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Children with fetal alcohol spectrum disorders (FASD) are often cared for in the child welfare system. Child welfare systems exist globally, and the roots of the intersection between FASD and child welfare have strong origins in North America. The role of child welfare at its core foundation is to assure the survival, security, and development of children and families. Child protection issues such as neglect, abuse, and failure to meet the care and developmental needs of children are primary reasons for removal from parental care. Infants, children, and youth with FASD have distinct care needs, and parents are often reluctant to share information about any alcohol use history during pregnancy out of fear of child apprehension and stigma. Despite a growing body of substantial research legitimizing FASD as a neurodevelopmental disability, FASD is still not perceived and well understood as a legitimate and accepted developmental disability. The behavioral challenges associated with FASD and the need for support by families often factor into referrals to child welfare. This population remains dramatically underserved and poorly understood in child protection services. Limited knowledge about FASD impacts the delivery of effective services aimed at ameliorating the social, emotional, sensory, physical, psychological, and neurological challenges that children living with this disability experience. It is critical that child welfare services to this population have a substantial knowledge base on prenatal alcohol exposure (PAE) and women’s health in order to provide a more nuanced response in work with children and families. This chapter explores the current state of child welfare care and FASD.

BackgroundFew studies have investigated the partner's influence on risk factors such as alcohol consumption and depression during pregnancy. Partner substance use and lower relationship satisfaction predict higher maternal alcohol use and depressive symptoms. Because prenatal alcohol use and maternal depression affect infant outcomes, it is imperative to examine how the partner affects these maternal risk factors. The current study examined the effect of a latent construct of partner influence on maternal alcohol use and depressive symptoms, and the effects on infant development of these maternal factors.MethodsParticipants were 246 pregnant women from 2 sites in Western Ukraine from whom longitudinal data were collected as part of a multisite study. In the first trimester, mothers reported on relationship satisfaction, partner substance use, and socioeconomic status (SES). In the third trimester, they reported on alcohol use and depressive symptoms. Infants were assessed using the Bayley Scale of Infant Development (average age = 6.93 months). A latent construct titled partner influence was formed using partner substance use and measures of relationship satisfaction, including the frequency of quarreling, happiness in the relationship, and the ease of talking with the partner. Using structural equation modeling, a model was specified in which partner influence and SES predicted maternal alcohol use and depressive symptoms, which in turn predicted infant neurodevelopmental outcomes.ResultsHigher partner influence significantly predicted lower prenatal alcohol use and lower depressive symptoms, controlling for the effect of SES. Higher maternal prenatal alcohol use significantly predicted lower infant mental and psychomotor development. Maternal depressive symptoms did not predict infant development over and above the effect of alcohol use.ConclusionsPartner influence is an important contributor to prenatal alcohol use and maternal depressive symptoms