Microsoft Word Parenting Children Who Have Been Exposed To Methamphetamine

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1 Non-Return Information Packet Assisting families on their lifelong journey Parenting Children Who Have Been Exposed to Methamphetamine A Brief Guide for Adoptive, Guardianship, and Foster Parents Oregon Post Adoption Resource Center ‹ Portland, Oregon 97214 2950 SE Stark Street, Suite 130 ‹ 800-764-8367 503-241-0925 Fax 503-241-0799 ‹ [email protected] www.orparc.org   Oregon Department of Human Services. ORPARC is a contracted service of the Please do not reproduce without permission.

2 XPOSED P W HO H AVE B EEN E HILDREN T O M ETHAMPHETAMINE C ARENTING A A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS BRIEF GUIDE FOR Table of Contents Introducti on: ... 1 Part I: Methamphetami ne: An Over view ... 2 What is meth? What are its effects on the user? How prevalent is meth use? How is meth addiction treated? Part II: Meth’s Eff ects on Ch ildren ... 7 What are the prenatal effects of exposure? What are the postnatal effects of prenatal exposure? What are the environmental effects on children? Part III: Parenting Meth-E xposed Children ... 11 Guiding principles Age-specific suggestions Part IV: Reprinted Articles ... 20 Appendix A: Recommended Resources Appendix B: Sources Page i

3 XPOSED P W HO H AVE B EEN E HILDREN T O M ETHAMPHETAMINE C ARENTING A A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS BRIEF GUIDE FOR Introduction This Information Packet begins with a brief overview of current knowledge regarding the abuse of methamphetamine– what it is, how it eff ects the user, and how addiction is treated. Part Two contains information about the know n and suspected effects on the children of al exposure effects and environmental exposure methamphetamine users. It includes both prenat effects. rdianship, and foster parents who care for the Part Three offers suggestions for adoptive, gua children from meth abusing homes. Part Four contains repr written specifically for foster and ints of several articles on the topic, adoptive parents. d resources for more information. Appendix A is a list of recommende ng more about the effects of this illicit drug on The scientific community is continually discoveri the children of its users, with new interven tions continually explored and recommended. Although the ORPARC staff will attempt to update this packet from time to time, it does not fall within the scope of this program to be a contin uing source of the latest medical and scientific information. Readers are encouraged to visit the websites on the Resource List. Many of these, such as the NIH and SAMSHA, will post new findings as soon as they are available. In terms of damage to children and to our soci ety, meth is now the most dangerous drug in America. U.S. Attorney General Alberto Gonzales Page 1

4 XPOSED P W HO H AVE B EEN E HILDREN T O M ETHAMPHETAMINE C ARENTING A A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS BRIEF GUIDE FOR mine: An Overview Part I: Methampheta What is meth? Methamphetamine, or “meth,” is a strong, highly a ddictive central nervous system stimulant. It differs from other illicit stimulants such as cocaine or heroine in that it is synthetically processed, using toxic and flammable chemicals. Meth can be injected, snorted, smoked, or swallowed. The highly addictive nature of meth is attributed to its pow erful and immediate release of “dopamine” into the brain of the user. Dopamine is a chemical that creates feelings of well being. You may be familiar with the effects of dopamine if you have experienced the strong emotional vigorous physical workout. satisfaction that follows a The dopamine released into the brain after physical ny fraction of the amount exertion is just a ti amount and the almost immediate release of released in response to meth. The exorbitant dopamine in response to meth creates extreme f eelings of omnipotence and euphoria. In its August 2005 expose, Newsweek stated that meth seduces its users “with a euphoric rush of confidence, hyperalertness, and sexiness that lasts for hours on end.” Meth is stronger and cheaper than cocaine. Researchers tell us that the amount of dopamine released by meth use is three times four times that released th rough morphine use. that released through cocaine use, and What are its effects on the user? Meth creates a short but intense “rush” when it first enters the body. Users experience increased activity, decreased appetite, and energy, and power, lasting from strong feelings of well being, 20 minutes to 12 hours. As the effects wear o ff, the drug leaves the user feeling “drained, 1 and craving the drug again. helpless, and deeply depressed,” cal, psychological, and cognitive effects. Meth brings to its users serious physi Short term physical effects: Strong and quick addition Insomnia Increased pulse, blood pressure, re spiration Decreased reaction time Large doses can cause: Convulsions Stroke Overheating Heart Attack Death 1 Newsweek . Aug 8, ’05. p.46. America’s Most Dangerous Drug. Page 2

5 XPOSED P W HO H AVE B EEN E HILDREN T O M ETHAMPHETAMINE C ARENTING A A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS BRIEF GUIDE FOR Long term physical effects: Weakness, tremors, seizures Dental decay Weight loss; anorexia Coughing, dry mouth Rapid facial aging Brain damage Kidney damage Liver damage Heart damage Skin sores and infection Increased risk of stroke Increa sed risk of HIV and hepatitis Cognitive Effects Include Decreased Ability to: Recognize and recall words and pictures Make inferences Manipulate information Learn from experience Ignore irrelevant information Short term psychological effects: Increased confidence Increased alertness Increased sex drive Increased good mood Increased talkativeness Decreased boredom, loneliness The brain damage caused by chronic meth use can also lead to: Long term psychological effects: Insomnia Aggression Anxiety Confusion Mood disorders Psychotic behavior: which may include hallucinations, delusions, paranoia, homicidal or suicidal thoughts A few observations on these effects: The appeal of meth might be unde t term psychological effects. rstandable in light of its shor Persons who are socially isol or low self esteem, may be ated, or who suffer from shyness particularly vulnerable as they pe rceive increased confidence as a re sult of meth use. But meth is an equal opportunity drug. Its users include th ose on all rungs of the socioeconomic ladder and all races and backgrounds. The damage to the brain by chronic meth use is de tectable even months after usage. Scientists have found the brain damage caused by meth to be similar to the damage caused by Alzheimer’s disease, stroke, and epilepsy. Brain scans perf ormed on users after ten years of meth use show destruction in the Limbic brain system, which regulates emotion, and in the Hippocampus, which aids memory. Experts believe the limbic syst em damage leads to long term depression and mptoms similar to early Alzheimer’s disease. anxiety, while the hippocampus damage leads to sy Page 3

6 P C W HO H AVE B EEN E XPOSED T O M ETHAMPHETAMINE ARENTING HILDREN A BRIEF GUIDE FOR G UARDIANSHIP AND F OSTER P ARENTS DOPTIVE A , Some Societal Effects: ƒ Increase in (violent) criminal activity ƒ Increase in domestic violence ƒ Increase in child abuse and neglect ƒ Increase in identity theft ƒ Endangerment due to chemical exposure ƒ Burns, maiming or death from volatile toxic chemicals, fires, lab explosions ƒ Pollution of air and ground due to toxic chemicals and vapors Withdrawal symptoms include: Depression Anxiety Fatigue Paranoia Aggression Intense cravings How prevalent is meth use? phetamine “the most prevalent synthetic A 2005 White House Drug Policy paper calls metham drug manufactured in the United St ates,” and attributes both its highly addictive nature and the 2 to its increased usage nationwide. ease in which it can be manufactured Two recent national surveys on methampheta mine usage report these findings: 3 2004 National Survey on Drug Use and Health Annual Monthly Lifetime (used in past year) (used in past 30 Days) (used at least once) US residents ages 12+ 4.9% 0.6% 0.2% 4 High School Students Reporting Methamphetamine Use, 2004 Lifetime Annual Monthly Grade (used at least once) (used in past year) (used in past 30 Days) th 2.5% 1.5% 0.6% 8 th 1.3% 3.0% 5.3% 10 th 6.2% 3.4 % 1.4% 12 2 Methamphetamines . Drug Facts 2005. Office of National Drug Control Policy . p.1. 3 : National Findings. Substance Abuse and Mental Results from the 2004 National Survey of Drug Use and Health , Sept 2005. Health Services Administration. th 4 th, th National Institute -School Surveys of 8 , 10 and 12 Monitoring the Future Grade Students. 2004 Data From In Dec 2004. on Drug Abuse and University of Michigan . Page 4

7 P ARENTING W HO H AVE B EEN E XPOSED T O M ETHAMPHETAMINE C HILDREN A P , G UARDIANSHIP AND F OSTER DOPTIVE ARENTS A BRIEF GUIDE FOR Note the disconcerting frequency of use among 10th and 12th graders compared to the usage for among high schoolers has decreased over the past all persons over age 12. However, meth use two years. than a similar 2003 survey, in lers in 2004 was slightly lower The rate of usage among high schoo th at least once was 7.6% for all high school which the percentage of students who used me grades combined. That survey also yielded demographic information about who uses meth: Male students (8.3%) were more likely than female students (6.8%) to report lifetime ƒ methamphetamine use. Hispanic (8.3%) and white (8.1%) students were more likely than black (3.1%) students to ƒ 5 use methamphetamine within their lifetime. A 2003 survey of meth use among college stude nts and non-college young adults yielded these statistics: Lifetime Annual Monthly Ages/grades (used at least once) (used in past year) (used in past 30 Days) 5.8% 2.6% 0.6% College students 0.7% 8.9% 2.7% Young adults (19-28) Meth use started in rural areas a nd on the West Coast, but it has spread across the states; it has reached epidemic proportions in most large ur ban areas and it is seeping steadily into the suburbs. Nationwide, law enforcement officers ra nk meth as the top drug they battle. Meth usage seems to know no demographic boundaries. A tablet form of meth is ga ug,” perhaps replacing the drug ining popularity as a “club dr “ecstasy” in popularity with young adults on the “rave scene.” meth’s lure of assured weight loss. Woman of varied ages have succumbed to Young women in particular may also tu rn to meth to handle depression. , businesspersons and executives of both Suburban housewives as well as professionals sexes have been arrested fo r meth possession or production. Many American communities have suffered the embarrassment of the arrest of prominent citizens for meth use. Gay community leaders are urging homosexual me n to practice “safe sex” in light of the clear link between meth use and the increase in AIDS. Men (both gay and straight) and women use meth to increase their sexual abilities. (But meth can actually cause impotence.) 5 Centers for Disease Control and Prevention. May 2004. Youth Risk Behavior Surveillance – United States, 2003. Page 5

8 XPOSED P W HO H AVE B EEN E HILDREN T O M ETHAMPHETAMINE C ARENTING A A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS BRIEF GUIDE FOR How is meth addiction treated? because the drug causes the brain to lose its Meth addiction is so very difficult to overcome ability to process dopamine, leavi ng the user less and less able to feel any enjoyment when not e drug creates “a depression so crushing that the using the drug. Furthermore, withdrawal from th 6 - seems preferable.” alternative - more meth Time and patience are needed before the user sees a reversal of meth’s effects. with the severity and length of The recovery rates are associated ilities after three mont usage. Studies have shown improved cognitive ab hs of abstinence, full recovery of attention, memory, learning, and ex ecutive function, and motor function after four ccessful recovery ra years. One study showed highly su tes for users able to remain drug free for nine months. Research is underway to develop medications for treating methamphetamine addiction and to find antidotes to treat overdose. Readers might want to refer to the Na tional Institute on Drug status on such research ( Abuse website for the current www.drugabuse.gov , select “Methamphetamine”). Cognitive/Behavioral therapy is the current treatment for meth addiction recovery. The goal is to help patients to modify their thinking and be havioral patterns, and to learn new and more effective skills for coping with life stresses. Antidepressants may be prescribed to help the patient cope with the depressive states that accompany withdrawal. 6 . p. 2 www.sciencecentral.com Your Brain on Meth . Page 6

