Alcohol and Drug Exposure Issues in Adoption

The potential for social, emotional, cognitive or physical delays or disabilities.

By Stephanie Bosco-Ruggiero, Gloria Russo Wassell and Victor Groza, authors of Adopting Older Children

Some pregnant mothers use alcohol and other drugs to suppress the pains of hunger. Some use them recreationally before they know they are pregnant. Some use them because they are addicted and unable to stop during pregnancy. The most common drug used during pregnancy is tobacco. Each drug has different effects on the developing fetus. The one that has been most widely studied is alcohol.

Fetal alcohol spectrum disorders (FASD) is a term used to describe a range of problems caused by prenatal exposure to alcohol. FASD includes Fetal Alcohol Syndrome (FAS), Alcohol-Related Neurodevelopmental Disorder (ARND), Alcohol-Related Birth Defects (ARBD) and behavior difficulties assumed to come from prenatal alcohol exposure. Physical FASD can result in birth defects, epilepsy, vision problems, poor muscle control, a lack of coordination, heart defects, problems with other internal organs, dental problems, hearing problems, growth issues and problems with brain development.

FAS is the most serious FASD. Children diagnosed with FAS can have profound physical, neurological, cognitive and growth problems. According to the Centers for Disease Control, children diagnosed with FAS have facial feature abnormalities including wide-set or narrow eyes, growth problems and nervous system issues that may or may not affect the brain structure. Children diagnosed with FAS often exhibit profound delays in cognitive, social and/or emotional functioning.

Your adoption agency may be able to tell you if your child's biological parents had substance abuse problems. If the biological parents did abuse drugs or alcohol, ask if your child was ever evaluated for FASD. Parents adopting internationally are less likely to get accurate information about their child's biological parents' lifestyle choices and health. Some adoptive parents do not know for certain that their child was exposed prenatally to drugs or alcohol but suspect he or she was. IF you are worried about prenatal exposure of our child and cannot live without knowing, you may not want to consider international adoption.

FASD problems are manageable with physical and occupational therapies, special education and medication, but FASD is not curable. Children diagnosed with FASD may have profound challenges throughout their lives. If your child has been diagnosed with FASD, stay current with the latest research about treatment, join a support group, visit relevant websites (such as the Fetal Alcohol Spectrum Disorders Center for Excellence), and maintain an open dialogue with your child's doctors, therapists, psychiatrist and teachers about how your child is doing.

Children exposed prenatally to illicit or even legal drugs that are harmful to a developing fetus could also exhibit social, emotional, cognitive or physical delays or disabilities as they develop. You may be able to get some information from a domestic adoption agency about the biological mother's history of drug abuse, but the full extent of her problem may not be known.

Researchers have difficulty separating out the effects of neglect, low birth weight, premature birth and other socioeconomic disadvantages from the long-term effects of prenatal drug exposure. The good news is that most researchers believe that careful monitoring by pediatricians and sound parenting practices can help children who have been exposed to drugs prenatally lead healthy lives. Notably, the research studies conducted by Stacy Buckingham-Howes et al. have shown that a majority of the children born to cocaine-addicted mothers in the 1980's did not grow up with the profound difficulties that were expected. In fact, as many media reports, including Susan Okie's in the New York Times, have illustrated, most of thee children have grown up to be productive, happy, functional adults.

In an ideal world, no child is exposed to alcohol, drugs or toxins while in utero or has to live in a family that neglects or abuses him or her. Yet this is reality for thousands of children, including children available for adoption. Our intent in mentioning these problems is not to frighten you, but to make you aware of all the possible difficulties you might encounter. While there is cause for concern, and you deserve information as complete and accurate as you can get, in life there are no guarantees. You might adopt a child who had prenatal alcohol exposure and suffers no effect you you might adopt a child with no known prenatal alcohol exposure who has some difficulties in her life. All you can do is deal with the hand you were dealt and work at creating the best life for you and your family.

Reprinted from the book Adopting Older Children, A Practical Guide to Adopting and Parenting Children Over Age Four, by Stephanie Bosco-Ruggiero, Gloria Russo Wassell and Victor Groza, with permission of the authors. Copyright protected, all rights reserved.