Transcript Healthy Start Coalition of Flagler and Volusia Counties, Inc

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 & Assessment
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Perinatal Periods of Risk (PPOR)
Alcohol, Tobacco, & Other Drugs
Child Abuse & Neglect
Other - Developmental
Protective Factors
Perinatal Periods of Risk
• Biopsychosocial Approach
• Age, Weight, History LBW or loss, Illness
& Infection,
• Practical Support, Stressors, Access,
Environment
• Mental Health& PPD, Substance Use,
Violence, Hunger, 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)
Stages of Change
PreContemplation
Contemplation
Preparation
Maintenance
Action
Child Abuse & Neglect
• History of Maltreatment or Domestic
Violence
• Timing & History of Pregnancy
• ACES - Adverse Childhood Experiences
• Criminal History
• Indicators vs. Predictors
Protective Factors
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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
Support 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
Planning - 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
Planning - Infancy
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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
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Fear of systems
Unresolved Trauma
Transportation
Employment/Income
Health Care
Treatment
Child Care
Housing
Questions?
Thank You!!