9 P ARENTING W HO H AVE B EEN E XPOSED T O M ETHAMPHETAMINE HILDREN C A A , G UARDIANSHIP AND DOPTIVE OSTER P ARENTS BRIEF GUIDE FOR F Part II: Meth’s Effects on Children The National Center on Substance Abuse and Child Welfare warns: drug in the U.S., it is drawing the most Although meth is not the most heavily used 7 attention, ... its risks to children pose new challenges not raised by other drugs.” effects of exposure? What are the prenatal Both born and unborn children are in danger due to the increase in meth use among women of child bearing ages. Whereas the male to female ratio of persons who enter treatment for alcohol and other drugs is 2:1 (2 men for every woman) th e rates for meth treatment are closer to 1:1. (In 2003, 47% of drug admission treatments for me th users were women.) Treatment admission data also shows an increase in meth usage among young women. (In 2003, 70% of the 12 to 14- of the 15 to 17-year-old female admissions year-old female drug treatment admissions and 58% were related to meth usage.) alcohol abusing mother is expos A child in the womb of a drug or ed to the harmful substances that cross the placenta. Some of the known risks of meth to the fetus are: ƒ Birth defects ƒ Growth retardation ƒ Premature birth ƒ Low birth rate ƒ Brain lesions But there are many unknowns, and exact effects of prenatal exposure are di fficult to predict. Variations can depend upon the mother’s freque ncy and intensity of us age, her nutrition and overall health, her prenatal care , and whether she also uses alc ohol or other harmful substances. In addition to the exposure to the harmful substances of meth, the fetus of the meth user is often rition and inadequate prenatal matern al health. Users, even pregnant subjected to irregular nut eating or sleeping for several days. ones, often go on meth “binges” without What happens to a baby after birth has great impact on the child’s development. The home environment is critical in th e child’s outcome, as consequenc es of exposure during pregnancy 8 can be mediated through ma ny available interventions.” 7 www.ncsacw.samhsa.gov (National Center on Substance Abuse and Child Welfare) 8 Amatetti, Sharon. Administration for Children and Families, Children’s Bureau. Keynote speech, national conference, Washingt on DC. Fall 2005. Page 7

10 P ARENTING W HO H AVE B EEN E XPOSED T O M ETHAMPHETAMINE HILDREN C A A , G UARDIANSHIP AND DOPTIVE OSTER P ARENTS BRIEF GUIDE FOR F What are the postnatal eff ects of prenatal exposure? Newborns exposed prenatally to meth ma y exhibit any or all of these problems: ƒ Difficulty sucking or swallowing ƒ Hypersensitivity to touch ƒ Extreme muscle tension ƒ Respiratory problems These young children are at risk for such future problems as: ƒ Failure to thrive ƒ Growth retardation Developmental delays or disorders ƒ ƒ Neurological abnormalities Cognitive impairments ƒ Learning disabilities ƒ In addition, babies may experience addiction wi thdrawal symptoms which can continue for months. Symptoms vary depending upon what other drugs have been used. (I t is likely that meth exposed babies have been exposed to alcohol or other drugs also.) Withdrawal symptoms may include: ƒ Difficulty with transitions or changes in the environment Discomfort with body sensations, (bowel m ovements, being undressed, being bathed) ƒ Their extreme sensitivity, neurological impairme nt, and difficulty being comforted render these babies difficult to care for. What are the environmental effects? The drug has seduced whole familie s and turned them into ‘zombies.’ 9 a police officer Whether or not they have been prenatally expos ed to harmful substances, children who live in substance abusing homes are subjected to phys ical and emotional dangers. The lack of appropriate stimulation in early ology the chance to develop as life denies their brain and neur they should, leaving them with academic difficu lties and delays. The lack of consistent interaction and care in their early years impact s their ability to trust others and to form relationships. 9 . p. 47 Newsweek Op. Cit. Page 8

11 P C W HO H AVE B EEN E XPOSED T O M ETHAMPHETAMINE HILDREN ARENTING A A , G UARDIANSHIP AND F DOPTIVE P ARENTS BRIEF GUIDE FOR OSTER ynopsis of the risks of Child Abuse and Neglect: The U.S. Department of Justice posts this s Parents and caregivers who are meth dependent typically become careless, irritable, and apacity to nurture their childre violent, often losing their c n. In these situations, the their children’s safety and to provide for essential food, failure of parents to protect ncluding immunizations, prope r hygiene, and grooming), and dental and medical care (i appropriate sleeping conditions is the norm. Ol der siblings in these homes often assume the role of caretaker. Some addicted parents fall into a deep sleep for days and cannot be awakened, further increasing will be exposed to toxic the likelihood that their children chemicals in their environm ent and to abusive acts committed by the other drug-using individuals who are present. Children living at meth lab sites may experience the added trauma of witnessing violence, being forced to participate in vi olence, caring for an incapacitated or injured parent or sibli ng, or watching the police arrest and remove a 10 parent. The National Center on Substance Abuse and Child Welfare and the US Department of Justice cite these additional harmful situations for children: Parent manufactures meth – Children living at methamphetamine laborator ies are at increased risk from severe neglect and are more likely to be physically and sexually abused by members of their own the site. Many children w ho live in meth homes are family and known individuals at sexual activity. A home lab carries the exposed to pornographic materials or overt e dangers and ongoing eff ects of chemical added risks of exposure to both immediat contamination, toxic fumes, fire, or explosi on. The child may inhale or swallow toxic substances, or absorb toxic substances through th e skin. Exposure to low levels of some , dizziness, and fatigue; exposure to high meth ingredients may produce headache, nausea coughing, chest pain, dizziness, lack of levels can produce shortness of breath, al burns (to the skin, eyes, mouth, and coordination, eye and tissue irritation, chemic nose), and death. The solvents and corrosive su bstances used in meth production can cause skin or respiratory tract irritations, or central nervous system damage. Chronic ital organs, and brain damage. Normal exposure may cause cancer, damage to v cleaning will not remove met hamphetamine and some of the chemicals used to produce it. They may remain on eating utensils, floors, countertops. Toxic byproducts are often 11 ng children and others in the area. improperly disposed outdoors, endangeri Parent is involved in trafficking meth – ers, including the presence of weapons, The children may be exposed to additional dang violence, physical or sexual abuse by par ents or by outsiders visiting the home. Explosive devices and booby traps have been f ound at some meth lab sites. Loaded guns and other weapons are usually present and of ten found in easy-to-reach locations. 10 Dangers to Children Living at Meth Labs . www.ojp.gov/ovc/publications/bulletins/children/pg5.html 11 Ibid and Op. Cit, Amatetti – condensed and summarized from both sources. Page 9

