1/26/2018 PREVENTING THE RETRAUMITIZATION OF CHILDREN FROM ADDICTED FAMILIES THE PROBLEM RISK FACTORS FOR ENDANGERMENT

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Lorraine Briggs
5 years ago
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1 PREVENTING THE RETRAUMITIZATION OF CHILDREN FROM ADDICTED FAMILIES Susan Kilman LCSW, AADC THE PROBLEM ABOUT 1 IN 8 (8.7 MILLION) AGED 17 OR YOUNGER LIVE IN HOUSEHOLDS WITH AT LEAST ONE PARENT WHO HAD A PAST YEAR SUBSTANCE USE DISORDER (SAMHSA, AUGUST 2, 2017) EVERY DAY IN THE UNITED STATES ABOUT 650 BABIES ARE BORN THAT HAVE BEEN EXPOSED TO ILLICIT DRUGS IN THE PRENATAL PERIOD (THE CARLAT REPORT CHILD PSYCHIATRY FEB :1) IN 2013 AN ESTIMATED 24.6 MILLION AMERICANS 12 YEARS OR OLDER HAVE USED AN ILLICIT SUBSTANCE IN THE 30 DAYS BEFORE A NATIONAL SURVEY (AMERICAN ACADEMY OF PEDIATRICS, 2016) RISK FACTORS FOR ENDANGERMENT PARENTS WHO HAVE ONGOING USE OF ALCOHOL OR DRUGS RESULTS IN PROBLEMS INCLUDING : DIFFICULTY CONTROLLING USE OF SUBSTANCE POOR HEALTH FAILING TO MEET OBLIGATIONS AT HOME, WORK, OR SCHOOL SPENDING AN INCREASED AMOUNT OF TIME GETTING, USING, OR RECOVERYING FROM THE EFFECTS OF USING THE SUBSTANCES ENGAGING IN SITUATIONS FILLED WITH CHAOS AND DRAMA BECOMING PART OF THE SUBSTANCE EXCHANGE/BUSINESS 1

2 IMMEDIATE IMPACT ON CHILDREN PARENTAL ABUSE OR NEGLECT OR BY THOSE IN CONTACT WITH PARENT FEWER HOUSEHOLD RESOURCES HIGHER RISK FOR DEVELOPING SUBSTANCE ABUSE PROBLEMS POOR ACADEMIC PERFORMANCE BEHAVIORAL PROBLEMS EXPOSURE TO DOMESTIC VIOLENCE EXPOSURE TO PARENT BEING IN THE DEPARTMENT OF CORRECTIONS/JAIL POTENTIAL LONG TERM IMPACT SEE HANDOUT FOR 25 QUESTIONS AND ADDITIONAL INFORMATION IT STARTS IN THE BEGINNING EXPOSURE TO SUBSTANCES DURING THE FIRST TRIMESTER CAN AFFECT THE STRUCTURE OF THE FETAL BRAIN DURING THE SECOND TRIMESTER CAN AFFECT BRAIN FUNCTIONING 2

3 OPIATES IN 2012, 22,000 INFANTS WERE DIAGNOSED WITH NEONATAL ABSTINENCE SYNDROME FROM OPIOD WITHDRAWAL THAT INCLUDES A COMBINATION OF PHYSIOLOGICAL AND NEUROBEHAVIORAL SIGNS SUCH AS: SWEATING IRRITABILITY INCREASED MUSCLE TONE AND ACTIVITY FEEDING PROBLEMS DIARRHEA SEIZURES EVEN TREATMENT CAN BE RISKY PRENATAL EXPOSURE TO METHADONE MAY CAUSE INCREASED ACTIVITY AND POORER CORDINATION WHEN COMPARED TO UNEXPOSED CHILDREN CHILDREN MAY BE MORE IMPULSIVE, IMMATURE, AND IRRESPONSIBLE THAN PEERS, AND PEFORM POORLY ON INTELLIGENCE TESTS LIMITED INFORMATION ABOUT IMPACT OF BUPRENOPHINE BUT MAY HAVE LOWER COGNITIVE SCORING AND POOR CELL GROWTH AND DEVELOPMENT TOBACCO NEWBORN BABIES OF SMOKERS ARE LESS RESPONSIVE TO SOUND AND HAVE HARDER TIME ADJUSTING TO NEW SOUNDS. 12 MONTHS TO 24 MONTHS THERE WERE LOWER AUDITORY PROCESSING AND COGNITIVE STORES WHICH LED TO POOR LANGUAGE DEVELOPMENT AGES TWO TO SIX OVERALL LOWER GLOBAL INTELLIGENCE SCORES RELATING TO VERBAL AND AUDITORY FUNCTIONING. MORE IMPULSIVE, OPPOSITIONAL, AND LOWER WORKING MEMORY 3

