Developmental Concerns in Substance-Affected Children
Factors that affect developmental outcome in the prenatally substance-exposed child:
Prenatal factors
> Genetic resilience of the fetus
> Maternal health
> Prenatal care
> Developmental status of the fetus at time of exposure
Postnatal factors
> Access to food and other basic resources
> Caregiver stability/responsiveness
> Caregiver’s internal working model of caregiving
> Caregiver risk factors (mental illness, uncontrolled substance use)
> Caregiver social support
> Consistency in housing, routine, guidelines
> Safety from abuse/neglect
> Caregiver’s ability to respond to child within context of child’s developmental needs
Disorganized Attachment
> Pattern used to describe infants who lack a coherent strategy for accessing their attachment figure
> Assessed using the Strange Situation experimental procedure
- Securely attached infants will use the caregiver as a reference point from which to explore their environment
- Infants with disorganized attachment will show confused, conflictual or fearful behaviour)
> Linked to fear of the caregiver, uncertainty about caregiver reactions, and a history of contradictory responses by the caregiver
> Families characterized by poverty, parental psychiatric disturbance, parental substance abuse, and a history of abuse of
the parent in childhood have much higher rates of Disorganized Attachment (Carlson et al., 1989)
> Strong links between quality of attachment and later cognition, social skills, adaptive behaviour, mental health