12 XPOSED P W HO H AVE B EEN E HILDREN T O M ETHAMPHETAMINE C ARENTING A A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS BRIEF GUIDE FOR Dangerous animals trained to protect illegal meth labs pose added physical and substandard housing structures may also sanitation hazards. Code violations and endanger children. the chaos associated with meth use and In addition to physical and health endangerment, meth production creates great stresses and trauma for children, impacting their social, psychological, and emotional de velopment. Their school at tendance may be sporadic. They may feel shame and have low self esteem. A lack of appropriate role models may leave them with poor personal boundaries and social skills. Shame and embarrassment over their home situation may leave them unabl e to form friendships. Parental neglect during the early years may leave the child with an impaired ability to form attachments. The lack of strong advocates and role models may render them vulnerable to engaging in substance abuse or crimi nal activity themselves. Children from these environments requi re developmental and mental health interventions, along with stable, nurturing caregivers. Fortunately, access to healthcare, adequate nutrition, and a nurturing environment do 12 make a difference in the outcome of these children. 12 . 9/2004. p. 7 Family Matters Huff-Slankard, Janie. Methamphetamine Abuse and its Effects. Page 10

13 XPOSED P W HO H AVE B EEN E HILDREN T O M ETHAMPHETAMINE C ARENTING A A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS BRIEF GUIDE FOR Part III: Parenting Meth-Exposed Children Due to the relative newness of meth abuse, and the lack of longitudinal studies of its effects on children, no exact prescriptions exist for parent ing children who have been prenatally or environmentally exposed to this dangerous subs tance. However, much of what we now know about the needs and the development of children who have been prenatally exposed to alcohol and cocaine will be applicable. A nurturing, calm, patient, parentin g style is especially crucial for drug exposed children, whose sensory and neurological impairments and potenti al learning disabilities do not match well with loud, controlling, punitive, distracted, or non-empath etic parents. Parents will also need to l adoptive and foster children face – grief and loss, identity and address the on-going issues that al role confusion, and the challenges of forming ne w attachments and integrating into a new family ubstance abusing household have witnessed warped system. Children who have spent time in a s parent is to re-educate them about appropriate family and social values. Your job as their interactions – in the home, at nd finally, for the children coming school, and in the community. A out of the chaotic and unsafe e nvironments of meth homes, a home with clear, predictable rules and routines is best suited to r eassure children that they will be sa fe and their needs will be met. ted children (see Appendix A: Recommended Many excellent resources exist on parenting adop Resources.) The goal of this packet is not to repeat those, but to a dd to them. Brush up on general adoptive parenting skills. A special needs pre-adoption class or seminar might also be in order. This section includes both guiding principles wh ich will apply to parents raising drug exposed children of all ages, as well as some specific rrant review with your suggestions which may wa pediatrician, occupational therapist, special educ ation coordinator, and the like, to determine their appropriateness for your child. Guiding principles: Develop a team of helping professionals. The last sentence in the previous paragraph hints at this first guiding principle. You will need the involvement of knowledgeable professionals to help determine your child’s needs. If you accept d, you must be willing to incorporate these the challenge of raising a meth exposed chil “outsiders” into your life. Develop a support system. In addition to your team of professionals, you will need persons you can turn to for encouragement and support. Although friends, neighbors and extended family can be wonderful resources, find an adoptive or foster pare nt mentor or a support group, where you can ng children with similar challenges. communicate with others who are raisi Page 11

14 XPOSED P W HO H AVE B EEN E HILDREN T O M ETHAMPHETAMINE C ARENTING A A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS BRIEF GUIDE FOR Avoid labels, stereotypes and self fulfilling prophesies. placed nine-year-old upon hearing a neighbor Can you imagine the crushing blow to a newly child state, “You must have been one of those dr ug babies!” Children repeat what they hear – and they live up to, or down to, labels. So wa tch what you say and ask your family and friends to avoid negative labels, descrip tions, or predictions. Coach your family members and extended support persons on responses to those who questio n the reason for the a doption, guardianship, or foster placement. Teach children that they need e histories, and work not share their entire lif with them on a “cover story” – a concise explanati on of their situation. Teach them to respond to intrusive questions with phrases like, “That’s priv ate,” or “I don’t want to talk about that.” Help your child develop positive self esteem by avoiding negative stereotypes. While children disabilities, many can su cceed in spite of their exposed to alcohol and drugs often have learning limitations. A twenty-three year old college grad uate, who has fetal alcohol spectrum disorder, stated of her grade school through high school placement in advance math classes, “I didn’t know FAS kids were supposed to be bad in math or down to the labels !” Children do live up to and predictions assigned to them. Avoid labels and description such as “a walking time bomb” in reference to drug exposed children. Respect your child’s privacy. Adoptive parents often struggle w ith the question of what and how much to share with school personnel about their child. A good ru le of thumb is to give information on an “as needed” basis. For example, the teacher will need a particular learning style or to know that your child has challenge, but not necessarily its cause. If your child has been sexualized, you may want to tell the teacher that this child should not be left unsupervised with younger children; but it is not necessary to disclose details of the child’s abuse. Use the same “need to know” rule with neighbors, youth group leaders, and the like. Establish predictable routines. To convince children from chaotic backgrounds of the continued care and safety they will encounter in your home, provide an extra large dose of predicta bility. Develop patterns of ily rituals. The spontaneity and surprises that regular meals, bedtime routines, and consistent fam children. One little girl who was removed from many families enjoy will not work well for these a meth home took great joy in describing to her caseworker the routines she and her brother had learned to depend upon in their foster home: We play outside after school until 5:00; then we come inside to do homework. We have dinner at 6:00. After dinner the girl s clear and the boys sweep the floor. with us at 7:30. At 8:00 we take baths. Then we finish our homework. Dad looks it over We wash our hair on Wednesdays and Saturdays. We have to be in our beds at 8:30 but we are allowed to read until 9:00. These mundane routines mean so much to a ch ild coming from a background of deprivation and unpredictability. Establish and follow patterns and vary them only upon necessity and with , we leave for Disneyland at daybreak!” do not forewarning. Surprises such as “Pack your bags Page 12

