Are you raising a grandchild (or niece or cousin) whom you suspect was prenatally exposed to alcohol or drugs? Do they have a confirmed diagnosis? You may wonder when and how to explain prenatal exposure to them. Avoiding the topic can lead to shame, confusion, and feelings of self-blame in the child. Telling them too much information too soon can confuse them.
How can you explain the complex issue of prenatal exposure to this child in a way that they can process, heal, and move forward? It might help to think of building your grandchild’s story like building a house.
Building Your Grandchild’s Understanding of Prenatal Exposure
Prepare the site.
Before a builder starts construction, they must get the ground ready. The same applies to having difficult conversations with children.
1. Identify your purpose.
Whether or not your grandchild has a confirmed diagnosis or you just strongly suspect that their mom used alcohol or drugs when pregnant, think through your purpose for telling the child. Knowledge can be empowering. It can help the child understand their struggles, and seek out the support they need to be successful in life. But while it can be a relief to know why they are different; it can also cause sadness.
2. Identify your feelings.
Another way to lay the groundwork is to identify your personal feelings about prenatal exposure and the child’s birth mother. You likely feel some degree of anger and frustration. Why would someone risk the health of their baby by abusing alcohol and drugs?!? However, most moms don’t want to hurt their baby. Alcoholism and drug addiction can happen to anyone and make it hard to make good choices. Is there room in your mix of feelings for some empathy for her struggles? Can you extend some grace to her? It’s helpful to be able to model these traits for the child.
Build the foundation.
A well-built house starts with a strong foundation. Courageous conversations such as this one can’t happen with your grandchild until you’ve built a foundation of love and trust with them. Only then can they believe what you say and feel safe hearing and processing difficult information. If this child has come to you with a deep mistrust of parental figures, this may take even longer.
1. Create routine, safety, and predictability.
Many kids come to us from chaotic or neglectful environments. Finding ways to create order, routine, and nurture for this child will strengthen the foundation of trust. For example, if you know his favorite bedtime blanket needs to be washed, get his permission first. Then on laundry day, invite him into the process. Show him that it will be clean and dry by bedtime.
2. Give the comfort that works.
Many kids need access to favorite foods to feel comforted and nurtured. For example, if you know that peanut butter with strawberry jelly is a comforting food, make sure he can see the extra jars of strawberry jelly you keep “just for him.”
The point is to do whatever reassures this child that you will meet his needs and wants because you love him. You aren’t spoiling him! And even *if* it feels like you are, this kiddo deserves the lavish love that tells him that he is valued and cherished.
3. Help the child shine!
Identify your grandchild’s (or cousin’s) strengths and give them plenty of opportunity to pursue those strengths. Even when their activities or attempts don’t succeed, don’t let this child feel like they are the failure. Prenatal exposure is just one part of their story. Nurture the things they’re good at to strengthen their foundation.
Follow the plan.
Every builder has some kind of plan they follow, whether designed by an architect, scribbled on a piece of paper, or imagined in their head.
1. Take your time laying out the information.
Your plan to explain prenatal exposure to your grandchild should include timing the conversations. It will not happen overnight! Rome wasn’t built in a day, and neither will your child’s knowledge of prenatal exposure. It will take multiple conversations at multiple times throughout their life.
2. Timing is everything.
Think about your grandchild’s current situation before telling them more about their prenatal exposure. For example, if they just had an upsetting visit with their birth parents or recently got in trouble at school, it’s not the time to add more information about their prenatal exposure. Look for those windows of time when your grandchild is calm and open.
3. Plan your materials.
Builders make materials lists before they begin a project. Your plans to share this child’s story can also include a list of materials. There are books about brain differences and prenatal exposure that can help. Stories using animals or other children can make the information feel less personal and soften the harsh realities the child faces. Make observations or ask open-ended questions to help your grandchild connect what is in the books to their life.
Here are some titles to get you started:
- “A Walk in the Rain With a Brain” is a picture book for young children that celebrates how each person’s brain is unique.
- “Sam’s Bear” is a picture book for young children. Developed by the National Indian and Inuit Community Health Representatives Organization, it is about substance use during pregnancy and brain development. You can find a read aloud version here.
- “Strawberry and Crackers” is a series of illustrated children’s books about twins with Fetal Alcohol Syndrome.
- “The Way I Am is Different” is about an elementary age boy with Fetal Alcohol Spectrum Disorder. This book helps children understand their “different” is perfectly okay, and they are not alone.
- “Hugs for Teens with FASD: A Book of Encouragement” is written for teens and young adults who struggle with their disability. It is a book filled with helpful quotes and ideas to help teens through different emotions they may be feeling due to prenatal exposure.
Get to work!
Sometimes builders have to wait for the right weather conditions to begin their project. You will need to decide when the time is right to start these conversations with your grandchild. Are they old enough to understand in the way you will tell them? Are they secure enough to believe you and handle tough information?
Diane Malbin, MSW an expert on prenatal exposure and the parent of a daughter with fetal alcohol spectrum disorder. She says you should start talking with children about their prenatal exposure as early as possible, in a way that’s developmentally appropriate. It’s important that you reassure your grandchild that they are not the problem, rather they have a problem. And that this problem has solutions. This assurance can help prevent frustration and increase understanding and confidence for you both.
Provide a lifetime warranty.
A good builder doesn’t just start the house. He also finishes it, patches nail holes, and returns to make repairs. Many offer a warranty that guarantees their work for years to come. In other words, revisit the conversations about prenatal exposure many times throughout this child’s life. You will help them understand themselves and prepare for adulthood. They will need your guarantee of love and support throughout their life as they process this and other challenges they face.
If you’d like more information, Fetal Alcohol Spectrum Consultation Education and Training Services (FASCETS) has a great tip sheet for talking with children, teens, and adults about prenatal exposure and other brain-based conditions: https://fascets.org/wp-content/uploads/2020/07/Talking-about-FA-NB.pdf
You might also want to read the article, “Building the Framework for Adopted and Foster Children to Process the Hard Parts of Their Stories.”