Family Care Plans for Infants with Prenatal Substance Exposure.

The federal Child Abuse Prevention and Treatment Act (CAPTA) requires that a plan of safe care, called a family care plan (FCP) in Connecticut, be developed for all newborns identified as being affected by substance abuse and their caregivers. In Connecticut, FCPs are developed in treatment or hospital settings, not by child protective services. Analyzing data from Connecticut from 2019-2021, we found robust yet uneven implementation of FCPs that may have resulted in inadequate support for some affected caregiver-infant dyads.

Child Abuse Prevention and Treatment Act, family care plans and infants with prenatal substance exposure: Theoretical framework and directions for future research.

In May 2021, a reauthorization of the Child Abuse Prevention and Treatment Act (CAPTA) was introduced in the U.S. Senate.

Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure.

Children and adolescents affected by prenatal exposure to alcohol who have brain damage that is manifested in functional impairments of neurocognition, self-regulation, and adaptive functioning may most appropriately be diagnosed with neurobehavioral disorder associated with prenatal exposure. This Special Article outlines clinical implications and guidelines for pediatric medical home clinicians to identify, diagnose, and refer children regarding neurobehavioral disorder associated with prenatal exposure. Emphasis is given to reported or observable behaviors that can be identified as part of care in pediatric medical homes, differential diagnosis, and potential comorbidities.

Medical marijuana laws and pregnancy: implications for public health policy.

Although there is much to learn yet about the effects of prenatal marijuana use on pregnancy and child outcome, there is enough evidence to suggest that marijuana, contrary to popular perception, is not a harmless drug, especially when used during pregnancy. Consequently, the public health system has a responsibility to educate physicians and the public about the impact of marijuana on pregnancy and to discourage the use of medical marijuana by pregnant women or women considering pregnancy.

Mental Health Disorders among Children within Child Welfare who have Prenatal Substance Exposure: Rural vs. Urban Populations.

This study analyzed differences in mental health diagnoses among Illinois child welfare-involved youth who have had prenatal substance exposure. Results indicate that youth from the rural area had a significantly higher rate of co-occurring mental health disorders. A multiple regression analysis revealed five significant predictors: living in a rural area, a history of neglect, having Fetal Alcohol Syndrome or an alcohol-related neurodevelopmental disorder, and age.

Misdiagnosis and missed diagnoses in foster and adopted children with prenatal alcohol exposure.

Objective: The purpose of this article is to assess the rate of misdiagnosis and missed diagnoses of fetal alcohol spectrum disorders (FASD) among a population of foster and adopted youth referred to a children's mental health center.

Methods: Data were collected from a sample of 547 children who underwent a comprehensive multidisciplinary diagnostic evaluation. Utilizing current diagnostic criteria, children were diagnosed, as appropriate, with fetal alcohol syndrome, partial fetal alcohol syndrome, alcohol-related neurodevelopmental disorder, or alcohol-related birth defects.

Neurocognitive habilitation therapy for children with fetal alcohol spectrum disorders: an adaptation of the Alert Program®.

Objective: This study evaluated the effectiveness of neurocognitive habilitation, a group therapy intervention for foster and adoptive caregivers and their children who were prenatally exposed to alcohol.

Method: Participants were recruited from clients seeking evaluation for fetal alcohol syndrome (FAS) and alcohol-related neurodevelopmental disorder (ARND) and were randomly assigned to treatment and no-treatment control groups. Forty children participated in the treatment program and were compared with 38 control participants using the Behavior Rating Inventory of Executive Function (BRIEF) and the Roberts Apperception Test for Children (RATC).

Neurodevelopmental functioning in children with FAS, pFAS, and ARND.

Objective: The purpose of this article is to compare the neurodevelopmental profiles of 78 foster and adopted children with fetal alcohol syndrome (FAS), partial FAS (pFAS), or alcohol-related neurodevelopmental disorder (ARND).

Method: Seventy-eight foster and adopted children underwent a comprehensive diagnostic evaluation. By using criteria more stringent than those required by current guidelines, the children were placed in 1 of 3 diagnostic categories: FAS, pFAS, or ARND.

Validation of the 4P's Plus screen for substance use in pregnancy validation of the 4P's Plus.

Objective: The purpose of this study is to validate the 4P's Plus screen for substance use in pregnancy.

