A misunderstood phenom
It is the sad truth that babies born to addicts continue to be outcasts in the medical field and subsequently in society, when their disturbing and curious symptoms begin to visibly emerge.
Labeling the child of an addict with separative diagnoses that do not confer to their mother’s drug use during pregnancy or to the results of a child living with an addict is a common phenom with psychiatrists, social workers and physicians. This practice is dangerous and insulting to the child’s whole development, particularly to their self esteem and individual abilities.
It is also very irresponsible and negligent.
Research on the effects of any, (but particularly moderate to severe), prenatal substance abuse exposure on that child’s growth stages, cognition, intellectual expression and abilities, sensory issues, behaviour disorders and the effects of subsequent social isolation and rejection, is ridiculously sparse.
So sparse, that the medical field has next to no professionals that specialize in this area and there is very little understanding, treatment or advocacy for this very delicate and (medically and socially) provocative population of innocent and vulnerable human beings.
In my quest to acquire appropriate care for my now 4 year old grandson, born out of a severe heroin abused prenatal existence, I am very fortunate to have found a provider that until recently, provided adequate and informed care fora child with his specific challenges;
Challenges such as irrational, explosive and self-injurious anger outbursts, problems with processing and follow-through, and especially problems with pre-addictive behaviours: sensory overload requiring excessive soothing methods, sensory deprivation requiring the same but in a different manner and very early social outcasting due to his behaviours now observed and not understood by his Montessori peers.
What I have experienced
In the beginning, Charlie was well-assessed by the developmental team, social workers, nurses in this specialty clinic, the physician and the nurse practitioner who had admirable knowledge on the subject of the dilemmas associated with his diagnoses.
The team of providers at the developmental delay clinic here in Austin echoed my concern that a child with his history would, by the very nature of his post abuse disorders, (especially the sensorial) be subject to not only addiction themselves, but more severe addictions and beginning at an even earlier age that his/her parents.
One aspect of our treatment plan for those particular issues was to be put on a waiting list for PCIT therapy.
PCIT is a mode of therapy in which the parents and the child are taught to interact and communicate in ways that that are supposed to be designed to build the child’s confidence and abilities to self analyze, soothe and calm him/herself and to develop communication methods that enable them to adequately ask for needs to be met and understand their own needs.
After waiting close to a year, for this therapy we were finally called to begin the process.
An intern void of sensorial knowledge or understanding of sensorial behaviours associated with post prenatal substance-abuse was assigned to our case.
I was informed in our second session with this intern that any child’s uncontrollable outbursts occurring in session would be handled with a “time-out” in a “closet”…door shut and kept closed until the child “adhered to the rules of the session.”
My jaw dropped. I asked if the intern actually meant that the closet, which was in the session room, would actually be forced to keep closed and if the child was actually behind a closed door for behavioural issues. My question was confirmed with a resounding “yes” and this: “Ma’am, you have to understand that we deal with behavioural issues with older kids as well, kids who use drugs, commit crimes and the like. This is an effectual tool.”
I went looking for the lobotomy room.
“That,” I exclaimed “is unacceptable. You will not be placing Charlie behind a closed or locked door for behavioural issues, or for any other reason!” I also shared my opinion on the subject of locking or holding children behind a closed door of any age and let him know this was irreprehensible.
We never returned.
When I had the followup visit with our developmental delay nurse practitioner, I relayed this information to her. I was disturbed that she was not surprised.
She shrugged her shoulders and referred us to another provider, whom I insisted have the experience required to treat post prenatal substance abuse issues and the sensorially based problems we were having.
As I was leaving, I asked her if the psychiatrist she referred us to had this experience. She stated, “No.”
What are we doing here?
I was so saddened and felt somewhat hopeless in confirming the availability of any treatment that he needed for his particular and unique needs.
Still searching for help
My subsequent research has offered very little hope to this end. There are treatment modalities for behaviours, but not behaviour related therapy for sensorial needs related to prenatal drug abuse and there is such a difference.
