If you’ve pursued foster care or adoption, it is likely you’ve been faced with The Form. The Form may look different depending on your agency, but at some point you’re going to have to physically check off boxes indicating what kind of potential issues you are willing to deal with in your future child. In domestic infant adoption that is going to mean questions about a child’s prenatal history or family medical records. In international adoption it means questions about a child’s level of special need with an understanding that some needs may not present themselves until a child is home. In foster care it means deciding what kind of medical/emotional/behavioral/educational needs you are capable of handling along with a child’s prenatal history (if any information is know). The form we filled out prior to taking our first foster placement listed syndromes I’d never even heard of along with the more familiar. It can be agonizing to try and objectively consider those children and anticipate your ability to meet their needs.
Photo by Rebecca Tredway Photography
A major consideration for families evaluating their ability to handle the children who may come into their home is the issue of prenatal drug and alcohol exposure. We have cared for kids with both prenatal drug exposure and FAS (fetal alcohol syndrome) and I know it can be intimidating to think through the practical realities of caring for these kids. I’m not a doctor, a teacher, or a therapist, but I have become a bit of a researcher and advocate when it comes to the uniquenesses of these kids. Here are some things I’ve learned:
Everybody lies (assume the worst): Even if you decide to check the box that says you are not open to taking placement of a child who has been exposed to drugs or alcohol prenatally, that doesn’t necessarily mean you won’t end up with a child who had a toxic prenatal environment. There may be a lack of honesty on the part of a birthparent or a lack of information from a child’s medical history. If an agency doesn’t know for a fact that a child was exposed, they may not want to scare people off by suggesting it, even if there’s a likelihood. There isn’t a definitive test (other than the ones performed directly after birth if there are suspicions), so sometimes you have to just assume. If a child you’re dealing with appears to have issues similar to a child who had experienced prenatal drug or alcohol exposure, it may be best to just assume that’s part of the issue even if you don’t have the information to prove it. It may help put some pieces together for you and the team working with that child.
What you see may not be what you get: If you are caring for a very young child with prenatal drug or alcohol exposure, there can be a wide array of problems that may present themselves, or no problems at all. A child may seem normal at birth, but then a serious learning disability presents itself when they start school. A child may have withdrawal symptoms in infancy, but then develop on schedule. You need to be prepared to make a commitment to that child no matter what the future holds, since there’s no way to predict how affected your child may be.
Do your homework: There was once a fear of an impending epidemic of “crack babies”. Those fears haven’t materialized. The research is constantly evolving and with each new drug that gains popularity, new concerns develop about the effects that drug will have on children. It takes decades to know the full extent of those effects as we see how these children grow and develop. We can now see that the effects of cocaine weren’t as horrific on most children as was predicted (although there are still long-term, frustrating effects), but the damage done by meth is still to be fully understood. If you are going to raise a child who has been exposed to drugs or alcohol, it is good for you to be up to date on the most current research. You may have to educate the team of professionals working with your child since not every doctor/therapist/caseworker will be familiar with the issues associated with each drug.
Be a team captain: You are likely going to be dealing with a team of professionals if your child is struggling with the effects of drug or alcohol exposure. You may be working with a pediatrician, neurologists, occupational therapists, physical therapists, speech therapists, psychologists, teachers, etc. (It’s good to note you may do fine with just a regular pediatrician with no complications. The diversity of outcomes is huge.) You are going to need to be able to keep everybody informed of your child’s needs and progress and be an advocate for them as a patient and as a child.
Find support: Not everybody will understand the strengths and struggles of your child. Since many of these kids don’t have obvious physical signs of their issues, you may not get the same kind of compassion and understanding that would be offered to someone with a more obvious disability. It is a huge blessing to find parents who understand what you’re struggling with. If you can’t find them, make them! Cultivate a few close relationships where you can be honest about the hard things and celebrate your child’s triumphs.
Have discretion: I have noticed that in an effort to explain their child’s behavior (maybe even to distance themselves from it) or to explain why the child is with them, a foster or adoptive parent may overshare about their child’s history. While it may be necessary to help teachers or other professionals understand your child’s needs, not everybody has a right to know about the struggles your child has been through. It may not seem like a big deal to disclose that your child was exposed to drugs in the womb to an acquaintance at church, but it may seem like a bigger deal when that information makes its way back to your child through his peers. And while some people may have compassion for your child because of that information, others may be suspicious or make untrue assumptions that can have a negative impact on how they treat your child or how they tell their children to treat your child. You are the guardian of your child’s story. Be a wise one.
Provide love and boundaries: The literature I read and my own experience with these children has taught me that there is something hugely important to provide for them: CONSISTENCY. Routines, schedules, advance warning, pre teaching, all of these things are helpful to the child who has had his brain development effected by drugs or alcohol. They may not be able to pick up on subtle cues the way other kids do or be as comfortable with change, so it’s great to be able to provide them with consistency and structure in their home. And all of this must be done in the context of a loving environment. They need to feel valued and safe so they can develop to their full potential, whatever that may be.
Flex your compassion muscles: It is easy (and right, even) to be angry about the fact that a child has been injured by something entirely preventable. I have had my angry moments at the mothers who did damage to their children. I have cried and prayed and eventually I have been able to find peace. It has been good for me to remember that these problems rarely happen in a vacuum. A woman whose life was otherwise pleasant and successful isn’t generally the woman who is doing cocaine while pregnant. In spite of my frustration and anger, I have to have compassion. Yes, they had a choice in the matter and they choose something terrible. They hurt a helpless child. But at some point you have to get past that and realize that no matter what they did, they matter in the life of this kid. The best outcome is for that mother to experience healing and recovery, which is something I want to support. It’s hard to support that if I’m harboring bitter feelings towards her.
Expect the unexpected: Being a parent to a child with prenatal drug or alcohol exposure is a learning experience each day. You can’t know what the future is going to hold for that child. We can only do our best to set them up for success and trust God with the rest. Being able to live in the moment and let go of our desire to control the outcomes is really key for finding joy in this parenting situation.
I hope this doesn’t feel overwhelming. The honest truth is that many of my most rewarding parenting experiences have come from kids who were prenatally exposed to drugs or alcohol. There have been frustrations and struggles, but SUCH joys along the way. My heart longs to see these kids embraced and welcomed into loving families that can give them the best shot possible at normalcy and success—whatever success may look like in their lives.
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