15 P C W HO H AVE B EEN E XPOSED T O M ETHAMPHETAMINE HILDREN ARENTING A A , G UARDIANSHIP AND F DOPTIVE P ARENTS BRIEF GUIDE FOR OSTER work well with these children. Inform them well in advance and provide reminders of any changes in routines, even pleasant on es such as company or vacations. Nurture in physical and emotional ways. xposed babies may have difficulty with physical closeness, We know that drug or alcohol e touching and eye contact. Even older children with sensitive neurology or impaired nervous systems may respond differently to physical aff ection. Gently find ways to initiate hugs, touching, and eye contact - even if at a reduced frequency and leve l than you would like. Oregon families can request the ORPARC “Attachment Info rmation Packet” for a summary of suggested techniques. Review Debor ah Gray’s excellent book, Attaching in Adoption , and study the sections that describe attachment building techniques for varied ages. Advocate for your chil d’s educational needs. Children prenatally and/or environmentally expose d to meth or to the toxins involved in its manufacture are at increased risk for learning disabilities. Parents must learn what services their child is entitled to, and how to advocate to a ssure the child receives appropriate educational services. Your partners in this endeavor are: 1. The Oregon Parent Training and Information Cent er (OrPTI). They offer a toll free Help lent trainings throughout the state. Line, an IEP Partner program, and excel : (503) 581-8156 ext. 212 or 1-888-505-2673 Help Line: 1-888-891-6784; IEP Partners ext. 212; www.orpti.org 2. Wrightslaw offers excellent online informati on and can give a more in-depth look at the recent changes to IDEA law. or www.wrightslaw.com www.wrightslaw.com/idea/osep.statute.htm 3. Oregon Advocacy Center has produced several shor t, readable articles on issues affecting persons with disabilities. Their booklet, “Special Educatio n: A Guide for Parents and Advocates” is available in both Englis h and Spanish. (503) 243-2081 or 1-800-452- 1694; www.oradvocacy.org Help your child to achieve success in at least one area. prenatal fetal alcohol The literature on adolescents and young adults with exposure points to the development of a talent or interest as a “protect ive factor.” Prenatally exposed children have ivities, and sports. With excelled in the arts, physical act appropriate accommodations, some have completed higher educations. Many have excelle d at jobs in areas related to their interest and talent – child care, pet gr ooming, gymnastics instruction. Help your child explore activities outside of school and especially promote those which seem to interest the child or for wh ich the child shows aptitude. Maintain a realistic yet positive attitude. Parents of meth exposed children must accept that there may be unde rlying biological issues that no amount of good parenting can correct. The pare nts’ role becomes that of encourager and advocate. You encourage the child’s fulfillment of his/her highest possible potential. You advocate to assure that the child receives all entitled services. As an advocate for your child, you also become the “teacher” who educates others about how to work with the child. As parents of Page 13

16 XPOSED P W HO H AVE B EEN E HILDREN T O M ETHAMPHETAMINE C ARENTING A A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS BRIEF GUIDE FOR children with developmental disabilities, you must learn to celebrate the tiniest of accomplishments, and not allow yourself to become discouraged. Charlene Sabin, M.D., a developm ental pediatrician, explains: Scientists now believe that the “pathways” for a child to develop interpersonal relationships are laid down in the early years of life. Inattentive or consistent care may impact the child’s ability to attach. To am eliorate impaired attach ment, adoptive parents will need more patience, more understanding, and more therapeutic parenting approaches. Learn tolerance for the unknown. As a recent study and literature review on this topic point out, ...there are likely to be adverse developmental effects for children exposed prenatally to methamphetamine ...either because of the drug per se, or because of the environment in we do not know specifically what those which these children are raised. At present, 13 effects will be. This same article states, “... the jury is still out on the effects of methamphetamine...” Consistent, nurturing care can ameliorate the eff ects of exposure to some extent, but the child may still have some long term impairments and delays. In drug exposed children, the development of many different parts of the brain is interrupted; some parts are recoverable and some are not. Each child’s situation is diffe rent. Learn to accept the many unknowns, and to take one day at a time. Don’t put undue pre ssure on anyone in the family – yourself, your partner, or the child. This textbook excerpt from a section entitled Understanding – and Misunderstanding – Parenting Influences , might be helpful: In the end, research shows that parenting does matter to children’s development. At the ngly recognizing the need to consider the same time, developmental scientists are increasi influence of a child’s heredity characteristics as moderators of parental influence, and to on to hereditary factors. As a result, a new incorporate into their research designs attenti generation of parenting research is emergi ng that more thoughtfully illustrates the 14 nurture in the family environment. developmental integration of nature and Take care of yourself. Caring for drug exposed children is demanding and e xhausting. Parental bur nout is a risk. Pay attention to your own needs. Take breaks, nurtu re yourself, continue with some interest or 13 Maternal Methamphetamine Use During Pregnancy and Child Outcome: What Do We Know? The New Zealand Medical Journal. Nov 26, 2004. 14 . The National Academy of Sciences. p. 49. From Neurons to Neighborhoods Page 14

