Raising Kids Impacted by Opioid Exposure to Thrive

Are you raising a child with known or suspected prenatal opioid exposure? Understanding the impacts and how to parent them will help you set your child up to thrive! We are joined by Lenette Serlo, an adoptive mom of four children impacted by prenatal substance exposure and the founder of Generation O, a nonprofit focused on creating understanding and support for children with prenatal opioid exposure and their families.

In this episode, we talk about:

• What are opioids, and what does it mean when a child has been exposed to opioids before birth?
• What are some of the short-term and long-term ways prenatal opioid exposure can affect a child’s brain, body, and development?
• What were some of the earliest things you noticed that helped you understand that your kids might experience the world differently?
• How can parents make the shift from asking “What’s wrong with this child?” to “What does this child need?”
• When a child has prenatal opioid exposure, what practical ways can parents help support emotional regulation and nervous system balance for these kids?
• What are some everyday challenges families might see at home?  And what strategies can parents and caregivers try to support their kids with those challenges?
• What tools or routines can help kids succeed with things like organization, memory, and follow-through?
• How could a parent or caregiver partner with teachers or schools so that children impacted by prenatal opioid exposure can succeed academically and behaviorally?
• What have you learned about helping children build friendships and navigate social situations successfully?
• In the baby and preschool years, what supports or parenting approaches can make the biggest difference?
• What challenges tend to emerge during the elementary school years, and how can caregivers support learning, independence, and confidence during that stage?
• As children move into adolescence, what new challenges can appear, and how can parents continue supporting identity, independence, and life skills?
• What is one small change parents or caregivers can make tomorrow that could have a big impact?
• You founded Generation O to support families navigating prenatal opioid exposure. What gaps did you see that made you want to start this organization? 
• What’s giving you hope right now? 
• What is one message would you most want our listeners to take with them about helping their kids with a history of opioid exposure thrive now and into their futures?

Resources:

• Prenatal Substance Exposure Workshop for Foster, Adoptive & Kinship Parents
• Raising a Child with Prenatal Substance Exposure
• P

Transcript

Please pardon any errors, this is an automated transcript.

Are you raising a child that you suspect or that you know has been exposed to opioids prenatally?
If you are, we are thrilled to have you here today. Hello, my name is Tracy Whitney, and I am the
host of Creating a Family Talk About Adoption, Foster Care, and Kinship Care. I'm excited to talk
with Lynette Serlo today to help us understand what opioid exposure is,
how it impacts our kids, and how we can set them up to thrive. Lynette Serlo is the adoptive mom of
four children impacted by prenatal substance exposure, and she is the founder of Generation O,
a nonprofit focused on creating understanding and support for children with prenatal opioid
exposure and supporting their families as well. So welcome to Creating a Family,
Lynette. Thank you, Tracy. It's awesome to be here. So let's start out with a basic understanding
or working definition of what opioids are and what it means when a child has been exposed to
opioids before birth. Sure. Well, opioids are medications or substances that treat pain.
So we've heard about oxycodone. We know fentanyl and heroin are opioids.
Methadone and buprenorphine, like Suboxone and Subutex, those are all opioids. And so if any of
these things are taken during pregnancy, it can affect how a baby's brain and nervous system
develop. So what are some of the short-term and long-term ways that we see those effects
happening? So short term, a lot of times these babies go through withdrawal at birth.
When the baby is removed from mom and the cord is cut, they're no longer receiving the opioids that
their system had gotten used to. There's a name for the collection of withdrawal symptoms that many
babies go through. Short term is NAS or NAS. And NAS stands for neonatal abstinence syndrome.
And NAS is neonatal opioid withdrawal syndrome. And so this is a diagnosis given to babies who are
going through these withdrawal symptoms at birth. And then longer term impacts,
we can see differences in regulation with these kids, learning, sensory processing,
behavior issues. What we've discovered is that a lot of these challenges emerge over time. They
don't all come at once at birth, you know, at any point in childhood. They're emerging as the child
grows. So you, as I mentioned in the intro, are the adoptive mom of four children who were impacted
by prenatal substance exposure. What were some of the earliest things you noticed that helped you
understand that your children might experience the world differently because of that exposure?
So I kind of have two sets of children. I have three teenagers. Two of them are currently 16 and
one is 19.
started coming into my life 20 years ago i didn't notice very much at all and what i did notice i
didn't necessarily extrapolate into oh i better watch out these could be long-term things you know
i just saw as many parents see a piece of paper that said your child was exposed to this and i'm
like great you know i'm gonna give them the best care i can and they're gonna be just fine but as
these kids began to develop and my first three children were born pretty close together,
two girls and a boy, and they had alcohol exposure, cocaine exposure, opioid exposure,
different cocktails for different children, all polysubstance exposed. But as they began to grow,
I started to see learning challenges, ADHD-type behaviors.