4 CANNABIS MOST COMMONLY ABUSED DRUG DURING PREGNANCY IT READILY CROSSES THE PLACENTA. ASSOCIATED WITH FETAL DISTRESS, LOW BIRTH WEIGHT, AND ADVERSE NEURODEVELOPMENTAL OUTCOMES INCLUDING HIGHER INCIDENCE OF PSYCHIATRIC DISORDERS NEWBORNS EXPERIENCE MILD WITHDRAWALS SYMPTOMS AND INCREASED STARTLE RESPONSE INCREASED HAND MOUTH BEHAVIOR HIGH PITCHED CRIES CANNABIS CONTINUED SLEEP CYCLE DISTURBANCES HOWEVER, BY AGE THREE THEY BEGIN TO SHOW IMPAIRED VERBAL, ABSTRACT VISUAL, AND QUANTITATIVE REASONING SKILLS AT FOUR, DIMINISHED VERBAL ABILITY AND MEMORY BY AGE SIX POOR EXECUTIVE FUNCTIONING, WITH DEFICITS IN ATTENTION AND PLANNING, PROBLEMS IMPULSIVITY AND HYPERACTIVITY WHICH PERSIST INTO EARLY ADULTHOOD SCHOOL AGED CHILDREN SHOW IMPAIRED VISUAL PROBLEM SOLVING AND DISORGANIZED SPEECH ALCOHOL CLOSE TO 9% OF PREGNANT WOMEN REPORT CURRENT ALCOHOL ABUSE; IMPACT FOUND IN HEAVY TO BINGE DRINKING (4+ DRINKS) FETAL ALCOHOL SPECTRUM DISORDERS (2% TO 5% OF YOUNGER SCHOOL AGED CHILDREN) ONE OF THE LEADING CAUSES OF INTELLECTUAL DISABILITY LEARNING DEFICITS IN A WIDE RANGE OF AREAS ISSUES WITH ATTENTION, EXECUTIVE FUNCTIONING, AGGRESSION, INATTENTION, AND POOR SOCIAL INTERACTIONS 4

5 STIMULANTS DATA SUGGESTS THAT THERE IS DISRUPTION IN THE DEVELOPMENT OF THE FRONTAL CORTEX WHICH MAY IMPAIR INHIBITORY CONTROL WHICH LEADS TO ATTENTION DEFICITS AND BEHAVIORAL PROBLEMS REDUCED NEONATAL SIZE REDUCED ALERTNESS DEFICITS IN FINE MOTOR SKILLS TO AGE THREE POOR MOVEMENT QUALITY INCREASED STRESS SUMMARY CHILDREN WITH PRENATAL DRUG EXPOSURE ARE MORE LIKELY TO DEVELOP DISTRUPTIVE BEHAVIOR DISORDERS SUCH AS ODD, IMPAIRED INTELLECTUAL FUNCTIONING AND ACADEMIC ACHIEVEMENT, POOR MEMORY, AND INABILITY TO LEARN FROM MISTAKES ANY OR ALL OF THESE EVENTS CAN LEAD TO ADDITIONAL TRAUMA FOR CHILDREN WHO ARE COPING WITH THE IMPACT. IT IS IMPORTANT TO UNDERSTAND THESE POSSIBLE OUTCOMES WHEN EVALUATING A CHILD S BEHAVIOR, ACADEMIC ISSUES, AND SERVICE NEEDS. PSYCHOSOCIAL TRAUMA Inconsistency in parenting Disruption of healthy family routines and schedules Lack of true security and structure Three times more likely to be physically/emotionally/sexually abused Four times more likely to be emotionally or physically neglected Higher rates of neglect in rural populations May be placed outside of home with strangers or unknown relatives 5

6 HOME ENVIRONMENT Lack of child proofing safety measures Open flames, lighters, and absence of monitoring around stoves Increased risk for infectious diseases due to needles, etc. Exposed to adult behaviors and/or criminal events The role of co occurring disorders Ignorance of basic parenting skills/generational connection Little or no health or dental care TRAUMA Toxic shame Chronic anxiety/constant fear Anger at helplessness and at others who don t understand what it is like Hoarding behaviors which may involve stealing or lying Poor reactions to noise or exaggerated startle response/hiding Attachment problems See handout PROBLEMS WORKSHEET 6

7 RULES IN ADDICTED FAMILIES Don t Talk Don t Feel Don t Trust 7

8 HELPING CHILDREN Teach the Seven Cs. According to the National Association for Children of Alcoholics, children need to know the Seven Cs of Addiction : I didn t Cause it. I can t Cure it. I can t Control it. I can Care for myself By Communicating my feelings, Making healthy Choices, and By Celebrating myself HELPING CHILDREN program kitsupportive education for children of addicted parents 7.pdf Using the supportive education tool kit to educate staff and begin services for children in a wide range of environments. HELPING CHILDREN Help them understand that addiction is a disease. Remind them that it is not their fault, regardless of what the parent may have told them. Make sure they know they are not alone. Peer support along with professional support Teach children to problem solve. Promote resilience not victimization Teach parenting skills while parents are working program 8

9 REMEMBER: CHILDREN LEARN WHAT THEY LIVE 9

The Impact of the Opioid Crisis on Children

The Impact of the Opioid Crisis on Children Guided Notes for Online Learning Name: Date: 1 Table of Contents Section 1: The Opioid Crisis Page 3 Section 2: Addiction Page 4 Section 3: Trauma Informed Care