17 ARENTING P HILDREN W HO H AVE B EEN E XPOSED T O M ETHAMPHETAMINE C A , G UARDIANSHIP AND F OSTER P ARENTS DOPTIVE BRIEF GUIDE FOR A activity outside of the family. Special needs childr en can take a toll on a marriage or partnership. Pay close attention to your partner’ s needs and nurture your relationship. Age-specific suggestions: For all ages: should receive a medical evaluation prior to Any age child removed from a meth-abusing home being placed in substitu te care. If you are the first caretaker, ascertain that this has been done and ask for a summary of the report. Monito r the child closely a nd get immediate medical attention for the following symptoms of toxic ch emical exposure: respirat ory distress (difficulty breathing, shortness of breath, ex cessive coughing) or changes in mental status (confusion, excessive sleepiness or leth argy, excessive hyperactivity.) Prior to the first placement, children will ha ve been “decontaminated” – their clothing and and hair thoroughly washed. Veri fy that this has been done. possessions destroyed, their bodies Then demonstrate your empathy for children that have had to leave all of their possessions or stuffed animal for comfort. Provide behind – no familiar clothing, no favorite blanket te way to communicate substitute items the child might find acceptable. Find an age appropria your compassion for the child’s losses and sadness. Newborns and babies: Caretakers of prenatally exposed babies must ba lance a calm, quiet enviro nment that soothes the oundwork for the baby’s ne urological and social baby, with interactive times that help lay the gr development. tween too much sleep and not enough sleep. They Prenatally exposed babies seem to vacillate be are usually very sleepy in the first weeks of life, and they will need to be awakened for feedings. dule rather than wait for the ba by to wake up on its own to be Parents should use a feeding sche fed. And by all means offer the baby a pacifier during non-feeding times- experts believe this “non- nutritive sucking” strengthen s the baby’s feeding abilities. After the initial sleepiness, these babies often become excessively irritable an d jittery. During this pha se they need a calm, quiet environment without a lot of stimulation. ss signals. These might include: changes in breathing, heart Learn to recognize your baby’s stre arms or legs; shaking; and if rate or temperature; stiffened the stress is not alleviated the symptoms may escalate to inconsolable scream ing, vomiting, or breath-holding until the baby turns blue. When stress symptoms first emerge , move the baby to a warm, quiet environment with low lighting. Experiment w ith soft music, swaddling in a blanket, gentle rocking or swaying, – to determine what best calms your baby. Soon after birth, babies need to learn the skills which lay the groundwork for social emotional, cognitive, and behavioral development. They need to partake in activities that help with their sensory and neurological organiza tion. Think about all th e tasks babies undertake in the first six months of life: – they watch people’s faces; they react to voices, lights, sounds, and facial expressions; they demonstrate an interest in their surroundings. Page 15

18 P ARENTING W HO H AVE B EEN E XPOSED T O M ETHAMPHETAMINE HILDREN C A A , G UARDIANSHIP AND DOPTIVE OSTER P ARENTS BRIEF GUIDE FOR F The drug exposed infant may need extra encour agement with these undertakings. Parents can s to talk to and sing to the baby, hold the baby, assist by taking advantage of the baby’s alert time e the baby’s fingers and toes, massage the baby’s rock and sway to soft music, touch and wiggl body. Be gently persistent even with a baby who turns away from visual contact or objects. “Providing opportunities for physical rbal interaction becomes an contact, visual regard, and ve 15 integral part of social developm ent in the early stages of life.” These interactions set the stage for the development of a healthy parent/child attachment. Work closely with your pediatrician during the child’s early month a nd years. Babies need to be evaluated and treated for drug wit hdrawal, feeding problems, and re spiratory distresses. Keep a journal in which you record your child’s activitie s and behaviors. Your observations will be helpful to the pediatrician w ho evaluates and treats the baby. share any changes, and bring your notes to Stick to the schedule of “well baby” check-ups progress, or regression you have noted. It is crucial that meth exposed babies receive intervention and treatment for any physical, neur ological, developmental delay or regression. educational assessment. Contact your local Any drug exposed baby should be referred for an public school or your school distri ct’s Educational Service Center to make arrangements. If your Early Intervention Services (ages 0-3) which are free of charge baby qualifies, he/she can receive school district. Follow the re commendations of the intervention and available at every public routines of interacting with your baby to help in his or her specialist, who may prescribe home development. Once past the fragile newborn stage, an older baby is ready for “floor time” – a designated daily child to play. The one-to-one interactions and time when the parent gets on the floor with the velopmental ladder” through playful activities undivided attention help the child “climb the de that involve parent and baby, lo ts of eye contact, vocal inte ractions, smiling, touching, and perhaps a few simple toys. Refer to Section Two of the book, The Child With Special Needs for tion about “floor time.” instructions and informa Toddlers and pre-schoolers: during these years. The MD can be your first Work closely with a knowledgeable pediatrician line of defense in recognizing latent drug e xposure effects and in seeking appropriate interventions. Keep a journal of your child’s illn esses, medications, activities and behaviors, and especially note any changes. Bring it along to all of your child’s medical appointments. ees of anxiety, from toddlerhood on up through Many meth exposed children exhibit high degr the school years. A consistent, calm, and highl y predictable environment works best for these youngsters. Be sure to discuss with the pediatri cian or mental health provider any signs of anxiety you observe in your child. 15 Care for Kids Exposed to Drugs Coehlo, Deborah Padgett, RN, PhD. . Handout from DHS training 10-05. Used with permission of author. Page 16

