1. LANGUAGE DEVELOPMENT OF CHILDREN PRENATALLY EXPOSED TO DRUGS AND/OR ALCOHOL; IMPACT OF AIDS

2. I. BACKGROUND AND DEFINITIONS** Children with prenatal drug and/or alcohol exposure (PDAE) are a very heterogeneous group Fetal Alcohol Spectrum Disorder (FASD) 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 FASD, but to a lesser degree

3. Statistics:** FASD is the leading cause of intellectual disability in the Western world It is entirely preventable FASD accounts for 1 in every 500-600 births in the U.S.

4. **There are studies linking an average of 1-2 drinks a day during pregnancy to low birthweight, growth abnormalities, and behavioral problems in newborns

5. Costs estimated nationally in U.S.:** (this slide is not on the 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

6. ** 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

8. 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

9. 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

10. III. CHARACTERISTICS OF CHILDREN WITH FASD**

16. 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

17. Olswang et al. (2011) found that:

18. Thus, we may need to:

19. 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

20. Substance Abuse and Child Welfare, 2014:** Each year, an estimated 400,000 infants (10- 11%) are affected by prenatal alcohol or drug exposure

21. 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”

23. V. BEHAVIORS AND CHARACTERISTICS OF DRUG-EXPOSED 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

25. **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***

26. **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

27. VI. SUGGESTIONS FOR INTERVENTION

28. Work on pragmatics skills:

29. Keep things structured and not overstimulating:

30. Remember that these children often do not retain what they learn, so…

31. 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

32. Lewis et al (2013) Language outcomes at 12 years for children exposed prenatally to cocaine. Journal of Speech, Language, and Hearing Research, 10/13.

33. 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

34. In addition….

35. 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

36. We can specifically work on: