I. Good Morning! Buenos Dias, I am so please to be here. I want to thank Madelyn Freunlich for inviting me to be on this panel. When Madelyn first asked me to be a presenter I said yes because the topic is adoption. Then I was concerned because professionally I have not had experience in working with children with FAS/FAE and children born exposed to drugs. However, I have lived with two kids that suffer to this day because of alcohol and drug exposure. I am embarrassed to say that even though at the time of their adoption I was given background information that my son Luis and my daughter Amanda were prenatally exposed to drugs and alcohol, like so many other parents in the 70's I ignored it. I thought love, good care and a good education would help them overcome whatever problems their "poor" beginnings had caused them. My son Luis was adopted at 4_ years old and my daughter Amanda at 19 months. It wasn't until very recently that I've learned about how they've been affected by their prenatal exposure to drugs and alcohol. All these years when they were growing up I just thought I was dealing with their learning disability and their emotional trauma of foster care and being separated from their birth parents I had a vague idea their learning disability was connected with their birth mothers drug use but that was the extent of my understanding of their many challenges. I wished this wealth of knowledge and information offered at this conference would have been available to me 20 years ago. However, I am very glad that the Evan B. Donaldson Adoption Institute is taking the lead in the field and has put together a conference like this one.

I am here today to speak to you not as an adoptive mother but as a professional who has had many years of experience in the field of child welfare and in the provision of services to Latino children and families. I will speak about the need for culturally relevant services in adoption and particularly services to children who were prenatally exposed to alcohol and/or drugs. I will also give some recommendations for providing culturally competent services to Latino children. Nineteen years ago the Council on Adoptable Children in its New York office developed the First Hispanic Adoption Program in the Country. As the Director of the Hispanic Adoption Program I saw many Latino prospective adoptive parents turned away not intentionally but because of lack of understanding of the parent's culture on the part of the agency and its workers. For example: 1) The Ecuadorian Parent - adopted a pre-teen boy and gave me a blanket - Issue: Latino parents need more outreach. Another example: 2) Cuban mother in New Jersey adopting Puerto Rican girls from the Bronx - Issue: ethnic differences and class. 3) Two parents from Dominican Republic wanting a white Latino child and looking at pictures of a "very dark child" - Issue: Ideas about color and race is different for Latinos. We have our prejudices and racism but its manifested slightly different.

We have long understood that one of the major problems in foster care and adoption today is the lack of cultural competence in the provision of services. It is inconceivable that in this age of advanced technology where test tube babies are a reality and not just science fiction, we have not progressed at a comparable rate in our provision of health and human services to the point where it's common practice to create cultural bridges to meet the needs of the large numbers of African American, Latino children and other children of color.

II. To learn to build cultural bridges let's examine the five elements of cultural competence developed by Terry L. Cross from the Indian Child Welfare Institute.

The Five Elements of Cultural Competence:

• In June 1997, the estimate of the Hispanic origin population in the United states was about 29.2 million or about 10.9 percent of the total population.
• In 1995, 74 percent of the nationís Hispanics resided in either California, Texas, Illinois, Florida, or New York.
• Each year from now to the year 2050, the Hispanic population is projected to add more people to the United States than the non-Hispanic white population (or any other single race/ethnic group); estimated at 59 million by 2025.
  Sources: U.S. Bureau of the Census, Population Division. (1996). Current Population Reports. Washington, DC: U.S. Government Printing Office.

• Although the educational attainment of Hispanics improved during the decade, it remains well below that of their non-Hispanic counterparts. In 1995, the proportion of Hispanics with high school diplomas was 53 percent; compared to non-Hispanic Whites at 83 percent.
• The proportion of Hispanics with low educational attainment-less than a 5th grade education-in 1993 was more than fourteen-times greater than that of non-Hispanic whites (0.8 percent).
• According to the U.S. Bureau of the Census, in 1995 forty-seven percent of Hispanics did not complete high school, in contrast to only 17 percent of non-Hispanic whites.
• Approximately, 9.0 percent of Hispanic young adults reported that they had a Bachelor's degree compared with about 24 percent of non-Hispanic white adults, in 1995.
  Sources: U.S. Bureau of the Census, Current Population Reports, (1996). Washington, DC: U.S. Government Printing Office.

