CASA of Arizona

Substance Exposure - pg. 6

Prognosis



Some of the effects of in utero substance exposure will weaken and subside over time. These temporary effects are mostly due to drug withdrawal. Some infants may need medication to help ease the symptoms or special therapy to work through the side effects, but they have a good chance of overcoming the problems within a few years.

Other effects will be permanent. Neurological damage to the fetus does not get reduced when the drug withdrawal has subsided. Neurological damage will impact a child's mental, social, and physical development. Muscle motor damage may be reversed with extensive therapy, but full motility will most likely never be achieved. Therapists with expertise in neurodevelopmental therapy can treat children and demonstrate effective changes. The neurodevelopmental approach to therapy is based on the premise that therapeutic intervention should take into account the child's present neurodevelopmental and functional skills and build on these, rather than intervene at the skill level expected for the child's chronological age. For example, if a 15-month-old child, who should be starting to walk, can only roll and sit, the intervention includes passive and strengthening exercises designed to promote crawling and pulling to stand. Neurodevelopmental therapy uses strategies for sensory-motor integration, inhibition of primitive reflexes, and facilitation of normal balance and equilibrium.

Adult family members may need training to learn how to handle and care for their drug exposed infant. They may also need therapy to help cope with the difficulties that raising a drug exposed child creates.

As children exposed prenatally to stances move into their preschool years, the frequency of visits to the physician decreases, but there is an increase in rehabilitation services needed from speech-and-language and occupational therapists. Special education and remedial services for learning problems need to be addressed. Behavior management can be provided by a psychologist in coordination with the child's physician. The psychologist must also teach parents and teachers how to use behavior management strategies consistently and effectively to prevent and correct behavior problems. Nursing services are important in coordinating care among teachers and health care providers.

Some of the long-term studies have shown that children exposed to substances in utero were more likely to have to repeat grades in school and were more often in trouble with school and legal authorities than their non exposed peers.


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