Adopting a Substance-Exposed Child

Prenatal exposures to drugs, alcohol, and other substances can be encountered in all types of adoption: infant or older child; domestic or international; public, private, or independent.

As you approach adoption, there are several steps you can take to learn more about these exposures, and separate fact from myth.

Originally, it was believed that younger children could overcome the exposure without any long term effects, however families are experiencing residual issues, including:

• ADD/ADHD
• learning weaknesses
• sensory integration issues

These aren't new disorders, they've simply been identified now.

Many encounter problems trying to differentiate between preemie development and the effects of the drugs and alcohol. While Fetal Alcohol Syndrome (FAS) is easiest to diagnose, some of the drug effects are not necessarily apparent immediately unless the child tested positive at birth. Drug effects are likely to manifest as low birth weight, tremors, under developed neuro systems, and the inability to be soothed or sleep.

Initial Steps

• Demand (don't just ask for) a complete medical history and details about exposures: what substances were taken, for how long, whether or not the child can be or was born addicted, results of neonatal and subsequent testing, developmental aptitudes, etc.
• Seek independent medical evaluations [also for international adoptions]
• Learn about prenatal exposures, what they are and potential effects.
• Examine your attitudes and work with adoption and/or counseling professionals if you need help assessing your own abilities and capabilities.

Before, During, and After Adoption

The best agencies will offer you access to, assistance with, or information about:

• adoption and/or medical subsidies
• continuing information about support or educational services
• health and child development follow-up, at least through preschool years
• early intervention services
• behavioral management
• special education services
• tutoring for academic underachievement
• assessment and intervention for neuropsychological problems
• counseling services for all family members
• support groups for parents
• education and guidance for dealing with childhood and adolescent behaviors
• respite care
• legal assistance for parents in finalizing the adoption and pursuing services

Early intervention will give your child the best opportunity for positive outcomes. The following resources provide excellent information and you are encouraged to bring your comments and questions about this topic to the forum.

Resources Used in this Article (recommended reading for all)

• Center for the Evaluation of Risks to Human Reproduction (CERHR)
  providing information on dangers as well as benefits of certain substances used during pregnancy. 
• Consequences of Prenatal Cocaine Exposure
  from the National Institute on Drug Abuse
• Diagnosing Fetal Alcohol Syndrome
  from the CASA program of Arizona
• Drug-Exposed Children
  from the National Adoption Information Clearinghouse
• Drug Facts
  from the National Clearinghouse for Alcohol and Drug Information
• Facts About Prenatal Drug Exposure
  from Emory University.
• FAS/FAE Reading List
  from Parentbooks
• Fetal Alcohol Syndrome
  potential effects and extensive information from the TRIUMF Project.
• Information on Common Drugs of Abuse
  from the National Institute on Drug Abuse.
• Maternal Exposure to Crack Cocaine
  from Brown University
• Neonatal Drug Withdrawal
  from the American Academy of Pediatrics
• Organization of Teratology Information Services
  for local information and resources
• Prenatal Exposure to Drugs
  from the National Institute on Drug Abuse
• Prospects for Crack Babies
  from Johns Hopkins

© Nancy S Ashe