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Facts and Statistics about Prenatal Alcohol and Drug Exposure

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Page 1: 5 Facts and Statistics about Prenatal Drug and Alcohol ...update.realityworks.com/Curriculum/Realcare/ST...Facts About Prenatal Alcohol Exposure • 1 in 100 babies (40,000 babies

Facts and Statistics about Prenatal Alcohol and Drug Exposure

Page 2: 5 Facts and Statistics about Prenatal Drug and Alcohol ...update.realityworks.com/Curriculum/Realcare/ST...Facts About Prenatal Alcohol Exposure • 1 in 100 babies (40,000 babies

Slide 2

The U.S. Surgeon General’s Warning• The dangers of consuming alcohol during pregnancy are

well-documented and have earned their own U.S. Surgeon General’s Warning:1– “Alcohol consumed during pregnancy increases the risk of

alcohol-related birth defects, including growth deficiencies, facial abnormalities, central nervous system impairment, behavioral disorders, and impaired intellectual development.”

– “No amount of alcohol consumption can be considered safe during pregnancy.”

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Slide 3

The U.S. Surgeon General’s Warning(cont.)

• U.S. Surgeon General’s Warning:– “Alcohol can damage a fetus at any stage of pregnancy.

Damage can occur in the earliest weeks of pregnancy, even before a woman knows that she is pregnant.”

– “The cognitive deficits and behavioral problems resulting from prenatal alcohol exposure are lifelong.”

– “Alcohol-related birth defects are completely preventable.”

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Slide 4

Fetal Alcohol Spectrum Disorders

• Abbreviated as “FASD”• Umbrella term for a spectrum of disorders caused by

prenatal alcohol exposure that includes:2– Physical disabilities– Mental disabilities– Behavioral disabilities– Learning disabilities

• Disabilities may range from mild to severe and may last a lifetime.3

• Any form of FASD is 100 percent preventable.2, 5

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Slide 5

Fetal Alcohol Syndrome

• Abbreviated as “FAS”• The most severe end of the FASD spectrum2

• Three major diagnostic criteria:2– Distinctive, abnormal facial features– Growth deficiencies– Central nervous system problems (structural and/or functional)

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Slide 6

Physical Signs of FAS

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Slide 7

Non-Physical Signs of FAS

• Reduced cognitive ability3

• Learning disabilities3

• Attention deficits3

• Hyperactivity3

• Poor impulse control3

• Poor social skills3

• Language difficulties3

• Memory deficits3

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Slide 8

Only Professionals Can Diagnose Prenatal Alcohol Exposure

• FAS can only be diagnosed by a clinical exam.3

• Because damage may be subtle, FAS is often missed or misdiagnosed.3, 6

• Genetic and environmental factors can cause similar disabilities and abnormalities.3

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Slide 9

Facts About Prenatal Alcohol Exposure

• 1 in 100 babies (40,000 babies annually) is born with some effects of prenatal alcohol exposure.3

• 1 in 1,000 babies is born with full-blown FAS.3

• Annually, FAS costs up to $6 billion in direct and indirect costs.4

• Lifetime expenses and costs for an individual with FAS are approximately $2 million.4

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Slide 10

Who Is At Risk?• Any woman of childbearing age is at risk of having a child with

FASD if she drinks alcohol during pregnancy.8

• Women particularly at risk of drinking alcohol during pregnancy and having a child with FAS include:8

– Women with substance abuse problems– Women with mental health problems– Recent drug users– Smokers– Women with multiple sex partners– Recent victims of abuse and violence

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Slide 11

Many Women Stop Drinking

• Many women who drink early in pregnancy will stop when they find out they are pregnant.

• Others cannot stop without help.• Discontinuing drinking, even late in pregnancy, is better

than not stopping at all.

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Slide 12

All Types of Alcoholic Beverages Should Be Avoided

• A standard drink = 0.60 ounces of pure alcohol:9

– One 12-oz beer or wine cooler– One 5-oz glass of wine– One 1.5-oz serving of hard liquor

• Some alcoholic drinks contain more alcohol and/or come in larger containers (22 to 45 ounces).

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Slide 13

How Alcohol Reaches the Fetus

• When a pregnant woman drinks alcohol, it readily moves across the placenta into the fetus’s bloodstream through the umbilical cord.10

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Slide 14

How Alcohol Reaches the Fetus

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Slide 15

Alcohol Can Damage All Organ Systems

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Slide 16

Alcohol Can Damage All Organ Systems (cont.)

