It seems likely that the behaviors you are seeing in your sister's children are due to a combination of the medical consequences of their parents' substance use or abuse, and environmental factors. Unlike Fetal Alcohol Syndrome, which results in profound and obvious damage to the child's physiological development, some of the parental behaviors you note may result in more subtle problems.
For the record,FAS has three major features: 1)Fetal growth retardation, in other words,low birth rate or size; 2)Facial dymorphism, or distortions of the facial features; and 3) Central nervous system dysfunction, such as irritability, poor sucking, and crying that does not respond to attempts to comfort.
Cocaine has some potentially serious, but less obvious, adverse consequences to the fetus. Since cocaine restricts or narrow blood vessels, blood flow to and from the fetus may be restricted, which inhibits nutrients ond oxygen from reaching the fetus, while impairing the discharge of waste products. Irritability and impaired cognitve development may be a result. Crack cocaine use by pregnant women may also increase the chance of premature labor and placental disruptions.
To complicate things, women who abuse substances frequently have environmental and lifestyle disruptions, such as poor nutrition, risky sexual behavior, and poor pre-natal care.
Less recognized, but equally important, is Fetal Tobacco Syndrome (FTS. Although you did not mention tobacco use, it has been estimated that approximately 85% of substance abusers also smoke cigarettes. Complications of FTS include miscarriages, crib death (Sudden Infant Death Syndrome), and proneness to respiratory illnesses. Neuro-behavioral problems, such as Attention Deficit Disorder, are more likely for children whose parents smoke during or after pregnancy. A recent study published in the Archives of General Psychiatry reports that women who smoke are more likely to give birth to boys who are later diagnosed with Conduct Disorder.
The effects of marijuana use are less clear. Studies suggest there may be some alterations in blood flow and oxygen delivery to the fetus when marijuana is administered to pregnant animals.
These medical problems are often combined with parental inconsistency in limit-setting and nurturance. A full discussion of these environmental and parenting factors is beyond the scope of this forum. Briefly, parents who abuse substances frequently have maladaptive coping mechanisms, and life circumstances complicated by the consequences of their substance use, such as poverty, homelessness, and violence. Furthermore, they may be pre-occupied with obtaining and ingesting the substances. As a result of all these factors, substance abusing parents may be overwhelmed with the demands of parenting. Children who start out life needing special attention and patience because ofthe effects of their parents' substance use can be further victimized if their parents lack the emotional and financial resources to provide much beyond minimal care-taking.
It is admirable you have agreed to provide a more stable environment for these children. They may require extra efforts to overcome the handicaps thet have experienced so far, and may present challenges to your parenting skills. YOu may want to seek out community resources to support yourselves in these efforts. At a minimum, these children will require stable and dependable relationships, firm but understanding limit-setting, clear values and guidelines, and good medical care, including psychological and neurological evaluations, especially if they continue to have behavioral or academic problems.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment optionspertaining to your specific medical condition.
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