They started to emerge in their elementary years. With my son, who was my first opioid exposed son,
I saw his NAS at the hospital. We got to see him for the first time at 10 days old,
and he was still tremoring. He still had the really tight muscles. He was going through a lot,
having a little trouble eating. And so we went through the last couple of days of withdrawal with
him. As many parents are told, the doctor said,
congratulations, here's your new baby. He's gone through his withdrawal. Nothing else to see here.
Raise him up as a normal child. And so we took that advice and we didn't see much until he got into
school. I look back now, Tracy, and I can see so clearly. all the times that things were going on
with him that were actually delayed withdrawal tremors.
I thought it was colic at the time. You know, I can see a lot of sensory processing stuff that he
was suffering with that I didn't know at that point in our lives that that's what it was. He always
struggled to sleep, to fall asleep at night. Horrible, you know, back in those days I was doing...
cry it out. That's what I was told to do. And specifically with these babies, he had already
suffered trauma and, you know, he just couldn't fall asleep. His body just didn't let him fall
asleep. And so I noticed those things, but again, you know, you just think, well, we'll get through
this and then they're going to be fine.
Other child was born in 2020. And so by 2020, I had learned a lot.
Science had come a long ways. His NICU experience was vastly different than the first one.
He had his own private room. There were dim lights. The nurses only went in once every hour for
clustered care. They really did all the right things that these opioid exposed babies need.
And had I... lived in the city where he was born, they would have put him in a follow-up clinic
and he would have been watched for all of the early things. We moved across state and so he didn't
get that. But I enrolled him into early intervention because I knew that. And he got great services
by occupational and physical therapists. And he's on a completely different trajectory than his
older brother. You know, he still has. a different wiring. He still has issues,
but I can see how helpful those first three years were in putting him in a better place than his
older brother. Yeah. So I'm hearing a theme starting to emerge here that number one,
early intervention and care with supports and scaffolding is critical. And number two,
many of the challenges show up around the same time that they start school. Yep. That's the
pattern. Yep, yep. So when you are a parent of a child that you suspect had exposure or you know
had exposure, how can you start to make the shift from asking what's wrong with this child?
Because, you know, maybe the doctors told you, well, once they get through withdrawal, they'll be
fine. From what's wrong with this child to what does this child need from me right now? So I was
thinking about this recently and... first answer is this is a huge ask of parents to do.
This is a really tough thing. You know, if we're following all the typical parenting guidebooks and
we're preparing to be parents and we're parenting how most of us were probably parented, we're
doing it all wrong. And so to be asked to completely change everything we know and really
understand this child who is has a different brain than ours and who has different needs and who's
experiencing life in a different way their whole nervous system and brain is wired differently and
so we have to consider that first before everything and once we understand this and you make the
mind shift so many things change and with my older son who's now 16.
None of this really clicked in until he was like in the five to seven year range. And that's when I
was first learning it and putting it into practice. And with my younger kid, he's gotten this from
the beginning. And it's now the only way I parent. I can't think of doing things any different,
but it was a big, big shift. And I think the educational piece of it is the most important,
you know, letting parents know we've come up with a constellation of challenges, 11 different
things that we see over and over again in these kids. And just understanding that that may be a
part of their life and these are things to look out for is a big piece in being able to make the
necessary changes in your parenting. Yeah. That's so good. And we'll get to those challenges in
just a second. But I do want to say parents, if this resonates with you, and you're looking at it
going, okay, I parented this child this way, prior to learning this important information and this
mind shift to now I'm parenting differently. cut yourself some slack and give yourself some grace.
You didn't know what you didn't know. And now that you know, you can do better. And that's part of
the reason creating a family exists. It's part of the reason that I know Lynette's organization
exists is to help parents go, okay, so we didn't know, but now we do, or here's where we can learn
what we need to know. And I think it's really important that we include that in the mind shift is,
okay, I have to shift. but I'm gonna give myself some grace while I shift and why I need to shift.
Yes, that grace is absolutely important. And if there's two parents,
they could be moving at different speeds. They could be learning this and understanding this at
different speeds and that plays into how it all works. Yep, yep.
