3,4-Methylenedioxymethamphetamine (MDMA)- street name Ecstasy, Opioids-(including heroin, fentanyl), Methadone or Suboxone, cocaine (including crack), and marijuana. While there are distinctions, after reviewing a lot of research it is fair to say that the following long-term impacts are often found.
• In newborns: growth restriction, decreased weight, length, and head circumference, but these don’t necessary follow the child through life.
• Executive function impairments. (Executive function is a set of mental processes for the management of cognitive operations that include attention, behavior, cognition, working memory, and information/problem solving.)
  • Attention and impulse control issues.
  • May include some learning difficulties.
  • Increased child externalized behavioral problems.

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