Practice Recommendations

I. Information Gathering

1. Practitioners should obtain an extensive history from/about birth parents as early in the pregnancy as possible. If it is not possible to obtain such a history, there should be a screening interview at the time a child comes into foster care or enters an orphanage.
2. Practitioners should be aware of the high-risk factors and use them determine the probability that the mothers used alcohol/drugs during pregnancy. Cultural sensitivity and competency are critical - there are, for example, issues related to Native American use of alcohol.
3. When there is inadequate maternal history and/or there is a question about he child's growth, developmental status or physical characteristics that may suggest prenatal exposure [such as facial appearance that might suggest FAS], practitioners should attempt to obtain such records as:
   • photographs of the child over time [such as school records]
   • growth data over time [height, weight and head circumference]
   • ages when development milestones were reached
   • observations of behavior by primary caregivers [birth family, foster family, teachers, health professionals, orphanage staff]
   • status of siblings - known diagnoses and current developmental status
4. Practitioners should keep an open mind about possible alternative diagnoses for developmental and neurological disabilities even in the face of known maternal alcohol/drug use.
5. Widespread awareness of the effects of prenatal alcohol/drug exposure should be promoted among the many disciplines that have contact with children and families - health care workers, substance abuse counselors, social workers, attorneys for children and families, and juvenile court judges.

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PROFESSIONAL EDUCATION
PRENATAL SUBSTANCE EXPOSURE

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