So let's talk about some of those challenges that you've identified. What are some of the everyday
challenges that families would see at home? what kind of strategies have you guys created to
support those challenges? So sleep is a big one. We really see that these opioid exposed children
have trouble falling asleep, staying asleep, and even during the night,
getting good sleep. So whether you're an infant or a toddler or an older child,
if you're not sleeping well, if you're not getting enough hours, if you're waking up and you're
still tired, everything's going to be hard. We know that as adults, you know,
and there's books, plenty of books written on how to help children to sleep. And, you know,
some of that stuff is important. You know, we need to have a consistent routine and we need to have
dim lights, but even putting all those things in place, if you have high anxiety levels,
which these kids tend to have, and you have just a brain workup that won't sleep,
you know, I don't know what the answer is. I just know that it's a challenge and different people
find different paths, but the consistent routines are important. The lower stimulation is
important. With my youngest one, we've developed a pattern where I know screens before bed are not
supposed to be the thing, but for him, we do 10 minutes together in bed on the screen, we turn it
off and he falls asleep. I contribute that to the fact that he had the early intervention and his
system, a lot of it was rewired early on. My 16 year old, he still can't sleep.
And, you know, some nights he stays up much later than he should. And he just,
you know, I don't know what the answer is, but other things we see transitions, you know, that's a
common theme. So, you know, I'm really good about letting my child know five more minutes and then
we're going to do this or. you know, letting them know in advance. The sensory issues that these
children have can come up in a lot of different ways. But the thing I think is funny about sensory
is that you can have overactive sensory system or an underactive sensory system. And one of the
things we see in these kids is they, it's both, right? So my son,
he loves to make noise. He is a loud child. He runs,
he screams, he likes to make throw things on the ground that make loud noises. But if an unexpected
loud noise comes in his environment, totally freaks out. Right. And so, you know,
just having to understand that he has a need to make noise. So I have to provide an opportunity
where he can make that loud noise. Maybe it's not during dinner, but, you know, maybe there's
another time he can do it. Yeah. And also, if I know we're going into a place that's going to be
really loud, I can warn him of that. He could wear earphones. You know,
we could somehow figure out a way that get him through that knowing that. It's not just an
annoyance to him. It's on a cellular level. He just can't handle it. Right. And then the last one
I'll mention is the incessant energy that a lot of these opioid exposed children have. It's just
there. It has to come out. And if you can provide, you know, full body.
Rolling around ways that they can get that energy out. I've heard the term a sensory diet,
you know, putting children on a schedule where before school, they're going to go run a lap.
They're going to go do some jumping jacks, you know, and just understanding that they may never
seem to get tired and that's who they are. And we just have to accept that they need a lot of
outlets. If they don't get those outlets, then they're going to turn that. internal energy that
needs to come out into misbehavior, into, you know, things we don't want to see.
Right. One of the things that we hear to be quite effective for kids with these energy levels,
and also some of the sensory... challenges is the concept of heavy work or core work,
you know, kind of running them through an obstacle course or dragging, you know, heavy laundry
baskets if they're really little. Anything like that that's going to just put those big muscle
groups to work kind of helps then all the other muscle groups settle in and find a good rhythm and
a good groove for the day. I have a friend that was joking that in the morning you will see
children pushing laundry baskets all over the house filled with stuff. not necessarily filled with
laundry. So one of the other struggles that many families face with kids that have had this kind of
prenatal opiate exposure is executive function, which impacts a lot of daily life,
especially when a child goes to school. What are some of the tools or routines that we can start
eyeing up as parents that will help our kids improve their executive function skills,
but also build new and more mature skills. Yeah,
that's really an area that, as you said, is a big hurdle for these kids.
The opioid epidemic has created a whole generation of these children. And it started about 25 years
ago. So the oldest ones are only in their early 20s. We're not even to the point yet.
Is it like... or 28 when your prefrontal cortex finally matures right and maybe they need that much
time maybe their prefrontal cortex will take even longer to mature so luckily for my kids i'm like
uber organized person and so i have been their executive function for all of these years and i
think that that is one helpful step, but also, you know, you're asking how do we put some of the
burden on them when they're ready? You know, they may not be ready at age 10 to do the same thing
the other 10-year-olds are doing, but maybe they can do a six-year-old version of that. And
what does that look like? The biggest thing I've learned is that the one-step, two-step
directions, you know, I can ask my child to go get your shoes on. If I say,
go get your shoes on and then grab your coat, that's too much. That's two things and it's too much.
So it causes frustration for everyone. And Tracy, 16 year old,
my 16 year old, one thing is still what here he's at. And,
you know, it's frustrating. It would be wonderful if I could tell him three things at a time, but
it's not happening. And I think this is kind of a funny story, but we talk a lot about executive
function issues with younger children and how they look in school. But my 16 year old just started
driving. And do you know what lack of executive function looks like when you're driving?
A four-way stop. How do you do a four-way stop with no executive function skills?
How do you figure out who's going to go next? When is it your turn? And so my son is a safe driver,
but he's the one at the four-way stop that has to get the horn signal in order to know it's time
for him to proceed. Yes. Right, right. Yeah, and I've found even in my own parenting,
executive function skills are aided by visual supports. So in our house,
if I have to give, I try not to, but if I have to give multi-steps, I will hold up my fingers,
step number one, step number two, step number three. Then I'll often have them repeat it back to
me. They're older now, so this doesn't apply. daily for us right now. But when they were younger,
I would, you know, give them step one, give them step two. Okay, now repeat those two steps back to
me. And then when you come back and say that you're all done, I want you to do them one and two on
your fingers to make sure that you caught everything that we talked about. So it's a lot of back
and forth that maybe with a child who has typical executive function skills for their age,
you don't have to do. But it's one of those things where we if we can catch ourselves thinking
ability, not chronological age or stage, not age. We're supporting them by not setting ourselves
and them up for frustration and giving ourselves collectively like a fighting chance at tasting
success with this skill building. I love those strategies. Yes. Yeah. It's hard.
I'm Italian. So I talk with my hands a lot anyway.
What's another tool or technique that parents can use for organization or memory or even follow
through, which seems to be a big struggle for a lot of families that they may know that their child
has executive function challenges, but they don't know that follow through is maybe part of that.
So what are some other tools that you guys have found successful? You know, one of the big things
that this makes me think about is children are often asked to clean their rooms.
And without executive function, that's a pretty overwhelming ask. And so with the visual system,
what does clean your room mean? We no longer tell my oldest who's in college now,
and thank God I don't have to look at her room anymore because it was never clean. But I had to
stop telling her to clean her room. I would say, please go pick up your clothes. and then when she
was done please bring me the dirty dishes that are in your room and then i one time you know spent
a weekend cleaned the whole room myself and took pictures of it this is what a clean room looks
like and that's genius
in her closets because she had the the kind of closets where you open it up and it has all the
little drawers and cubbies in it so you know inside of each closet door it had this is what this
one should look like this is what this one should look like you know and she needs that because you
not only do you have the trouble breaking down the different pieces of it You're constantly getting
distracted if you're a child like that when you want to do what mom says, but, oh, you just heard a
bird chirp. And I wonder what bird might be out the window that I can go see right now. Yeah. Yeah.
We love the way that Ross Green puts it. Kids will do well if they can. And so when you set them up
for success and you give them an actual example of what you're asking for, you're number one,
assuming that they want to please you. work with you on this and number two you're assuming that
there might be something getting in their way so here's what we can do to figure out what that is
and how to fix it
Listeners, I hope you're enjoying this conversation with Lynette as much as I am and learning from
the things that she and her family have experienced. If you are interested in other learning
opportunities, we have a library of 15 free courses. Thanks to the Jockey Being Family Foundation
for their generous partnership, we can offer you these 15 free courses. You can take one of them or
all of them, whatever suits you, and you can find them all at bit.ly slash jbfsupport.
That's bit.ly slash jbfsupport. Thanks so much.
And let's go back and listen to the rest of the interview.
One of the things that happens when kids enter school, and that's kind of one of the ages that
starts to become very obvious that something is going on, maybe that we didn't have to pay
attention to before, is that kids start to struggle with Again, those executive function skills,
they start to struggle with some of the social skills. How can a parent or a caregiver in our
audience cases, sometimes it's a foster parent, sometimes it's a grandmother raising a grandchild.
How can they work with the school to let them know that this is the child's context and this is
where they struggle and this is what works at home? How do we get that started?
difficult question because one of the things we see in these kids is the anxiety level is high the
sensory system is haywired and so there's not necessarily official iep accommodation tools that
that you know can overcome that and so you know if in your body everything is just not right I
don't know. What I'd like to do is tell you about the schooling of my older child and tell you what
we've done different for my younger child. So my older child,
he's a smart kid. Like I knew as he was a toddler and,
you know, he's a smart kid. He could have conversations with kids much older than him, you know,
and he just puts ideas together. He can do stuff. But then he couldn't.
spell his spelling words in first grade. And I'm like, well, this doesn't make any sense. You know,
and that started us down a path. We found out that he had vision processing issues, which is
another thing that we've seen in these kids. Vision processing is different than vision, but it
really contributes to how a child can understand what they're seeing and what they can put out,
like what they might know the information, but that doesn't mean they can write an essay on it. And
so. He kind of, because he was smart enough to put the pieces together,
could kind of like make his way through up until second, third grade. And then it got too hard.
You know, those concepts just layer on each other. And if you kind of missed a little bit of one
and then the next year you miss a little bit of two, by the time it gets reintroduced in third
grade, you're kind of clueless. That's when we saw the grades start to go down. And,
you know, we went through the whole process with getting an IEP and 504 and all these things.