Study Design: A total of 228 pregnant women enrolled in prenatal care underwent screening with the 4P's Plus and received a follow-up clinical assessment for substance use. Statistical analyses regarding reliability, sensitivity, specificity, and positive and negative predictive validity of the 4Ps Plus were conducted.

The 4P's Plus screen for substance use in pregnancy: clinical application and outcomes.

Objective: Determine the prevalence of substance use among pregnant women in five diverse communities utilizing the 4P's Plus screen for alcohol, tobacco, and other drug use.

Study Design: Pregnant women enrolled in prenatal care clinics in five communities were screened for substance use with the 4P's Plus. Those women with a positive screen underwent an assessment for substance use through a follow-up structured clinical interview conducted at the same prenatal visit.

Screening for substance use in pregnancy: a practical approach for the primary care physician.

Our goal was to identify risk factors for substance use during pregnancy for primary care physicians so that we could assess a woman's risk of alcohol or illicit drug use. Participants were 2002 Medicaid-eligible pregnant women with < or =2 visits to prenatal care clinics in South Carolina and Washington State. Structured interviews were used to collect data.

Perinatal substance abuse treatment. Findings from focus groups with clients and providers.

Thirty-three focus groups were conducted with pregnant women in substance abuse treatment and their providers in order to identify factors in women's lives that facilitate and hamper their treatment process and successful program components to address the needs of this high-risk population. The focus groups were conducted as part of a larger evaluation of demonstrations funded by the Health Care Financing Administration. From the 88 women in the focus groups we received a picture of their troubled lives and the events that led to their participation in the programs.

Prenatal exposure to cocaine and other drugs. Outcome at four to six years.

In a longitudinal, prospective study, 95 children born to mothers who used cocaine and other drugs during pregnancy and 75 matched, nonexposed children born to mothers who had no evidence of alcohol or illicit substance use during pregnancy were evaluated for cognitive and behavioral outcome at 6 years of age. Prenatal exposure to cocaine and other drugs had no direct effect on the child's cognitive outcome (measured as IQ), but it had an indirect effect as mediated through the home environment. However, prenatal exposure to cocaine and other drugs did have a direct effect on the child's behavioral characteristics at 4-6 years of age, with the home environment having little impact.

Prenatal Exposure to Cocaine and Other Drugs: Outcome at Four to Six Years.

In a longitudinal, prospective study, 95 children born to mothers who used cocaine and other drugs during pregnancy and 75 matched, nonexposed children born to mothers who had no evidence of alcohol or illicit substance use during pregnancy were evaluated for cognitive and behavioral outcome at 6 years of age. Prenatal exposure to cocaine and other drugs had no direct effect on the child's cognitive outcome (measured as IQ), but it had an indirect effect as mediated through the home environment. However, prenatal exposure to cocaine and other drugs did have a direct effect on the child's behavioral characteristics at 4-6 years of age, with the home environment having little impact.

Three-year outcome of children exposed prenatally to drugs.

Objective: To evaluate the 3-year behavioral and developmental outcome of children prenatally exposed to maternal substances of abuse.

Method: Ninety-three children exposed prenatally to cocaine and other drugs taken by the mother during pregnancy (Group 1), 24 polydrug/noncocaine exposed children (Group 2), and 25 nonexposed children (Group 3) were evaluated at 3 years of age as part of a longitudinal prospective study of the impact of intrauterine substance exposure on long-term outcome. The Stanford-Binet Intelligence Scale: Fourth Edition(SBIS) was administered by examiners blinded to the exposure background of the children, and a pediatrician performed a complete medical evaluation on all the children.

Outcome of children prenatally exposed to cocaine and other drugs: a path analysis of three-year data.

Objective: Cocaine and other drug use during pregnancy continues to be a major health concern. With increasing use of cocaine by women of childbearing age, large numbers of children have been exposed to this and other substances in utero. Currently, very little information regarding the long-term developmental implications of cocaine/polydrug exposure exists.

Motor assessment of cocaine/polydrug exposed infants at age 4 months.

Fifty nondrug-exposed infants and 74 cocaine/polydrug-exposed infants were evaluated on the Movement Assessment of Infants (MAI). The test provides an assessment of risk for motor dysfunction at age 4 months. There was a significant difference in total risk scores between the two groups of infants with cocaine-exposed infants having higher total risk scores (p less than .