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Special Topic – Understanding Prenatal Substance Exposure and Child Welfare Implications

Description and Objectives

The goal of this special topic training is to understand the unique needs of infants with prenatal substance exposure and their families. The training will cover the effects of prenatal substance use on an infant by providing an overview of fetal alcohol spectrum disorders (FASDs), neonatal abstinence syndrome (NAS), neonatal opioid withdrawal syndrome (NOWS), and withdrawal symptoms. Participants will gain knowledge in screening and treatment referrals for affected family members, including services to address the needs of infants who were prenatally exposed. Collaboration between the systems of care to serve infants and their families is critical for successful outcomes. The training will also highlight amendments made to the Child Abuse Prevention and Treatment Act (CAPTA) by the Comprehensive Addiction and Recovery Act (CARA) of 2016, specifically related to infants with prenatal substance exposure and their families.

After completing this training, child welfare workers will:

  • Discuss the context and prevalence of prenatal substance use
  • Identify the effects of prenatal substance use on infants and their families.
  • Discuss FASDs, NAS, and NOWS
  • Increase knowledge of screening and referral for treatment and resources
  • Identify the treatment needs of parents and infants
  • Value collaboration between systems of care for successful outcomes
  • Understand the implications of the CARA amendments to CAPTA related to infants with prenatal substance exposure and their families

Training Tips

  • Partner with a local expert on substance use disorders to co-facilitate the training
  • Share any community initiatives on opioids
  • Use the ***bolded discussion questions integrated in the module talking points to enrich the training
  • Share specific screening tools for substance use disorders used or vetted by the child welfare agency
  • Supplement content with information about how child welfare workers can locate treatment for parents in the community
  • Highlight child welfare programs that have expertise in serving families affected by substance use disorders or that provide family-centered treatment
  • Contact the National Center on Substance Abuse and Child Welfare for more information about using the Collaborative Values Inventory, a self-administered questionnaire that provides jurisdictions with an anonymous way of assessing the extent to which group members share ideas about the values that underlie their collaborative efforts, in your community


  • Computer and projector
  • Speakers
  • Internet access
  • PowerPoint slides
  • Facilitator's Guide
  • Flip chart paper or white board (for use as a visual aid during discussion)

Find Help with a Personal Situation

Substance Use and Mental Health Treatment Locator

To find treatment facilities confidentially, 24/7, please call 1-800-662-4357 (HELP).

To locate general treatment services, visit the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Treatment Locator online or call 1-800-662-4357 (HELP). This service provides referrals to local treatment facilities, support groups, and community-based organizations. It is a free, confidential, 24-hour-a-day, 365-day-a year information service, in English and Spanish, for individuals and family members needing treatment for a mental and/or substance use disorder.

National Child Abuse Hotline

If you suspect a child has been harmed by abuse or neglect, please call 1-800-422-4453.

If you suspect that a child has been harmed or is at risk of being harmed by abuse or neglect, call the National Child Abuse Hotline at Call the National Child Abuse Hotline at 1-800-422-4453. Serving the United States and Canada, the hotline is staffed 24 hours a day, 7 days a week with professional crisis counselors who—through interpreters—provide assistance in over 170 languages. All calls, texts, and chats are confidential. If you believe a child is in immediate danger of harm, call 911 first.

National Suicide Prevention Line

For free and confidential support for people in distress, 24/7, please call or text 988, chat, or call 1-800-273-8255.

If you or someone you know is having thoughts of suicide or experiencing a mental health or substance use crisis, help is available and there are options to receive compassionate care. You can call or text 988 or chat You can also call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Both are confidential and available 24/7 to everyone in the United States and will connect you to a trained counselor at a suicide crisis center nearest you.

Contact Us

The National Center on Substance Abuse and Child Welfare offers free technical assistance to a variety of systems on making policy and practice changes to improve outcomes for families affected by substance use disorders and involvement with child welfare services. To learn more about technical assistance services or if you have a question please email NCSACW at or call toll-free at 1–866–493–2758.

National Center on Substance Abuse and Child Welfare