19 P C W HO H AVE B EEN E XPOSED T O M ETHAMPHETAMINE HILDREN ARENTING A A , G UARDIANSHIP AND F DOPTIVE P ARENTS BRIEF GUIDE FOR OSTER The bulk of evidence to date about the problems these infant s face points to learning disabilities and higher brain f unction impairment. While a me th-exposed infant may be eschooler, and school age child need to be relatively symptom free, the toddler, pr 16 evaluated for cognitive function. nal evaluation, whether the child is new to your This statement indicates the need for an educatio home or has been with you since babyhood. If the toddler or preschool er qualifies for special educational services, begin them as soon as pos sible. These services are free and available through all public school districts. Speech therap y may be included as a part of these services, and you may be asked to undertake a home routin e as well. Remember - the child does not have to be of school age to receive special educational services. Refer to the helpful resources previously listed under Advocate for your child’s educational needs . Newborns and babies - add more age appropriate Initiate “floor time” ac tivities described under interactions and toys. Conti nue with your “floor time” throug hout the toddler and preschool years. Allow the child to direct th e play and follow the child’s lead. School-aged children: Continue with regular medical, vision, and dent al check ups. Follow up in a timely manner with any recommended treatments. ce consistent rule s and routines. Establish and continue to enfor difficulty going to school due to their anxiety. They may have Meth exposed children often have trouble leaving the security of home or separating from pa rents. Work with both your ntal health provider on these c pediatrician and your child’s me oncerns, and solicit the assistance of school personnel. Remember that one of the long te ure is learning disabilities, in rm effects of prenatal drug expos particular, challenges in the areas of attention and abstra ct thinking. Many drug exposed children function acceptably in the early grades, but as the work becomes more abstract (around th If not addressed via grade), they may begin to fall behind thei r peers academically. the 4 appropriate educational intervention s, this may lead to problems in self esteem, social skills, and abreast of their child’s learning n behaviors. Parents who can keep eeds are often able to avoid or minimize the emotional and behavioral challe nges that may accompany drug exposed children into their later childhood and adolescent years. Continue to seek educational evaluations and interventions. Learn the laws re garding eligibility and know your righ ts as a parent. Refer to the previously listed resources for special education advocacy. Many of the principles espoused in the resear l alcohol exposure may ch on children with feta apply to meth exposed grade schooler s. Read Diane Malbin’s booklet “ Trying Differently Rather Than Harder .” Your job as your child’s advocate is to figure out how your child learns best, so that you can: 16 Op. Cit. Huff-Slankard, p. 7 Page 17

20 ARENTING P HILDREN W HO H AVE B EEN E XPOSED T O M ETHAMPHETAMINE C A ARENTS , G UARDIANSHIP AND F OSTER P DOPTIVE BRIEF GUIDE FOR A 1. provide appropriate nurturing and discipline in the home, and 2. educate teachers, child care providers, youth group leaders, and the like, about the most successful types of environments and interventions for your child. guardianship and foster parents to initiate The grade school years are a good time for adoptive, nd out when your child’ s school is teaching a drug and alcohol abuse prevention education. Fi s at home with the school’s schedule. unit on this topic, and coordinate effort . This website contains www.theantidrug.com Refer to the website: “Parents: The Anti Drug” at very helpful information on the effects of meth and helpful resources for parents. If your child has a “lifestory book,” review it together, and use it as a tool to discuss the damaging effects of illegal substances. If the li festory book is non-existent or substandard, work update it. (ORPARC has several lif estory book resources for this with your child to create or purpose and sometimes offers classes on this topic.) ing of the reasons for removal from birth family. A book you Enhance your child’s understand . might find helpful is Telling the Truth to Your Adopted or Foster Child ngry over the harm inflicted by substance-abusing Adoptive and foster parents are sometimes so a to speak of the birth family in an empathetic or kind manner. birth parents that they are unable But one of the greatest gifts you can give your ch ild, one that will go a long way in furthering the do just that. Practice saying, w child’s attachment to you, is to ith sincerity, statements like: “Your mom had such a pretty smile – I can see where you got your good looks,” or “Your dad buse.” If such statements are true, they are a was a very good man before he fell victim to drug a positive way to honor birth family members, and they will enhance your child’s attachment to you. Teach children that they are not destined to repe at their birth parents’ mistakes, and that they do have control and choices in the outcomes of their lives. Pre-teens and teens: Continue to advocate for your ch ild’s educational needs, as le arning disabilities are common the child is new to your home or has not been among meth exposed children at all ages. If recently evaluated for learning disabilities, reque st such an assessment from your local public ices are available in the public schools for school. Remember that special educational serv qualified youth through age 21. Thes e services can include prepar ation for life after high school. Children in their pre-teens and teens really do benefit from learning more about their own histories. At all developmental stages they wi ll need to review their history with increased information. In adolescence they will be tryi ng to understand their history with new eyes and deeper insight. So even if you have explained their stories to them in the past, initiate new conversations and give more information. Pre-te ens and teens need a continual review of their histories because their capacity to understand their stories in diffe rent ways increases as they grow older. Follow the guidelines in the prev ious section regarding compassion and respect for the birth family. Page 18

21 XPOSED P W HO H AVE B EEN E HILDREN T O M ETHAMPHETAMINE C ARENTING A A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS BRIEF GUIDE FOR These are important years for pare nts to initiate or increase th eir efforts at substance abuse prevention. In a matter-of-fact and non- judgmental manner, inform them that scientists believe they may be “genetically more at risk” for addic tions. Teenagers need to know this information about themselves. You might solicit the help of a trusted family doctor or a mental health provider to assist in this educat seems aloof or the information ional effort. Even if your teen does not sink in at first, th ey need to keep hearing it. Remember that every child matures at his or he r own rate, and that the developmental timelines for meth exposed children are delayed. Gear your interactions and info rmation to the child’s his or her chronological age. level of maturity rather than Meth exposed children may not reach the developm ental milestones at the same time as their and parental supervision you would provide for a peers. They will likely need the structure much younger child. Don’t overburden them with the kinds of responsibili ties they are not yet mature enough to handle. Decisions about dating, curfews, learning to drive, and the like must be made with the child’s developmental level (a nd learning challenges) in mind. Do not expect your child to emancipate from home when other ki ds do so. They may need to live at home well into their 20’s and they will need a slow transiti on to independent living. For those who are able to undertake college work, living at home and attending the local comm unity college is a good choice. Initiate or continue your efforts at substance abuse prevention edu cation. Coordinate efforts with the school’s health class or special assemb lies on this topic. Refer to the website www.theantidrug.com . Your child might view this site as well. cohol exposed children through adolescent and An excellent book that has guided parents of al early adult challenges is , edited by Judith Kleinfeld. Fantastic Antone Grows Up Some of the suggestions may also be helpfu l for meth exposed youth. Written by parents, helping professionals, and alc ohol exposed youngsters themselves , the various vignettes offer suggestions on topics such as adjusting to hi gh school, finding and keeping a job, relationships, learning to drive, emancipation, and marriage. A final suggestion: read Diana Haskins’ book Parent as Coach: Helping your teen build a life of confidence, courage and compassion . It helps parents move be yond the kind of authoritarian with drug and alcohol exposed adolescents. role that we know does not work effectively Page 19

