Prenatal alcohol and other substance exposure can result in long-term developmental impairments in children, presenting challenges to parents and other caregivers. Child welfare professionals can help identify prenatal substance exposure in children and guide families to needed services and supports. Families of color and low-income families are disproportionately reported to child welfare because of substance use during pregnancy and are more likely to have their children removed and placed in out-of-home care. Therefore, child welfare professionals should ensure the screening methods and decision-making processes they apply do not have racial or other biases.
Services tailored to families impacted by substance use are critical to help keep families together and address challenges caused by prenatal alcohol and other substance exposure. Child welfare agencies should partner with families, especially families of color and those who are economically disadvantaged, in a culturally appropriate manner and using a racial equity lens. Use the resources in this section to learn more about prenatal alcohol and other substance exposure and how to effectively engage impacted families
Disrupting Stigma: How Understanding, Empathy, and Connection Can Improve Outcomes for Families Affected by Substance Use and Mental Disorders (PDF - 1,938 KB)
National Center on Substance Use and Child Welfare (2022)
Presents information to help reduce stigma in interactions with families affected by substance use and offers strategies to successfully engage with this population.
Factors Contributing to Level and Type of Child Welfare Involvement Following Prenatal Substance Exposure: A Scoping Review
Peddireddy, Austin, & Gottfredson (2022)
Child Abuse & Neglect, 125
Examines factors associated with child welfare decision-making and outcomes in cases of prenatal substance exposure. The findings show that factors such as socioeconomic status, race, and substance type were associated with different outcomes for families.
How States Serve Infants and Their Families Affected By Prenatal Substance Exposure [Series]
National Center on Substance Abuse and Child Welfare (2021)
Offers a series of briefs that highlights States’ approaches to working with infants and families affected by prenatal substance exposure.
- Brief 1: Identification and Notification (PDF - 2,202 KB)
- Brief 2: Plans of Safe Care Data and Monitoring (PDF - 3,292 KB)
- Brief 3: Lessons From Implementation of Plans of Safe Care (PDF - 3,209 KB)
Infants With Prenatal Substance Exposure and Their Families: Five Points of Family Intervention (PDF - 8,952 KB)
National Center on Substance Abuse and Child Welfare (2020)
Provides information on key times when cross-system, collaborative efforts can work to prevent prenatal substance exposure, address the needs of pregnant and parenting women with substance use disorders, and respond to the needs of affected children and families.
Plans of Safe Care for Infants With Prenatal Substance Exposure and Their Families
Prenatal Alcohol and Other Drug Exposures in Child Welfare Study: Final Report
Ingoldsby, Richards, Usher, Wang, Morehouse, Masters, & Kopiec (2021)
U.S. Department of Health and Human Services, Administration for Children and Families, Children’s Bureau
Presents findings from a study on child welfare interactions with families affected by prenatal alcohol and other substance exposure. The study measured child welfare staff knowledge of prenatal substance exposure, how information is shared, and how child welfare agencies interact with caregivers and service providers.
Tribal Family Wellness Plan Learning Module
Children and Family Futures (2021)
Presents a four-part training that guides Tribal child welfare professionals on how to implement programs to address substance use among pregnant and parenting families. The training covers program planning, partnerships, responding to infants and families affected by substance exposure, and family wellness programs.
Understanding Fetal Alcohol Spectrum Disorders: Child Welfare Practice Tips (PDF - 1,640 KB)
National Center on Substance Use and Child Welfare (2022)
Describes fetal alcohol spectrum disorders, their effects on child development, and treatments. This tip sheet also offers practice tips for child welfare professionals to help them support infants, children, and families affected by prenatal substance exposure.