And then in middle school, he had a 504 and his guidance counselor did an amazing job getting him
through middle school. Because one of the things that's important for Johnny is like a lot of
opioid exposed kids, they have these magnetic personalities. And like, we also.
know that there's kids that have social skill problems and struggles, but there seems to be more
than the typical amount of kids in this population that are just magnetic and people want to be
around them. And so he was like that. And he's a very extroverted person and he needs to be with
his people. He will not do well in a situation with kids who say are on the autism spectrum you
know that might need that might learning wise be where he needs to be but if he's not around a
bunch of kids who he thinks look like him and he can talk to and hang out if he suffers So the
middle school counselor got him through three years of middle school by just, you know, giving him
peers that would help take notes for him and they would help him after school. And so we got him
through with good enough grades. But then what happened when he got into high school was not good.
And so we're still in the middle of that. We've got a good IEP now and he's in a specialized
program. But what we ended up doing for number two with all the experience that we had was we
realized that his developmental disharmony, meaning, you know,
he might be age six, but his emotions are age three and,
you know, he has skill levels that are upper in different areas. He's in an environment that's a
school environment, but he is not asked to sit down and do work every day.
He is not asked to. do the things he's not ready to do. He gets movement whenever he needs
movement. And, you know, education is changing so much. And there's so many different programs and
homeschool ideas. And it's, there's plenty of parents who have to use the school system they have
and use those. But if you have an opportunity to look at programs outside of the traditional
school, I think that you might find something that fits these kids and their developmental needs.
Yeah, I think that the options that are available by opening that door of communication with the
school, even if it ends up meaning homeschooling, just opening that door and having that
conversation. One of the things that we recommend at Creating Family is sometimes. Parents want to
write a letter to the teacher at the beginning of every school year. And that can be really helpful
towards kind of just giving a brief context. You don't have to give private details that your child
doesn't want shared or that are integral parts of their private story.
But the impacts that you're seeing definitely should be something that the teachers can be made
aware of and see also. And then just keeping that door open between school and home.
Having that regular conversation, having that kind of the brainstorming sessions. I know I've done
it in IEP meetings before where we say, okay, well, this worked last year, but it's not working so
great this year. What can we do that might work better? How can we keep respecting her privacy and
her dignity, but giving her the opportunity to really thrive differently than last year turned out
to be? Those things have been really helpful for us walking through keeping that door open and
regular communication with the school. Another thing that I think can be really helpful in a school
setting is, and you alluded to it with your son, is the taking the accommodations and not always
putting them in a quiet room alone for extra test taking time, but mixing that up with peer
involvement. Whether in your son's case, it was a friend helping him take notes or in some kids'
cases, it's taking them into a separate room where other kids are that also need some specialized
attention and allowing them to learn how to work collaboratively in a small group that failure is
okay. Setting the safe space that says failure is okay.
And it's really just a matter of learning. how to do it differently. It's not a failure on your
part, and it doesn't mean you're a failure as a student. Those are some of the things that I've
seen to be very helpful when handling the school situations. Well, in academics,
that's one of the big learning curves that I've had. You know, I was raised by teachers and a
school principal. And so academics was first and foremost, for me, my whole childhood.
And I succeeded because of the brain I was given. And it was... An interesting,
you know, to watch our substance exposed adopted children go through the school system was very
different than what my husband and I's experience were. And I think in the end,
what we realized was obviously academics are important and there's a place for them.
But in a child's whole world, especially a child whose strengths might not match with what.
academics is made up of you know we really need to surround that kid with places where they can
really succeed you know they're going to have to go to school they're going to have to do certain
things but my older son is a dirt bike rider he wins races you know we're putting a lot of emphasis
on that and he has places where he can really succeed because schools even when he tries his very
very best you know his best is not going to give him the same rewards as someone with a typically
wired brain is. Right. And that segues beautifully into the next question about social skills.
Many of our kids who have had opioid exposure struggle to build friendships or maintain
friendships. They may be great at making a new friend, but to maintain that friendship is really
challenging. They also sometimes struggle with how to navigate social situations like how to pay
for their own water at a concession stand or how to ask where the bathroom is,
those kinds of things. What have you learned in addition to the finding a space where they can
shine? What else have you learned about helping them navigate social skill building? There's a lot
of fear put into children about things that might be scary or unsafe.
That's not really... on par with reality you know like plenty of people are afraid that their child
is going to get abducted from the front yard you know and we hear about that all the time because
we have social media and because it's publicized but the reality of abductions from the front yard
in the 50s compared to now is that it barely ever happens and so being cognizant of What we're
teaching our children, they already have enough of their own fear if they're living with this high
level of anxiety. And so, you know, my child is allowed to ride his bike to the stop sign and back.
I can see him. We live in a safe neighborhood. But, you know, allowing them to do confidence
building techniques, allowing them to understand who they are and what they can do.
I remember going to the playground with my children when they were much younger.