• A mother’s drinking can affect all parts of a developing fetus.10

• The time during pregnancy at which she drinks alcohol determines the type of injury.3, 10

• The more alcohol she drinks, the greater the injury.3

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Slide 17

Babies Are Also Vulnerable While Breastfeeding• A breastfeeding baby takes in alcohol, too, in the breast

milk of a mother who drinks.9

• Because a baby’s brain continues to grow and mature after birth, alcohol could still affect a child’s normal development.9

• If a breastfeeding mother has four alcoholic drinks in a day, the alcohol her baby takes in may impair motor development – the baby’s ability to roll over, to sit, to crawl, and to walk.9

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Slide 18

Severe Injury to the Developing Brain

“Of all the substances of abuse (including cocaine, heroin, and marijuana), alcohol produces by far the most serious neurobehavioral effects on the fetus.”11

- Institute of Medicine Report to Congress, 1996

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Slide 19

FASD = Lifelong Problems and Lower Quality of Life• People with FASD can have lifelong disabilities and a

reduced quality of life:– Low self-esteem12

– Poor impulse control12

– Disruptive school experiences7, 12

– Incomplete education2

– Unemployment2

– Psychiatric problems2, 7

– Inappropriate sexual behavior7

– Criminal behavior2, 7

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Slide 20

What Can We Do?

• Stop all drinking, including social drinking, if we are pregnant or could become pregnant.

• Help our pregnant partners and friends to stop all drinking, including social drinking.

• Encourage our pregnant partners and friends to see a doctor.

• Help families of babies born with FASD find medical, county, and community resources.

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Slide 21

How to Stop Social Drinking

• To avoid social drinking and continue getting along with your partner and friends:– Explain that there is no known safe amount of alcohol, and

that any type of alcoholic beverage can hurt your unborn baby.5

– Keep several alternate activities in mind that you, your partner, and your friends enjoy doing.

– Be assertive!– If you cannot stop drinking:2

• Talk with your physician• Seek community services and intervention• Ask your partner and friends for support

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Slide 22

How to Help Pregnant Partners and Friends Stop Social Drinking• Share information about FASD and the importance of not

drinking during pregnancy.8

• Model safe behavior by abstaining from drinking alcohol yourself and attend social gatherings that do not involve drinking alcohol.8

• Encourage her to discuss the reasons leading her to drink alcohol (e.g. various problems in her life).8

• Help her find community services and/or interventions to help her stop drinking alcohol.8

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Slide 23

How to Help Families of Babies Born With FASD• Encourage families to contact medical, county, and

community resources.• Encourage families to visit their local school district’s early

childhood and family education programs.• Attend meetings or sessions with families as they learn

about available services and interventions.• Offer to stay and help care for the baby to relieve

caregiver stress.

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Slide 24

Prenatal Alcohol Presentation Endnotes

1. U.S. Department of Health & Human Services. (2005, February 21). U.S. Surgeon General releases advisory on alcohol use in pregnancy. Retrieved from http://www.surgeongeneral.gov/pressreleases/sg02222005.html

2. Centers for Disease Control and Prevention. (2006, May 2). Fetal alcohol information. Retrieved from http://www.cdc.gov/ncbddd/fas/fasask.htm

3. Wake Forest University Health Sciences. (2004). Fetal alcohol syndrome: A parents guide to caring for a child diagnosed with FAS. Retrieved from http://www.otispregnancy.org/pdf/FAS_booklet.pdf

4. Substance Abuse and Mental Health Services Administration. (2007). Fetal alcohol spectrum disorders by the numbers. Retrieved from http://www.fasdcenter.samhsa.gov/documents/WYNK_Numbers.pdf

5. Centers for Disease Control and Prevention. (2005, September 9). Fetal alcohol spectrum disorders. Retrieved from http://www.cdc.gov/ncbddd/factsheets/FAS.pdf

6. Substance Abuse and Mental Health Administration. (2005, March). Understanding fetal alcohol spectrum disorders: Getting a diagnosis. Retrieved from http://www.fasdcenter.samhsa.gov/documents/WYNKDiagnosis_5_colorJA_new.pdf

7. Centers for Disease Control and Prevention. (2006, May 2). Frequently asked questions. Retrieved from http://www.cdc.gov/ncbddd/fas/faqs.htm