In fact, in my nursing and parenting experience, I have observed that treatment modalities for any behaviour-related issues focus mainly on the behaviour and NOT the cause…rendering it completely ineffective for that child, longterm, and very, very difficult for a child whose behaviours are related to abuse, trauma, neglect, abandonment and the like…both in the womb and out.
Here are some of the results we as a society are seeing due to the lack of recognition, knowledge and intervention for babies and children of all ages who have suffered from either/both prenatal drug exposures and addiction, overdoses and the effects of the strong possibility of such a child living with an addict after his/her birth.
- Inability to handle stress or discipline (even appropriate discipline) as exhibited through complete withdrawal or overt violence to themselves or others or severe, inconsolable “meltdowns.”
- Severe sleep disturbances.
- Inability to follow directions or very slow to follow through with directions second to auditory or neurological processing difficulties.
- Increased need for affection, confusion on how to express or accept affection, or inability to accept or express affection.
- Inability to understand one’s own feelings and thus confusion in how to appropriately respond in various social and familial situations. “My grandson still says “ I don’t know what to do…” in some situations where he is receiving instructions, discipline/guidance, including 1–2 steps to correct present issue, or responds to busy family conversations with screaming and interrupting (he cannot effectively handle more than one or two conversations at once.)
These abnormal reactions are not a comprehensive list, as children who have been affected by a variety of substances and home environments related to drug abuse exhibit unique symptoms to their own body’s reactions to the drugs and to the home situations they have either been taken from or continue to suffer in.
So what needs to happen? How do we help and how do we prevent future addiction in these kids?
Acknowledging the existence and prevalence of this medical population is the primary need.
The subsequent education and training for health care providers and caregivers in this area is the most imperative need following.
Without an in-depth understanding of the abnormalities and diversions from expected behaviours that are present in children with severe prenatal substance abuse, heroin/opioids being a specialty altogether, these children are defenseless against their own bodies and minds’ reactions to everyday experiences.
Beginning from birth, these children need caregivers who are trained to spot sensorial difficulties, excessive need, alternate needs, self-deprivation and injurious behaviours, severe trust and security issues…to just name a few.
Foster parents, adoptive parents and monitored parents who are working on their sobriety must all be fully trained as soon as they assume care of a child who has undergone prenatal exposure, overdoses, use of substances and any child who has had to live or is living in a drug using environment.
Trauma training is a very small start and is now required in many facets of CPS cases, foster home and daycares…but it is not near enough education to fully prepare and equip a family member, parent or caregiver for the myriad of long-lasting and permanent challenges associated with these children’s needs.
A final comment on this issue is that I strongly suggest that any caregiver/healthcare provider who is raising/following a child with prenatal drug exposure, whether behaviours are exhibited or recognized yet or not, begin documenting all of the behaviours/responses they do see that do not appear to be normal. Slight variations that catch your eye, ear or heart should be immediately noted and addressed because they will become more forthright and more signs will come.
All the while, that child is suffering. Immediate recognition and intervention, even if that intervention is just more love, patience and concessions to ease the child…generational addiction can be halted.
Connection to society, family and self is what is now seen as a major contributor to long-lasting and permanent sobriety in addicts. These components are what are compromised in children born of addicts, due to their demanding needs and often-time bizarre symptoms and behaviours.
Thus reconnecting, through understanding the origin of their problems and providing stable, patient, interactive, calm and creative methods and home life to manage and respond to it all, is more key to their success, I think, than even complex medical intervention.
That said, intervention stemming from the medical community’s recognition and validation of this population and its needs is an immediate must and is imperative in preventing the increased risk of and the development of addiction in these innocent lives.
It can be done.
For more articles/education on this subject-type please see the following:
Prenatal Overdose Rejection Syndrome
A silent and disturbing trait in babies born out of addiction