Behavioral Outcomes of Children With In-Utero Opioid Exposure Age 2-7 and Parenting Self-Efficacy

Abstract

Background: The relationship between behavior difficulties and parenting self-efficacy in children with in-utero opioid exposure (IOE) remains a significant gap that needs to be addressed for providers to better understand the mental health trajectories of children with IOE and help these families. Aims: In this study, caregivers’ perception of their child’s behavior and potential relationships between parenting self-efficacy, child temperament, and behavior difficulties were investigated. Methods: A descriptive survey design with a convenience sample of 143 caregivers of 2- to 7-year-old children with IOE who had follow-up visits in a Neonatal Abstinence Syndrome (NAS) clinic was used for this study. Data were collected using a survey of demographics, the Children’s Behavior Questionnaire, the Strengths and Difficulties Questionnaire, and the Parenting Sense of Competence Scale. Results: The overall sample scored in the average range of behavior difficulties, but a subgroup of children with very high difficulties was identified who exhibited a negative temperament, and caregivers reported a lower sense of parenting competence. There were no differences between groups on demographic variables. Conclusions: High negative affect and low effortful control are predictive of later internalizing and externalizing problems, as well as broader problems in self-regulation, school readiness, and socioemotional competence. Thus, although a large percentage of children treated for NAS appear to be functioning at the same level as their peers, a subset of children appears to be at higher risk. Child behavior as well as caregiver self-efficacy should be assessed during all provider encounters.