8. Substance Abuse and Mental Health Services Administration. (2007). Preventing FASD: Healthy women, healthy babies. Retrieved from http://www.fasdcenter.samhsa.gov/documents/WYNK_Preventing_FASD.pdf

9. Substance Abuse and Mental Health Services Administration. (2007). Effects of alcohol on women. Retrieved from http://www.fasdcenter.samhsa.gov/documents/WYNK_Effects_Women.pdf

10. Substance Abuse and Mental Health Services Administration. (2007). Effects of alcohol on a fetus. Retrieved from http://www.fasdcenter.samhsa.gov/documents/WYNK_Effects_Fetus.pdf

11. National Organization on Fetal Alcohol Syndrome. (2006, February 16). FASD: What everyone should know. Retrieved from http://www.nofas.org/MediaFiles/PDFs/factsheets/everyone.pdf

12. National Organization on Fetal Alcohol Syndrome. (2006, February 16). FASD intervention. Retrieved from http://www.nofas.org/MediaFiles/PDFs/factsheets/intervention.pdf

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Slide 25

Drug Categories—Part 1

• Prescription drugs: Prescribed by a doctor and used under a health professional’s supervision.

• Nonprescription drugs: Over-the-counter drugs that can be purchased at a pharmacy or drug store without a prescription.

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Slide 26

Drug Categories—Part 2

• Social drugs: Used in social settings; examples are tobacco, alcohol, and caffeine.

• Illicit drugs: Illegal drugs that can be smoked, snorted, swallowed, injected, or inhaled, such as heroin, cocaine, marijuana, and methamphetamine. Also called “street drugs.”

• Dietary supplements: Nonprescription vitamins, minerals, or medicinal herbs used to improve nutritional status and overall health.

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Slide 27

What Is a Teratogen?• Teratogen: An agent that causes physical or

developmental defects in an unborn child.

Examples include:– alcohol– mercury– nicotine– isotretinoin (brand name Accutane®, a treatment for severe

acne)– phenytoin (brand name Dilantin®, a treatment for epilepsy)

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Slide 28

Drug Use Affects the Unborn Child At Any Time During Pregnancy

• The larger the amount of a drug a mother uses, and the longer she uses it, the greater the risks to the unborn baby.1

The physical, emotional, cognitive, social, and behavioral problems from prenatal drug exposure can

continue into childhood and beyond!

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Slide 29

Combining Drugs Causes the Greatest Danger

• The risks are significantly higher for children whose mothers used a combination of drugs during pregnancy.1

• Additional risks exist if a pregnant woman also smokes and drinks alcohol.1

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Slide 30

Who Is At Risk?

• Research indicates that “the age groups (18-34) with the highest birth rates are also the age groups most likely to use legal and illegal drugs.”2

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Slide 31

Babies Are Also VulnerableWhile Breastfeeding• Women who are breastfeeding should check with their

doctor or health care professional before taking any drug, even a nonprescription drug or dietary supplement:1– Most drugs that a mother takes are present in her breast milk

in a small amount.– Very small amounts of some prescription drugs can harm the

baby.– Breastfeeding mothers should not take any amounts of

amphetamines or illicit drugs.

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Slide 32

Many Women Stop Using Drugs During Pregnancy

• Many women who use drugs early in pregnancy will stop when they find out they are pregnant.

• Others cannot stop without help.• Discontinuing drug use, even if it is late in pregnancy, is

better than not stopping at all.

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Slide 33

How Do Drugs Reach an Unborn Child?

• When a pregnant woman takes a drug, it readily moves across the placenta into the fetus’s bloodstream through the umbilical cord.1

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Slide 34

How Do Drugs Reach an Unborn Child?

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Slide 35

Using Drugs Increases Risk• A pregnant woman’s use of drugs can increase the risk of

the following:– Prenatal death6

– Premature birth3, 5, 6

– Miscarriage3, 4

– Birth defects3, 4

– Low birth weight4, 5, 6

– Small size for gestational age5

– Small head size4

– Neurobehavioral symptoms5

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Slide 36

Withdrawal Symptoms

• Withdrawal from drug addiction is physically distressing. A newborn who was exposed to drugs before birth shows several typical signs of withdrawal:6– Tremors– Sleeplessness– Muscle spasms– Feeding difficulties

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Slide 37

Short-Term Effects of Prenatal Drug Exposure

• A fetus exposed to a mother’s drug use can experience a number of effects from birth to age two:– Breathing problems6

