Developmental Patterns of Prenatally Drug-Exposed Children : Toddlerhood and Preschool Years

by Child Welfare Information Gateway

(Page 9 of 10)

Toddlerhood (15 to 36 Months)

Atypical Social Interactions. Toddlers see themselves as the center of the universe, around which all activities focus. The pronoun "mine" epitomizes this particular age. The building of trust in one's own social relationships is an important behavior learned during this period.

An important factor that determines later successful social interaction relates to the kinds of early experiences children have with their parents/caregivers. If a child has a secure attachment relationship with his/her primary caregiver, there is increased likelihood that the child will later have effective social interactions. Because children who are raised in chaotic home situations are at high-risk for later problems with appropriate social behaviors, one of the important tasks professionals face is to ensure that children have opportunities to acquire the trust needed for later healthy interpersonal relationships.

Toddlers who have had prenatal drug or alcohol exposure, or who live in environments in which there is unpredictability in caregiving may demonstrate atypical social behaviors, including overfriendliness, withdrawal, and impulsive behaviors. For toddlers who display such behaviors, professionals can encourage the parent/caregiver to:

Provide consistent and nurturing caregiving within the home setting.

Enroll the toddler in an early intervention program that can provide daily substitute nurturing and consistency when the parents/caregivers are not readily available.

Delayed language development. Toddlers have a growing vocabulary but understand (receptive language) more words than they are capable of speaking (expressive language). Toddlers who were prenatally substance-exposed or who live in substance-abusing households tend to have decreased vocalizations and immature pronunciation of single words. Professionals can recommend several specific intervention strategies, including the following:

Parents/caregivers can use body language and direct eye contact to reinforce verbal directions.

Parents/caregivers can use objects and pictures to augment the meaning of spoken words and read simple picture books with the child.

Minimal play strategies. Play is central to the young child's early cognitive development. A toddler's pretend play with dolls, baby bottles, cooking utensils, and trucks becomes more elaborate. Children's interactions with toys and other objects within their environment become more purposeful and organized, and their activities are sequenced, with a beginning, middle, and end. For instance, most toddlers will hold a baby doll, feed it, and then put it to bed. In testing situations, some substance-affected children appear less able to independently organize a meaningful sequence of play with such common toys. Intervention techniques for children that professionals can recommend include the following:

Parents/caregivers can discuss daily events and activities in a way that highlights cause-and-effect relationships, sequences of events (i.e., emphasizing the beginning, middle, and end), and social relationships and characteristics (e.g., the differences between relationships with family members and with strangers). This can be done simply while looking at picture books, during meals, at bath time, on trips to the grocery store or park, and after watching a children's television program together.

Parents/caregivers can model play with toys in a meaningful sequence with use of words and body language so that the child can imitate and, eventually, generalize this behavior.

Preschool Years (3 to 5 Years)

Preschoolers are more socially independent and are able to learn to share and take turns. Their language skills are more sophisticated, and their attention spans are sufficient to allow them to learn within a group setting that provides less individualized attention.

Many children who live in chaotic environments and/or who have suffered prenatal substance exposure show increased activity levels, short attention spans, impulsivity (e.g., they lose control easily), mood swings, and problems with moving from one activity to another.

Some substance-affected preschoolers also may continue to demonstrate difficulties in the auditory processing of spoken words as well as visual processing of material presented to them in the form of pictures. Furthermore, some demonstrate "sporadic mastery of tasks," in which the skills they demonstrate one day are absent another. Concern about the social development of substance-affected preschoolers also has led to ongoing research into the patterns of attachment and social interaction within this high-risk population of children.

Professionals working with drug- and alcohol-affected preschoolers have developed the following recommendations for addressing the special problems of this population within a classroom setting:

For the child who is easily overstimulated, it is helpful for professionals to limit the number adults and children in the classroom and regulate the number and types of toys available at any given time.

For the child who has difficulty with social interactions, professionals should provide consistent and explicit expectations of his/her behavior and use verbal cues and physical contact to direct or redirect the child's activity and model behavior that emphasizes taking turns.

For the child who has difficulty with task mastery, professionals can verbalize the steps in task performance, ask the child to verbally repeat these steps, and model approaches to completing the task.

For the child who has difficulty with transitions (changing from one activity to another), professionals can provide a predictable daily routine that includes a regular pattern of play, rest, and meals. They also should provide consistent praise for accomplishments and prepare the child for transitions by discussing planned changes in activities in advance.

For the child who displays behavioral problems, professionals can encourage dramatic play, allow time for him/her to express emotions, and assist the child in developing alternative ways of expressing feelings.

About the Author

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