• Hispanic persons were much more likely to be living below the poverty level than were non-Hispanic Whites in 1996. About 29.4 percent of Hispanic persons in the United States were living in poverty in 1996 compared to 11.2 percent of non-Hispanic Whites. As a result, although the Hispanic population was only about 11 percent of the total population, more than one in every six persons (18 percent) living in poverty in the United States was of Hispanic origin.
• Hispanic children were more likely than non-Hispanic White children to be living below poverty level. In 1992, about 39.9 percent of Hispanic children under 18 years of age were living in poverty compared to only 13.2 percent of non-Hispanic white children. Hispanic children represented 11.7 percent of all children living in the United States but were 21.3 percent of all children in poverty in 1992.
  Source: U.S. Bureau of Labor Statistics, (1996). Employment and Earnings. Washington, DC: U.S. Government Printing Office.

• In 1992 seventeen-percent of Hispanic teenagers gave birth compared to only 11 percent of non-Hispanic whites. Moreover, 39 percent of unmarried Hispanic woman gave birth in contrast to just 23 percent of unmarried non-Hispanic whites.
• According to the U.S. National Center for Health Statistics, in 1992 sixty-four percent of Hispanic mothers began prenatal care (1st trimester) compared to 81 percent of non-Hispanic white mothers.
  Source: U.S. National Center for Health Statistics, Vital Statistics of the United States, (Annual). Washington, DC: U.S. Government Printing Office.

• Hispanic children comprised 14 percent of the total U.S. child population, yet represented 12 percent of the children with substantiated abuse or neglect in 1995.
• Within the child welfare field, there is concern about the overrepresentation of children of color in out-of-home care. Among the 28 states responding, Hispanic and African American children are highly overrepresented in the number of children in out-of-home care; 12 and 44 percent respectively.
• Similarly, Hispanic and African American children are overrepresented in both foster care and in group care compared to the U.S. child population. Specifically, Hispanic children comprise 14 percent of the nations total child population, yet represent 17 percent of Hispanic children in group care as opposed to 12 percent in foster care.
• Both African American and white children in out-of-home care are far more likely than Hispanic children to have a goal of adoption or to be legally free for adoption. Specifically, 41 percent of white children and 49 percent of African American children are legally free for adoption in contrast to only 8 percent of Hispanic children.
  Source: Child Welfare League of America. Child Abuse and Neglect: A Look at the States, (1997). Washington DC: CWLA Press.

Research - Few studies done on Latino subgroups to understand the prevalence of alcohol and drug abuse and their awareness about the effects of FAS & FAE. We need research conducted around dual language acquisition for this population

Our children (especially in urban settings attend overcrowded and schools with limited resources. In rural areas very few Bilingual programs.

Special education evaluators do not have a full understanding of dual language learning nor can they properly evaluate children whose language is other than English.

They also often lack knowledge about FAS/FAE and they misdiagnose children because of they assume it's ADD or problem related to learning disability.

Latino parents because of traditional cultural patterns have a harder time advocating for their children. i.e. Mexican parents at Juanita's school at P.S. 205. (they are afraid to question the school)

For FAS/FAE kids who need routine, consistency and effective discipline dealing with 2 sets of cultural values can be even more confusing than children without this medical condition. i.e. the expectation in school is to participate and ask questions the expectation at home is to listen and be humble.

NOTES - pg. 68 Aronson Olegard (1987) noted that a stable environment resulted in fewer psychosocial problems for children with FAS.

Latino children have to deal with immigration, two languages, two cultures, prejudices and racism.

Latino and other minority children with FAS/FAE and other drug related developmental problems have to deal with of societies prejudice against their ethnic group, in addition to dealing with low self esteem because of failure to achieve in school.

There is very little information available in Spanish for parents. There are few bilingual professionals who can do assessments and treat Spanish speaking children with FAS/FAE. Few bilingual professionals who can educate Latino parents who do not speak English.

The need to educate Latino parents about how to select a provider how the process truly works, what are some key questions to ask HMO's and to be clear about service limitations that may exist in the particular HMO selected.

• Education parents on FAS/FAE. Provide them with information that will help them identify and understand the effects of FAS/FAE under child's development. With these tools, parents will be able to make informed decisions on their child's education (i.e. proper selection of schools).
• Research
• Conduct research studies on the effects of FAS/FAE on a child's ability to acquire two languages (bilingualism). This will help parents navigate cultural difference and acculturation issues that hamper, their child's social emotional development.

• RFP's for research and demo projects targeting Latino populations.
• Awareness and education campaign in Spanish about FAS/FAE
• Develop materials in Spanish
• Invite Latino CBO's in your region to be part of the policy and practice discussions in this area.

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