Developmental Differences Require Developmentally Appropriate Interventions
“How do I help my substance-exposed child? What types of interventions will support their development? What are some evidence-based interventions to prevent and mitigate the effects of prenatal substance exposure?”
Casey Family Programs has answers to these questions. Whether they are still in diapers or have a driver’s license, programs have been developed to help these kids thrive.
Title: What are some developmentally appropriate interventions for infants and children affected by prenatal substance exposure?
Summary in Plain English :
Infancy and early childhood
Babies exposed to substances before birth should be checked for developmental delays and connected to services that can help reduce the effects of exposure. These services include early intervention and therapy to strengthen the bond between parents and children. Regular check-ups and early childhood programs provide opportunities to identify babies and young children who may need extra support.
Screening and referral to early intervention services
The American Academy of Pediatrics recommends all infants with substance exposure receive a referral to early intervention services and developmental screenings. There are two primary ways of accessing services:
Kids and young adults up to age 21 with Medicaid can get check-ups and support through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. This includes screenings for developmental delays and mental health.
Under Part C of the Individuals with Disabilities Education Act (IDEA), all infants and toddlers (ages 0-3) in confirmed child abuse or neglect cases must be referred for early intervention services to check for developmental delays and provide support. Each state sets its own eligibility rules. Babies exposed to substances before birth may qualify under the “at risk” category, and some states automatically qualify infants with neonatal abstinence syndrome (NAS). Since some children in need may not meet state requirements, regular screening and reassessment throughout childhood are important.
Effective interventions during the early years
There are a number of evidence-based parent-child interventions that have demonstrated effectiveness among families affected by substance use disorders. As of April 2023, 23 family-centered, parent-child interventions have been approved under the Title IV-E Prevention Services Clearinghouse. Some of them are included here, as well as additional interventions:
START (Sobriety Treatment and Recovery Teams) is a special program that helps families affected by parental substance use and child abuse. When used correctly, it improves outcomes for children and families. It brings together child protection services, addiction and mental health treatment providers, the courts, and other family support organizations to work as a team.
SafeCare is a program for children ages 0-5 at risk of abuse and neglect, as well as their parents and caregivers. It helps parents recognize and respond to children’s cues and develop other parenting skills.
Nurturing Parenting Program for Parents and their Infants, Toddlers, and Preschoolers is a family-centered interventions for parents with goals that include promotion of nurturing parenting skills and prevention of child abuse and neglect.
The Incredible Years® – Parents and Babies (0-12 months), Toddler (ages 1 to 3), and Preschool Basic Programs (ages 3 to 6) are group-based programs that serve parents and their children. The goals of the interventions include: strengthening parents’ abilities to provide a safe environment for their infants and children; helping parents and children form secure attachments; and encouraging development of children’s social, emotional, and self-regulation skills.
Primary school-aged children
Children exposed to substances before birth need regular check-ups to catch developmental, social, and learning challenges early. Screenings should use proven, age-appropriate tools and lead to helpful services.
Since effects can appear at different ages or be missed in earlier tests, ongoing screening is important. For example, fetal alcohol spectrum disorder is hard to diagnose before age 3 because thinking and learning problems often show up later in school. Tools like the Ages and Stages Questionnaire (for ages 1 month to 5½ years) and the Child Behavior Checklist (for emotional and behavioral issues) help track development.
Incredible Years® – School Age Basic Program can be offered as a group-based prevention or treatment program designed for parents of children ages 6 to 12. It aims to strengthen parent-child interactions and attachment, and parents’ abilities to promote children’s social, emotional, and academic development.
Multisystemic Therapy – Building Stronger Families is designed for families with children ages 6 to 17 who come under the guidance of child protective services as a result of parental substance use disorders. Comprehensive family services including case management. Clinical services are provided in a team-based approach.
Nurturing Parenting Program for Parents & Their School Age Children 5 to 11 Years is a family-centered interventions for parents with goals that include promotion of nurturing parenting skills and prevention of child abuse and neglect.
Special Education Services
Some services to help with physical and developmental delays from prenatal substance exposure are available through Part B of the Individuals with Disabilities Education Act (IDEA). Part B provides free support through public schools for kids ages 3 to 21 with developmental disabilities. These services include special education, therapy (physical, occupational, and speech), and other classroom supports.
Children who qualify get an Individualized Education Plan (IEP) outlining their needs and services. If a child doesn’t qualify under Part B, they may still get extra help in a regular classroom through Section 504 of the Rehabilitation Act.
Adolescents and Young Adults
Multidimensional Family Therapy focuses on adolescents and young adults with substance use and mental health disorders. It is an integrated therapy model that incorporates parents, families, and community partners, including the child protection agency. The goals are to help adolescents and young adults reduce substance use, stabilize their mental health, and develop coping and communication skills. The therapy also aims to improve parenting skills, parent-child attachment, and family communication.
Adolescent-Focused Family Behavior Therapy is provided within a family context for adolescents with substance use disorders and co-occurring issues such as conflict, depression, child maltreatment, trauma, noncompliance, or risky sexual behavior.
Any Age
Celebrating Families! offers prevention and intervention to promote family healing and improve family relationships. It is a family-inclusive, trauma-informed, skill-building program for families affected by parental substance use disorders with infants and children up to 17 years.
Many thanks to Casey Family Programs for assembling and making public these useful resources.