And other adoptive parents, I don't know if they see this or not, but one of my children is
transracial. And so when we were at the playground and you're looking at all the kids and all the
parents, since I don't match him, they didn't necessarily know I was the parent. And I would let
him climb higher than maybe the other six-year-olds were climbing or do things more than other
parents would allow their kids to do because... I knew how adept my child was and I knew what he
could do. And he was testing his own boundaries too. But there were times when I would see the
other parents looking around like, who's the parent? of this child and why are they allowed to do
this? Go all the way up to the top level of the playground. And I would just, you know, laugh to
myself. But I think that there's a lot of ways you can build confidence and give children
responsibilities that are age appropriate that allows them to have that internal sense of being
able to do things. Yeah. So one of my favorite suggestions for confidence building skills is help
them find a place to volunteer. So kids that are especially good at calming animals can volunteer
in a local shelter. A lot of our kids that have had prenatal substance exposure are really good
with kids much younger than they are. And so let them volunteer in the church nursery under
supervision or at the local Y, again, under supervision and be wise and judicious about how you
pursue that, but give them places where they can kind of be in charge and taste that confidence of
I successfully calmed this scared animal or I successfully engaged this small child and kept them
happy while mom was at her Bible study or at her church service or whatever.
Finding those kinds of places where our kids can serve and then serving with them in those
volunteer capacities gives them such a great model for everyone needs somebody.
We all need each other. And that builds confidence to see mom and dad doing it with them.
Yes. Let's talk a little bit about the brain differences in the kids across the ages and stages.
In the baby and preschool years, what supports or parenting approaches make the biggest differences
with these brain differences? I think attachment is huge. That's going to apply to any child that's
going through the adoption journey. i think about what they experienced with the opioids in utero
they may have gone through withdrawal in utero you know if mom wasn't getting a consistent dose of
opioids throughout the pregnancy and so there's so much trauma attached to that before birth and
then if their first experience at birth is going through this withdrawal you know that's adding to
it and then if at some stage if you're listening to this podcast you're probably been separated
from your first mom you know so that's a lot going on and they need attachment more than anything
else these babies are typically difficult to console they cry more and they sleep less and they eat
less and they might have diarrhea and vomiting in the beginning and so skin-to-skin contact
holding them, you know, having them be with you. When we get to the point as an organization to be
able to just give every family taking home an opioid exposed child a gift,
it's going to be a carrier because those babies, those babies just need to be on you all the time
to regulate because that's where babies can't regulate on their own. They need the adult to
regulate with them. And so that creates the attachment. It helps with the regulation.
And then The other piece is the sensory control, because if their sensory system is unusual,
you know, maybe they're going to get hot more than another baby. So they need to wear less clothes
or not no hat or whatever. A lot of times these babies do better in low lights with less sound.
And it's. easier to give that to a baby but think about what an environment with lower lights and
less sound looks like for a three-year-old you know a lot of times we put three-year-olds in an
environment that's bright and colorful with so much visually going on and for a child like this
that might not be a great match so i think those are the things that are probably most impactful at
that age And the early intervention. You know, the early intervention at that age is the most
important thing. Many states have automatic referrals now where if a baby was opioid exposed,
they would be referred. But not every opioid exposed baby is going to get that NAS or NAS
diagnosis. And so we may have to advocate for them, even if they didn't get the diagnosis. If we
know that they're opioid exposed, they need to get in those same services. Right.
I would add that a very important strategy in those early years is to start setting the habit of
welcoming others in to help support you while you are doing the very consuming work of building
that attachment, building that felt safety. So keeping up with laundry is not necessarily going to
be building felt safety, but it still has to be done. Is there someone in your life that you can
welcome into your life and say, okay, we brought home this baby. This baby is definitely struggling
with the lights and the noises and the sensory issues. I need to be fully calm and present with
this baby. Can you please take over my laundry for me so that I'm not burning myself out by trying
to do everything? That would include asking for meals if you need them, having somebody come watch
the other kids for a couple hours every week so that you can either get a nap or catch up on things
that are important to you. But building those rhythms and habits now when the child is very,
very young of adding that kind of self-care into your routine will help you then be calm and
regulated and present for that baby to build that connection and attachment. That's so important.
And I think it's easiest to ask at that age, because when you have a newborn, everyone's what can I
do? How can I help? Yeah, yeah. And you know, it's easy to say no, when it doesn't seem like you
can still handle it all. But you definitely need that stuff. Yeah, we I always encourage young moms
to have a canned response. Well, a meal from my freezer would be great. Or I would love it if you
could pick up my laundry on Friday and just kind of have that canned response ready to go so that
you don't even have to stop and think about it. You just know what you need and you can identify
it. We talked already about the challenges that tend to emerge during the early elementary years.
