Parental Substance Abuse : Intervention, Part 3

by Child Welfare Information Gateway

(Page 8 of 10)

Foster Parent Training

There's really no preparation for foster parents, and there should be. We need to know what to look for with the babies . . . because it's really trial-and-error trying to figure out what to do.

Even experienced foster parents often find themselves poorly prepared to care for drug- and alcohol-affected children. Burnout is common among the foster families who care for this high-risk population, and substance-exposed children are at increased risk for multiple failed placements. To help ensure that children from chemically involved families are placed with foster parents who are equipped to accommodate the child's special needs, specialized foster parent training curricula have been developed to better educate caregivers.

Typically, training takes place over a period of several weeks. It is designed to increase the foster parents' knowledge and enhance caregiving skills as well as to better acquaint foster parents with relevant community agencies. The training also encourages empathy for the chemically involved parent and the family's circumstances. Model curricula typically address the following areas:

• alcohol and other drug abuse;
• the chemically involved family;
• common medical problems of substance-exposed infants and children;
• normal child development, developmental needs, and age-appropriate toys and play activities;
• special techniques for caring for drug-affected infants and toddlers;
• nutrition;
• first aid and cardiopulmonary resuscitation;
• impact of caring for special-needs children on the foster family;
• working in partnership with social service and health care professionals; and
• community resources.

Successful completion of training programs generally is linked with increased foster care payments.

Grandparent Support Groups

You'd think it's time for me to enjoy my life and work and eventually get my little pension.... But I'm stuck with children all over again.

Increasingly, grandparents are caring for grandchildren whose parents, because of their abuse of alcohol and other drugs, are unable to provide for their children's needs. In many instances, those grandparents are elderly or have health problems that limit their stamina or restrict their mobility. Many also live on fixed incomes and have few resources for providing for their grandchildren's special needs.

Even middle-aged grandparents, however, frequently find themselves overwhelmed by the responsibility of assuming full-time care for a young child. For some grandparents, a child's placement may necessitate early retirement. For others, it may mean deferring lifelong plans that were made in anticipation of the time when their own children would be raised and gone from the home. To enable these caregivers to cope with this inordinate burden of responsibility, grandparent support groups have been developed specifically for grandparents caring for drug- and alcohol-affected children.

Typically, such programs provide a range of services designed to assist grandparents in caring for their dependent grandchildren while still maintaining their own physical and psychological health. Such services generally include education about addiction, codependency, and stress management, and information related to child development, nutrition, and parenting. Grandparent programs also offer specific training to help grandparents acquire skills to care for grandchildren who may have special medical or behavioral needs. In addition, programs typically provide information about community resources and practical help with such things as how to obtain legal custody of grandchildren and how to apply for extra food stamps. Grandparent support groups also serve as advocates for caregivers and assist them in dealing with complex and unfamiliar bureaucracies. Finally, these support networks provide mutual assistance and peer counseling that can help decrease grandparents' isolation and thus better support them in times of personal and family crisis.

Meeting Health and Educational Needs

Comprehensive Health Care Clinics for Substance-Affected Children

The pediatrician I take the kids to is a real old-fashioned family doctor. And he's great for everyday problems, but he doesn't really know about drug babies.... For instance, he says they've got colic. But I've seen colic, and it doesn't resemble this at all. So then I go home frustrated, because I have no more information on how to deal with them.

The multiple medical and developmental problems of some substance-exposed infants and children require a wide range of health care services. To address this growing need, specialized pediatric clinics have been developed in many communities to provide these children and their caregivers with high-quality, "one-stop" medical and developmental services.

Such clinics are staffed by specially trained interdisciplinary teams of physicians, nurses, social workers, and psychologists. These facilities provide well-baby and pediatric care; psychosocial, developmental, and educational assessments; and coordination of subspecialty medical care when needed. In addition to services for children, model clinics also often provide a range of supportive and case management services for parents as well as relative and foster caregivers. These services may include individual counseling, parenting education, group counseling and peer support, advocacy, and referral assistance. Many clinics also have an aggressive outreach component that helps ensure adequate medical followup through home visits and frequent phone calls to families.

Early Childhood Programs

One 4-year-old child in Ann Doherty's classroom started this school year violent and self-destructive. He hit, bit, and spat at other children and had difficulty controlling his movements.

Infant, toddler, and preschool programs for drug- and alcohol-affected children have been developed to more effectively address the unique developmental and educational needs of substance-exposed children and the parenting concerns of their caregivers. Model programs offer children a consistent, nurturing, and safe environment on a daily basis and help caregivers acquire the skills needed for providing more appropriate and effective parenting.

Typically, specialized programs are staffed by an interdisciplinary team of teachers, social workers, psychologists, and health care professionals who work with both the children and their caregivers as well as with siblings or other children in the home. Classroom activities reflect this population's heightened need for predictable routines and structured environments. Active parent involvement in the classroom and in parent groups is required by most programs, and in some programs, such parental involvement may be court-ordered. In many projects staff routinely make home visits to reach out to caregivers and to better ensure that classroom curricula are meeting the needs of both children and parents.

In many cases, these specialized programs have served as pilots in order to identify components that can be incorporated into more inclusive settings, such as Head Start, child care, and public school-funded preschool settings.

About the Author

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Formerly the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse, Child Welfare Information Gateway provides access to information and resources to help protect children and strengthen families. A service of the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.