– Cerebral palsy7

– Disrupted sleep patterns5, 7

– Hearing problems6

– Irritability5, 7

– Reduced cognitive ability7

– Poor fine motor skills5

– Vision problems3, 6

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Slide 38

• A child can experience additional effects from age two through preschool:– Abnormal and minimal play skills5, 7

– Atypical social interactions5

– Delayed language development 7

– Difficulty organizing behavior 7

– Difficulty transitioning between activities5

– Hyperactivity5

– Lack of tolerance for frustration 7

– Mood swings with loss of control5

– Shorter-than-normal attention span5

Long-Term Effects of Prenatal Drug Exposure—Part 1

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Slide 39

Long-Term Effects of Prenatal Drug Exposure—Part 2• Research suggests that the following risks are greater

for children who have the developmental problems described on the previous two slides:5– Behavioral problems– Learning disabilities– Neglect and abuse

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Slide 40

Intervention Is Required to Help Drug-Affected Children• A number of approaches are used to help drug-affected

children cope with their surroundings:– Emotional self-control by caregivers5

– Avoidance of abrupt transitions7

– Avoidance of excessive touching7

– Fairness, firmness, and consistency7

– Predictable routines5

– Calm and secure environments5

– Special positioning techniques7

– Protection from bright lights and noise7

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Slide 41

Strategies for Support

• County and community programs can provide support in a variety of ways:7– Help the whole family as a unit– Integrate family needs with existing services– Provide competent, consistent, sensitive, and respectful care– Provide parenting skills training– Create partnerships between parents, caregivers, and health

and educational providers– Promote child’s bonding with at least one responsible person in

his or her life (need not be a parent)– Refer family to drug treatments and interventions

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Slide 42

What Can We Do?

• Stop using all drugs, including social drugs, if we are pregnant or could become pregnant.

• Help our pregnant partners and friends to stop using all drugs, including social drugs.

• Encourage our pregnant partners and friends to see a doctor.

• Help families of babies born with effects of prenatal drug exposure find medical, county, and community resources.

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Slide 43

How to Stop Drug Use

• To avoid using illicit and social drugs and continue getting along with your partner and friends:– Explain that any amount and any type of drug can hurt your

unborn baby.1

– Keep several alternate activities in mind that you, your partner, and your friends enjoy doing.

– Be assertive!– If you cannot stop using illicit or social drugs:

• Talk with your doctor• See community services and intervention• Ask your partner and friends for support

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Slide 44

Helping Pregnant Partners and Friends Stop Using Drugs

• Share information about prenatal drug exposure and the importance of not using drugs during pregnancy.7

• Model safe behavior by not using drugs yourself and attend social gatherings that do not involve drug use.7

• Encourage her to discuss the reasons leading her to use drugs (e.g., various problems in her life).7

• Help her find community services and/or interventions to help her stop using drugs.7

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Slide 45

Helping Families of Drug-Affected Babies

• Encourage families to contact medical, county, and community resources.

• Encourage families to visit their local school district’s early childhood and family education programs.

• Attend meetings or sessions with families as they learn about available services and interventions.

• Offer to stay and help care for the baby to relieve caregiver stress.

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Slide 46

National Statistics• More than 90 percent of pregnant women take or use some type of

drug (including prescription drugs and social drugs).1

• Each year, 550,000 to 750,000 infants have been prenatally exposed to drugs.4

• Two to three percent of all birth defects are attributed to the use of drugs during pregnancy.1

• Each year, an estimated 2.6 million infants are prenatally exposed to alcohol.3

• Each year, approximately 1.3 million infants are prenatally exposed to nicotine.3

• Each year, an estimated 92,400 infants are prenatally exposed tostimulants, 43,500 to hallucinogens, and 38,300 to sedatives.3

• Each year, the number of crack- or cocaine-exposed newborns ranges from approximately 30,000 to 100,000.3

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Slide 47

Conditions Associated with Prenatal Drug Exposure

• Birth defects5, 7

• Difficult to comfort (withdrawn or unresponsive)7

• Failure to thrive (FTT)2

• Fetal Alcohol Spectrum Disorders (FASD)4

• Increased susceptibility to infectious diseases2, 4

• Low birth weight4, 6, 7

• Miscarriage5, 7

• Neurobehavioral symptoms4

• Premature birth4, 5, 6

• Prenatal death6

• Small head size7

• Small size for gestational age4

• Sudden Infant Death Syndrome (SIDS)4, 6

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Slide 48

Birth to Two Years

• Problems interacting socially4

• Breathing problems6

• Cerebral palsy8

• Delayed language development4

• Disrupted sleep patterns4, 8

• Feeding difficulties4

• Hearing problems6

• Irritability4, 8

• Reduced cognitive ability8

• Poor fine motor skills4

• Poor weight gain8

• Seizures8

• Tremors8

• Vision problems5, 6

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Slide 49

Toddler and Preschool Years

• Abnormal and minimal play skills4, 8

• Problems interacting socially4

• Delayed language development8

• Difficulty organizing behavior8

• Difficulty processing auditory information and instructions4

• Difficulty processing visual information and instructions4

• Difficulty transitioning between activities4

• Hyperactivity4

• Lack of tolerance for frustration8

• Mood swings with loss of control4

• Shorter-than-normal attention span4

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Slide 50

Early School and Teenage Years

• Greater risks with: – Behavioral problems

– Learning disabilities

– Neglect and abuse

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Slide 51

Follow-up and Long-Term Care• Use of adapted activities to meet the child’s abilities and needs4

• Emotional control by caregivers to reduce anger, frustration, and disappointment4

• Avoidance of abrupt transitions8

• Avoidance of excessive touching8

• Fairness, firmness, and consistency in expectations, limits, anddiscipline8

• Encouragement of self-control and the use of calming behaviors4

• Predictable routines4

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Slide 52

Follow-up and Long-Term Care – cont.• Introduction of new activities and skill-building when child is calm and

receptive4

• Calm and secure environment4

• Physical, gentle touches during care4

• Protection from bright lights and noise8

• Limited environmental distractions4

• Gentle but firm tactile stimulation around the face8

• Special positioning techniques to improve posture and movement8

• Specific containment measures (e.g., swaddling, holding firmly against caregiver’s skin)8

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Slide 53

Follow-up and Long-Term Care – cont.Beneficial intervention strategies• Helping the whole family as a unit• Integrating the family’s needs with existing community services• Obtaining competent, consistent, sensitive, and respectful care• Obtaining parenting skills training• Creating partnerships between parents, caregivers, and health and

educational providers• Promoting the child’s bonding with at least one person in his or her life

(need not be a parent)• Referring the family to agencies providing drug treatment and

intervention

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Slide 54

Financial Costs

• Newborns and infants may experience longer and additional hospital stays as a result of maternal drug use and\or alcohol use

• Subsequent abandonment. This extra care has significant financial costs: $47 million annually

• An additional $360 million each year in hospital costs for newborns

• An additional $47 million each year for housing abandoned babies beyond medical requirements

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Slide 55

Financial Costs – cont.

Individual, Family, and Social Costs• Disruptive school experiences10, 11

• Incomplete education12

• Unemployment12

• Psychiatric problems11, 12

• Inappropriate sexual behavior11

• Criminal behavior11, 12

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Extra Nurturing

• A loving, nurturing, and stable home life12, 13

• Avoidance of disruptions, transient lifestyles, or harmful relationships12

• Consistent routines10

• Limited stimulation10

• Concrete language and examples10

• Multi-sensory learning (visual, auditory, and tactile)10

• Realistic expectations10

• Supportive environments10

• Supervision10

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Prenatal Drug Use Presentation Endnotes

1. The Merck Manuals. (2007, May). Drug use during pregnancy. Retrieved from http://www.merck.com/mmhe/sec22/ch259/ch259a.html

2. Gomby, D. S., & Shiono, P. H. (1991). Estimating the number of substance-exposed infants. The Future of Children, 1(1), 17-25.

3. Organization of Teratology Information Services. (2001, August). Cocaine and pregnancy. Retrieved from http://otispregnancy.org/pdf/cocaine.pdf

4. National Toxicology Program. (2006, September 28). Drugs. Retrieved from http://cerhr.niehs.nih.gov/common/drugs.html

5. ARCH National Resource Center for Respite and Crisis Care Services. (1997, April). Children with prenatal drug and/or alcohol exposure. Retrieved from http://www.archrespite.org/archfs49.htm

6. Organization of Teratology Information Services. (2005, September). Dextroamphetamine/Methamphetamine and pregnancy. Retrieved from http://otispregnancy.org/pdf/methamphetamines.pdf

7. Kronstadt, D. (1991). Complex developmental issues of prenatal drug exposure. The Future of Children, 1(1), 36-49.