These behaviors and things are starting to emerge at school. What can parents and caregivers do at
home that would support what the school is doing? The hardest thing that I dealt with during those
school years with my older child was that he used all his energy during the school day,
holding it together, masking. And I picked him up with his sisters in the car line after every
elementary school day. And the minute that door closed, he started attacking his sisters verbally,
you know, and it was all he could do to hold. And I'm grateful I didn't have any behavior problems
at school with him, which is not what everyone experiences. Right. But our home life was really
difficult. I remember at parent teacher conferences talking to the teachers about.
how polite my son was and how much he participated and this and that. And I'm like,
man, I would love to meet that kid. That is not the kid that's coming home every day. And,
you know, it's a hard thing to get through. Maturity helped a little bit for him,
but we just had to do everything we could at home to keep everyone safe.
But I would think back to the academics and the importance of academics. in the lives of these
kids, one of the things that we had to sacrifice was homework because he was so tired at the end of
each day and he needed to go into his quiet, dark place in his bedroom and just unwind for a little
bit. He needed to go out. He likes to fish and we have a place he can fish nearby.
He needed to be him and detox from the day. And usually by the time dinner rolled around,
you know, we could have a dinner together. But then after that, then tiredness of the evening set
in. And there really was no opportune time to get homework done. And for years,
I would find that minute. I would pressure him to do it. And you know what? Even if he did get to
it, it wasn't good. It didn't help. You know, what was best for our relationship was to get the
understanding with the school that he can do everything he can do during the school day. But at the
end of the school day, there's nothing more that can be done. And whatever that means, it means.
That is a tough row to hoe when you're working with a school district that just does not want to
give up that holy grail of homework. Having been in that role already a couple times myself,
we ended up compromising on reduced homework. And so I made it clear to my student,
I tried to get the no homework thing. They weren't going to go for that. But we did compromise on
reduced homework. So we're going to work together on the reduced homework. But you also are going
to have time to do the fun things that make you feel you.
and refresh you the letdown after school is a real thing and I think one of the most important
things parents can do is have a consistent regular predictable schedule after school and that
should include a really high protein snack and hydration just like they don't drink enough at
school all day long so you're backfilling their hydration but it's so important to kind of keep all
those parts moving towards what is the priority, and you mentioned it, is family time.
That they need to know that when they come back from school, they're coming into a safe landing
place and that they can be themselves. It might be messy and ugly for the first hour or so after
school, sometimes longer, but that no matter what, you're with them. And that this is how we run
our day together. And you're not going to leave them to navigate it by themselves. Because all of
those big feelings of the after school letdown are scary for kids. And you mentioned that,
you know, the hyper anxiety and the hyper vigilance, it's even more scary and confusing for our
kids who have that hyper vigilance. kind of regular state of elevated anxiety.
As our kids are moving then into adolescence from those early elementary years,
there's new challenges that come. And you've alluded to some of them as you've talked about your 16
year olds. But let's talk about maybe identifying a couple of the challenges specific to this age
group, and then how we can continue to support our children as they become teenagers and young
adults. Well, I think supporting their identity. and their independence to help reduce some of the
shame that they might be feeling just because they're living life through this lens that they've
been given by teenage years you're going to know what they like what they're gravitating towards
hopefully it's something that you like too you can participate in or you can learn to like it
absolutely absolutely but um you know sharing in and what they like to do and helping to be a part
of it. And, you know, they're all going to find something different if they like to draw, if they
like music, if they like sports. My son likes sports. So it was really easy. You know, he would
just pick up any sport that was going on and just then I got the energy out, got the sports out and
he's good at it. So he would get all of that great identity building thing. It's a rocky time for
any adolescent to go through. And I think that. You know, the independence piece is tough because
they don't necessarily have the skills to be as independent as their peers in some areas.
In some areas, they might be, you know, already doing things at ages above, you know,
but I would assume that not all kids would be ready to drive. Mine was ready to drive. And that's
been a great outlet for him, just knowing, you know, before he used to get on his bike all the time
and now he can get on his car. So, yeah, it's really going to be an individualized approach,
I think. Yeah. And I think one of the things that's really important to remember about adolescence
is kind of the driving force of adolescence is to be just like all the other adolescents in their
life. And so if they've already identified that their brain is wired differently than their peers,
there could be that sense of shame or that sense of rejection that they're carrying. And by finding
things that other teenagers are doing. that they're good at, they start to see,
oh, well, yeah, my brain is wired a little bit differently, but I'm not the only teen that loves
this or that is good at this. And so getting them involved in those activities is super important
for reducing the shame and stigma that they may be carrying, but also building that self
-confidence. And I love Dr. Ken Ginsberg was on our podcast a while ago, and he talked about
healthy interdependence. I like that approach because when you are parenting a child who's kind of
many kids in one body, interdependence says, well, in this area, I think you can handle this and
you can be pretty independent. But in this area, I see where you still need me and you still need
me to guide you and help you scaffold through this issue or this skill building thing.
