Download - Mitigating Risks of Substance Exposed Infants and Their Families Dixie L. Morgese, BA, CAP, ICADC
Learning Objectives
• Review models of risk determination (PPOR, ATOD, and CAN)
• Discuss risk mitigation strategies used in home visiting and family coaching
• Gain understanding of Strengthening Families Protective Factors as a Framework
• Learn strategies for enhanced risk mitigation using the Protective Factors Framework
Risk Screening & AssessmentRisk Screening & Assessment
• Perinatal Periods of Risk (PPOR)Perinatal Periods of Risk (PPOR)
• Alcohol, Tobacco, & Other DrugsAlcohol, Tobacco, & Other Drugs
• Child Abuse & NeglectChild Abuse & Neglect
• Other - DevelopmentalOther - Developmental
• Protective FactorsProtective Factors
Perinatal Periods of RiskPerinatal Periods of Risk
• Biopsychosocial ApproachBiopsychosocial Approach• Age, Weight, History LBW or loss, Illness & Age, Weight, History LBW or loss, Illness &
Infection,Infection,• Practical Support, Stressors, Access, Practical Support, Stressors, Access,
EnvironmentEnvironment• Mental Health& PPD, Substance Use, Violence, Mental Health& PPD, Substance Use, Violence,
Hunger, Timing of Pregnancy, RelationshipsHunger, Timing of Pregnancy, Relationships
Alcohol, Tobacco & Other Drugs*
• 5 P’s Screening Instrument (includes violence)
• ASI – Addiction Severity Index - onset, type of substance, frequency, dosage, route of administration. (concentrate on three months prior to and during pregnancy)
• Stages of Change (Readiness)
Child Abuse & Neglect
• History of Maltreatment or Domestic Violence
• Timing & History of Pregnancy
• ACES - Adverse Childhood Experiences
• Criminal History
• Indicators vs. Predictors
Protective Factors
• Family Resilience
• Social Connections
• Parent Knowledge of Child Development
• Nurturing and Attachment
• Social and Emotional Competence
• Practical/Concrete Support in Times of Need
Strength Based Family Strength Based Family Support Planning - PrenatalSupport Planning - Prenatal
• Medical Risk – access, awareness, support, address barriers – carry pregnancy to term, coordinate with prenatal clinical provider, ICC.
• Behavioral Health - supports, resilience, history of success, social connections, parenting, childbirth ed. & plan, options.
• Environmental – housing, preparation, safety.
Strength Based Family Support Strength Based Family Support Planning - BirthPlanning - Birth
• Multi-disciplinary staffing activities to support birth plan
• NICU staff support, handling techniques, nurturing & attachment, breastfeeding, social connections – labor support
• Substance Abuse & Mental Health Treatment Options
• Medical – linkage to and coordination with pediatric and developmental services.
Strength Based Family Support Strength Based Family Support Planning - InfancyPlanning - Infancy
• Linkage to pediatric and developmental services• Ensure caregivers are aware of unique needs of infant• Consider all caregivers with access• Address safe sleep• Consider respite• Foster self regulation and routine – access to child care
services• Siblings• Child Welfare systems that may be involved.• Strive for Social Equality, Parent Engagement, and foster
empowerment.
Post Partum
• Post Partum check-up – family planning, follow up on health conditions, ongoing health care access.
• Post Partum Depression – support exercise, self care, personal awareness, social connections.
• Recovery – twelve step support, follow up on recovery plan.
• Other
Address Barriers
• Fear of systems
• Unresolved Trauma
• Transportation
• Employment/Income
• Health Care
• Treatment
• Child Care
• Housing