22 E P HILDREN W HO H AVE B EEN C XPOSED T O M ETHAMPHETAMINE ARENTING A BRIEF GUIDE FOR A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS Part IV: Reprinted Articles Page 20

23 EEN P HILDREN W HO H AVE B C E XPOSED T O M ETHAMPHETAMINE ARENTING A OSTER BRIEF GUIDE FOR DOPTIVE , G UARDIANSHIP AND F A P ARENTS Page 21

24 EEN P HILDREN W HO H AVE B C E XPOSED T O M ETHAMPHETAMINE ARENTING A OSTER BRIEF GUIDE FOR DOPTIVE , G UARDIANSHIP AND F A P ARENTS Page 22

25 EEN P HILDREN W HO H AVE B C E XPOSED T O M ETHAMPHETAMINE ARENTING A OSTER BRIEF GUIDE FOR DOPTIVE , G UARDIANSHIP AND F A P ARENTS Page 23

26 EEN P HILDREN W HO H AVE B C E XPOSED T O M ETHAMPHETAMINE ARENTING A OSTER BRIEF GUIDE FOR DOPTIVE , G UARDIANSHIP AND F A P ARENTS Page 24

27 P C W HO H AVE B EEN E XPOSED T O M ETHAMPHETAMINE HILDREN ARENTING A A , G UARDIANSHIP AND F DOPTIVE P ARENTS BRIEF GUIDE FOR OSTER Appendix A: Reco mmended Resources Books, Booklets and Videos: Most of these resources are av ailable through the ORPARC library. Attachment: ƒ Attachment, ORPARC Information Packet ƒ Attaching in Adoption, Deborah Gray Parenting: ƒ Parent as Coach , Diana Haskins ƒ Self-Esteem: A Family Affair , Jean Illsley Clarke Adoptive Parenting: ƒ The Child With Special Needs, Stanley Greenspan Lois Melina ƒ Raising Adopted Children, ƒ Twenty Things Adopted Kids Wi sh their Adoptive Parents Knew, Sherrie Eldridge Telling the Truth to Your Adopted or Foster Child ƒ , Keefer and Schooler Parenting Drug/Alcohol Exposed Children: ƒ Trying Differently Rather Than Harder , Diane Malbin ƒ Fantastic Antone Grows Up, edited by Judith Kleinfeld ƒ Bruised Before Birth , Joan McNamara Videos: ƒ Worth the Trip ƒ Students Like Me Websites for more information: National Institute on Drug Abuse www.drugabuse.gov , select “Methamphetamine” National Center of Substance Abuse and Child Welfare www.ncsacw.samhsa.gov , search for “Methamphetamine” Office of National Drug Control Policy , search under “Drug Facts” for “Methamphetamine” www.whitehousedrugpolicy.gov Parents: The Anti Drug www.theantidrug.com

28 XPOSED P W HO H AVE B EEN E HILDREN T O M ETHAMPHETAMINE C ARENTING A A DOPTIVE , G UARDIANSHIP AND F OSTER P ARENTS BRIEF GUIDE FOR : Sources used for this packet Appendix B Note to the Reader: Many times links to specific ar ticles on websites change. A Web Administrator may remove or relocate a partic ular article on the site. If you would like to receive further information on a topic it is proba bly best to access the basic URL (web) address (i.e., www.drugabuse.gov ) and select or search a particular topic. . Aug 8, 2004. p. 41-48. America’s Most Dangerous Drug. Newsweek Methamphetamine – Drug Facts 2005 Office of National Drug Control Policy www.whitehousedrugpolicy.gov “Methamphetamine” under “Fact , select “Drug Facts,” select Sheets” ved From Clandestine Labs FAQ # 2 Medical Evaluation of Children Remo How to Care for Children Removed form a Drug Endangered Environment FAQ # 3 The Colorado Alliance for Drug Endangered Children. , select “Questions and Answers,” see “Frequently Asked Questions #2 - www.colodec.org Medical Evaluation of Children Removed from Clandestine Labs” and “Frequently Asked Questions #3 - How to Care of Children Removed from a Drug Endangered Environment,” Fact Sheets published in both Microsoft Word and Adobe Acrobat formats NIDA Community Drug Alert Bulletin: Methamphetamine National Institute on Drug Abuse , select “Methamphetamine” www.drugabuse.gov National Center of Substance Abuse and Child Welfare , search for “Methamphetamine” www.ncsacw.samhsa.gov Children at Clandestine Meth Labs US Department of Justice: www.ojp.usdoj.gov , enter “Children at Clandestine Meth Labs” in ecember 28, 2004 and January 11, 2006) sites search (two versions: D Care for Kids Exposed to Drugs, Coehlo, Deborah Padgett. Handout from October 2005 DHS training. . Huff-Slankard, Janie. Family Matters . September Methamphetamine Abuse and its Effects 2004. Administration for Children and Families, Child ren’s Bureau. Keynote speech. Amatetti, Sharon. National Conference, Washington, DC. Fall 2005. oviding input on this Information Packet. Many thanks to Dr. Charlene Sabin for pr

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