1. 1 st National Conference on Substance Abuse, Child Welfare and the Dependency Court Developing and Implementing Services for Children within the Substance Abuse Treatment Environment J u l y 1 4, 2 0 0 4 Kathy Icenhower, PhD, LCSW Executive Director SHIELDS For Families, Inc. Sara Tienda, MSW Assistant Director SHIELDS For Families, Inc.

2. In The Beginning

3. Treatment Commandments This was the context of treatment when we opened our first perinatal program.

4. We quickly found out that our families had not read the commandments

5. Our first client showed up with a six month baby… that was fine… it met the criteria… … then she brought her six year old and her 15 year old… now what do we do? That didnt follow the rules… and on top of that… these kids had problems

6. … who was prenatally exposed to drugs, was born prematurely. According to her pediatrician, she had a feeding disorder and some developmental delays. The Baby… She was constantly crying and appeared to have difficulty bonding with her mother.

7. … was overly parentified. She ran the household, The Six Year Old… took care of the baby and cared for her mother when the mother was incapacitated by drug use.

8. The Fifteen Year-Old… … had been expelled from school for marijuana use And that was just the first family had anger issues (especially toward her mother) and was sexually active.

9. We began to see more and more children with different sets of problems. We had to begin to modify our services to better meet the needs of the children in our program. Including the fact that we had to begin to serve all the children in the family no matter how many, how old or how many problems they had. In this presentation, we will discuss how we went about developing and implementing services for the different age groups of children seen by the program.

10. The risk factors that will be discussed are not consistent with every child coming from a substance abusing family. Generally speaking, the issues children experience are based on several factors – however the longer they have been separated from their mother, the age intervention begins, and what their living environment has been prior to enrolling in services – are all critical factors that affect their growth and development.

11. Children: Ages 0 - 5 Developmental Delays – due to prenatal exposure to drugs or socioeconomic factors Risks/Consequences of Substance Abuse Difficulty with bonding/attachment – especially if removed from mothers custody at birth Medical problems – FAS, asthma, high risk for SIDS, failure to thrive

12. Children: Ages 0 - 5 1.On Site Child Care Services Services/Strategies 2.Developmental Screenings and Assessments

13. Children: Ages 0 - 5 3.Individual Education Plans Services/Strategies 4.Developmental Activities Responsive to Needs

14. Children: Ages 0 - 5 5.Specialized Services to Children with Identified Developmental Needs Services/Strategies 6.Child Development and Parenting Education

15. Children: Ages 0 - 5 7.In-home and Individual Parenting Education Services/Strategies 8.Access to and Provision of Health Care

16. Children: Ages 6 - 18 Difficulty with life skills Risks/Consequences of Substance Abuse Poor social skills Poor school performance Lack of supervision High risk for early drug use

17. Children: Ages 6 - 18 Chaotic family environment Risks/Consequences of Substance Abuse Sexually Acting Out Behaviors High Risk for child abuse & neglect Mental health problems High risk for involvement with the Juvenile Justice System & with gang affiliation

18. Children: Ages 6 - 18 Individual Domain Services Service/Strategies Alcohol and Drug Education Problem Solving Decision Making/Goal Setting Communication Skills Self-Esteem Building Cultural Enrichment Activities

19. Children: Ages 6 - 18 Individual Domain Services Service/Strategies Gender Based Activities Alternative Activities Case Management Linkage to Services Individual Counseling Mental Health Services

20. Children: Ages 6 - 18 Family Domain Services Service/Strategies Parenting Education Parent/Youth Interaction Communication Skills Family Counseling Family Reunification

21. Children: Ages 6 - 18 School Domain Services Service/Strategies Tutoring Computer Lab Academic Enrichment Parent/School Involvement Program/School Involvement

22. Children: Ages 6 - 18 Peer Domain Services Service/Strategies Group Counseling Youth Advisory Council/Leadership Training Alternative Activities

23. Children: Ages 6 - 18 Community Domain Services Service/Strategies Mentoring Community Service

24. Discussion Presented by SHIELDS For Families, Inc. IT Department, ©2004