Transcript LANGUAGE DEVELOPMENT OF CHILDREN PRENATALLY …

LANGUAGE DEVELOPMENT OF
CHILDREN PRENATALLY
EXPOSED TO DRUGS AND/OR
ALCOHOL; IMPACT OF AIDS
I. BACKGROUND AND
DEFINITIONS**
• Children with prenatal drug and/or alcohol
exposure (PDAE) are a very heterogeneous group
• Fetal Alcohol Syndrome (FAS) (Fetal Alcohol
Spectrum Disorder) involves damage to an unborn
baby due to the mother’s alcohol consumption
during pregnancy
• The child who has Fetal Alcohol Effects (FAE) has
problems similar to those of a child with FAS, but
to a lesser degree
Statistics
Owens, Farinella, & Metz 2015**
• FAS accounts for 1 in every 500-600 births
in the U.S.
• **There are studies
linking an average of 12 drinks a day during
pregnancy to low
birthweight, growth
abnormalities, and
behavioral problems in
newborns
Costs estimated nationally in
U.S.:** (not on exam)
• $14.9 million for treatment of
FAS babies
• $670 million total treatment
costs for FAS children under 18
• Lifetime care for ONE child
born with FAS is $2.62 million
**
• First trimester of pregnancy--period of
brain growth, organ and limb formation
• Embryo most susceptible to alcohol from
weeks#2-8 after conception
• New research: if a woman drinks during
the first week after conception, there can
be negative effects
Paul & Norbury, 2012:
II. PATERNAL ALCOHOL
CONSUMPTON & SMOKING**
• In one review of data on nearly 15,000
newborns, scientists concluded that a
father’s drinking and smoking habits can
increase his child’s risk of birth defects,
ranging from cleft palate to hydrocephalus
• Ongoing exposure to job chemicals can
predispose a man’s baby to low birthweight
and birth defects
Smoking and alcohol can
damage sperm**
• Male smokers double their chances of
fathering babies with problems like
hydrocephalus
• Recommended: men abstain from smoking,
drinking for 5-6 months before ch conceived
III. CHARACTERISTICS OF CHILDREN
WITH FAS**
• 1. Small head—microcephaly**
• 2. Pre- and post-natal growth problems; low
birth weight and length
• 3. Central nervous system dysfunction
delayed motor development, mild-profound
mental retardation, learning disabilities
17. The eyes may be set wide apart also
Olswang, Svensson, & Astley (2011). Observation of
classroom social communication of FASD
children…Journal of Speech, Language, & Hearing
Research, 53, 1687-1703.**
• Examined social classroom skills of typically
developing (TD) and Fetal Alcohol Spectrum
Disorder (FASD) students
• 12 pairs of ch observed in classrooms 20
minutes a day for 4 days across 2 weeks
Olswang et al. (2011) found
that:
Thus, we may need to:
Youtube**
• Fetal Alcohol Syndrome
• Students Like Me: Episode 1 of 9
IV. CHILDREN WITH PRENATAL
DRUG EXPOSURE:
INTRODUCTION**
• The National Institute on Drug Abuse
estimates that 5.5% of women use some
illicit drug during pregnancy
• Drugs that do the most serious damage to
the developing fetus are cocaine, heroin,
morphine, and LSD
National Center on Substance
Abuse and Child Welfare,
2014** (not on test)
• Each year, an estimated 400,000–
440,000 infants (10–11% of all births) are
affected by prenatal alcohol or illicit drug
exposure
Problems in pregnancy…**
• For mothers who use
cocaine, this causes her
blood vessels to constrict,
thus reducing the flow of
oxygen and other nutrients to
the baby
• The baby is “dealt a small
deck”
Goldberg et al. May 2010 Communication
Disorders Quarterly**
• Article:
• Methamphetamine exposure, iron
deficiency, and implications for cognitivecommunication function: A case study
Whether an expectant mother snorts,
smokes, shoots, or orally ingests meth…**
• Mother: problems w/ memory, judgment,
emotions, sleep, appetite, aggression
• Alters activity of neurotransmitters in the brain—
especially dopamine, serotonin, norepinephrine,
epinephrine
Problems for babies prenatally exposed to
meth:
Meth-exposed children also…
Effective treatment of iron deficiency…
V. BEHAVIORS AND
CHARACTERISTICS OF DRUGEXPOSED CHILDREN**
• Fewer spontaneous vocalizations from
infancy
• Lack of appropriate gestures and words
to communicate needs
• Poor visual tracking
• Gross and fine motor problems
• Decreased awareness of body in space
• **Indiscriminate attachment to new people
• Decreased responsiveness to praise,
rewards
• Decreased use of gestures and words to
initiate social interactions; poor eye
contact
• Articulatory-phonological disorders
• ***Language difficulties that are not easily
determined by standardized measures***
**Because of this:
• In assessment, it may be best to informally
evaluate these children’s language skills in
everyday settings
• These children may not qualify for therapy
in the public schools
VI. SUGGESTIONS FOR
INTERVENTION**
• EARLY INTERVENTION KEY
• Studies: parents of cocaine-exposed children ↑
insecurity, disorganization, avoidance of
attachment
• Look at environment, work w/ parents
Work on pragmatics
skills:
Keep things structured and not
overstimulating:
Remember that these children often do
not retain what they learn, so…
Also…**
• Help them learn appropriate play skills,
especially cooperative play involving other
children
• Give physical movement breaks; don’t
expect them to sit still for long periods of time
Lewis et al (2013) Language outcomes at 12
years for children exposed prenatally to
cocaine. Journal of Speech, Language, and
Hearing Research, 10/13.
VII. LANGUAGE AND BEHAVIORAL
CHARACTERISTICS OF CHILDREN
WITH HIV/AIDS**
• HIV manifests primarily in the central
nervous system
• Children may have chronic OME
• They may also have delays in
communication skills
In addition….
VIII. SERVICE DELIVERY**
• One issue for babies with HIV/AIDS is
prolonged hospitalization
• Language stimulation is minimal
• Thus, we can provide early language
stimulation programs, working with the
family
We can specifically work on: