A Court Team Model for Young Children in Foster Care: The Role of Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorders

Abstract

Prenatal alcohol exposure (PAE) is common with about 80,000 women continuing to drink through all three trimesters of pregnancy each year. PAE is also associated with postnatal adversities, including abuse and neglect, which increase risk for foster care placement. Each day 700 children enter the foster care system. A diagnosis of Fetal Alcohol Spectrum Disorders (FASD) also increases the risk for foster care placement. Among children diagnosed with FASD 70% are or have been in foster care. FASD prevalence rates are increased 10- to 15-fold in foster care systems. Foster care is an important opportunity to detect FASD and provide services to infants and children with FASD. FASD is the third most common identifiable cause of mental retardation in the United States. We describe a court-team-based model of care developed to improve management of children with PAE or FASD entering foster care. The programmatic objectives include: enhancing detection of PAE; screening for FASD; increased consideration of FASD as a potential issue in treatment planning with foster parents; improved entry into treatment; and increased surveillance for parents with an FASD.