AAP encourages pediatricians to screen for parental substance abuse
Pediatricians are encouraged to screen their patients’ parents for substance abuse, be alert for symptoms of child abuse or neglect, monitor children for developmental and academic delays and be familiar with mandatory reporting requirements for suspected neglect or abuse, according to an AAP clinical report.
“Being familiar with effective harm reduction strategies and prepared to inform public debate on how to use evidence-based strategies to protect and advocate for children whose parents have [substance use disorders] are important roles that the pediatrician can assume,” Vincent C. Smith, MD, MPH, and Celeste R. Wilson, MD, both researchers at Boston Children’s Hospital, and the AAP Committee on Substance Use and Prevention wrote. “In addition, medical professionals are mandatory reporters of suspected child maltreatment and may be the only professionals who have the opportunity to recognize that a child, especially one of preschool age, has been abused or neglected.”
The authors and the committee pooled data from recent studies and a 2013 national government survey on drug use and health to develop the report. It highlights the short-term effects of maternal substance use during pregnancy and the long-term consequences of fetal exposure, developmental and behavioral differences in children in homes with substance abuse. It urges pediatricians to mandate family screening and report signs of abuse and neglect, and pediatricians are encouraged to direct substance abuse-positive families to local and state resources for assistance.
Results from the recent literature included studies that estimated 8.3 million children in the United States aged younger than 18 years (12%) were living with at least one substance user or substance-dependent parent between 2002 and 2007. Smith, Wilson and the committee suggested that proficiencies range across three levels depending on the pediatrician’s acquired knowledge of treating families with substance use. Also, they encouraged multiple approaches, including collaborating with other physicians, in screening parents for substance use and physically examining children in cases of suspected child abuse or neglect.
“A transparent, caring, and direct approach when engaging the substance-using parent will help increase the likelihood of maintaining an ongoing relationship, which often is in the child’s best interest,” they wrote. “Parents may be willing to enter treatment of the sake of their children, as they often realize that their substance abuse is interfering with their ability to be the parent they want to be; in this regard, pediatricians have a unique opportunity to intervene to help improve the lives of the family.” – by Kate Sherrer
Disclosure: The researchers report no relevant financial disclosures.