ADOPTION AND PRENATAL ALCOHOL AND DRUG EXPOSURE
The prenatal environment, not the postnatal environment, is the primary determinant of a child's health and development.
The outcomes for children of drug-using parents depend on the dynamic interaction of the child and the social environment. Postnatal factors bear on the ability of the newborn prenatally exposed to drugs to recover; recovery of functioning is facilitated by a favorable care taking environment.
Factors related to mother's prenatal and postnatal status:
Environmental factors in the home associated with developmental outcomes:
- Medical problems: mothers who misuse drugs are less likely to have prenatal care and suffer from a number of medical problems
- Co-morbidity: presence of associated mental health and social problems [histories of childhood physical and sexual abuse, physical abuse during adulthood; depression and associated problems]
Environmental factors related to foster care entry:
- Environmental factors, such as family violence, can be as significant in determining the child's health and developmental outcome as the prenatal substance exposure.
- Environmental factors, such as a nurturing and appropriately stimulating environment, can promote the child's health and development.
- A substantial number of children who have been prenatally exposed to alcohol/drugs - most of whom remain with their birth families - grow up in environments characterized by postnatal risk factors:
- exposure to violence
- inadequate caregiving; inadequate or inappropriate interactions with children
- lack of adult supervision
- parental abuse of alcohol and other drugs
- child abuse and neglect
- foster care entry with multiple placements
- disorganization and instability
With abuse and neglect, there is the risk of foster care entry and for many children, multiple placements while in care - the research confirms that the number of moves a child experiences while in care is more significant in determining how well a child will function later than whether or not the birth mother used drugs during pregnancy
Ornoy, Michailevskaya, and Lukashov (1996): The Developmental Outcome of Children Born to Heroin Dependent Mothers, Raised at Home or Adopted
Israeli study of 5-6 years old, comparing 83 children born to heroin-dependent mothers with 76 children born to heroin-dependent fathers and three control groups: 50 children with environmental deprivation, 50 normal children from families of moderate to high socioeconomic status without environmental deprivation, and 80 children from kindergarten in Jerusalem.
Among the findings:
The researchers concluded that "the developmental outcome of children born to heroin-dependent mothers seemed to be influenced by the environment, as those raised in adopting families had normal development".
- When children born to heroin-dependent mothers were divided to those what were adopted at a very young age and to those raised at home, the adopted children were found to function similarly to the controls while those not adopted functioned significantly lower.
- The children not exposed in-utero to heroin but reared in "neglecting" and "abusing" environments functioned even less well than the children born to heroin dependent mothers.
PRENATAL SUBSTANCE EXPOSURE
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