And I think that... of all of our teens want independence, but they may not be ready for it can be
greatly supported and solved by looking at it instead as interdependence. The many kids in one
body, especially when they're teenagers is super, super challenging. It is super challenging.
Yeah. So I like the way you said disharmony of maturity. There's like mature social skills,
but you know, really immature. self-care, body hygiene skills.
When those don't match, that can be really challenging to navigate. And there's many different
types of disharmony that are going on for our kids.
Listeners, let me interrupt just one final time to tell you that we want to hear from you.
We want to know what app you listen on. We want to know where you're from. We want to know what
your adoption or foster care or kinship care journey has been like so far. We want to know what
else you want to know about. Use the link in your podcast player or the link in the YouTube show
notes to tell us any of those things that I just mentioned or whatever else you want to tell us.
If you're watching us over on YouTube, it's right in the show notes. If you're listening on a
podcast player, it's underneath our title and underneath the description of the show. And we hope
that you do that and we can't wait to hear from you. So we're going to go back and finish up the
interview with Lynette. Thank you so much. So let's start to bring it home here a little bit.
What is one small change that a parent or caregiver can make tomorrow that will have a big impact
when they're trying to help a child with prenatal exposure thrive? Understanding what their nervous
system is experiencing in that moment. So you're seeing the behaviors and the reactions,
but what's going on inside of them? You know, is it as simple as the room is way too bright?
Is it as simple as I didn't get enough protein? All I've been eating all day is chips and cereal.
You don't even have to say or do anything differently. It's a mindset shift. Thinking about it
through their eyes. Yeah. Handing them a cheese stick without any condemnation. We love cheese
sticks. Yeah, right. Quick, easy protein. You founded Generation O to support families navigating
prenatal opioid exposure. So what gaps did you see that made you want to start? a nonprofit,
you know, because you didn't have enough on your plate already. So what gaps did you see that made
you want to start this organization? And then listeners, we did include the link to the
organization in our show notes for you. Thank you, Tracy. So huge gap. There was no national
organization for opioid exposed children. i think the precursor to generation o was a facebook
group that is still thriving there's over 8 000 members there and these are members from primarily
the us but around the world raising these children and over and over again seeing the same things
in these children yeah and people every day were asking the same questions and we were giving the
same answers and you know the research is coming it's not there yet it's going to take a long time
there are unique characteristics for opioid exposed kids that are different than kids with
stimulant exposure or kids with alcohol exposure you know we see different things and there's also
a lot of crossover and a lot of the services that are helpful for children with autism or children
with alcohol exposure are also helpful for these kids but there's some unique differences that we
aren't seeing in these other populations and so that was the gap to fill and so there was about 10
moms who are all raising opioid exposed kids who met in this facebook group we live all over the
country so via google meet we created this organization and we have lofty goals of all the things
we want to do we're coming up on our second birthday and we're yeah we're um just really wanting to
raise awareness about the unique both strengths and challenges that these opioid exposed children
have as well as you know down the road there's policy changes that are needed the opioid epidemic
has shed a lot of light on what these babies go through at the hospital.
You know, people know what NAS and NOWS is. People know that these babies go through withdrawal.
But once they are discharged from the hospital, the landscape was empty before we came along.
And we're still only getting to. maybe five percent of of the families raising these kids so we
have big work ahead of us but we're doing what we can to share what we've learned both in what to
expect how to handle and the early intervention piece which i won't say enough because it's just
and and here's the problem tracy is that at two years old these kids don't look any different than
the other two-year-olds. And so it's really hard to understand how important this is.
But if you don't do it when they're two, you're going to see what happens later on.
And everyone wants to think that, yes, my child was opioid exposed, but maybe it was mild enough or
maybe it was minor enough that it won't affect my child. And even people doing the early
intervention don't always understand how important the subtle things that they might see in a
child, how important it is to treat it. But it really does make a huge impact. So look out for Moms
on a Mission filling that gap. Yes, of course. So given how far you've come in these two years with
the organization, what's giving you hope right now as an organization? Well,
as we've seen the caregivers understand the things we've been talking about in this conversation,
we've seen the shifts. And we've seen that it helps mom, it helps child,
it helps foster carer, it helps aunt who's raising child. You know, it's a tool that really does
help. And seeing that is just amazing. We want these kids to thrive and we know that they can
thrive. And it's just, you know, giving them what they need and understanding what those needs are.
We're also involved in research and tracking the real life experiences that are going on.
This is kind of a new problem. I mean, there's been opioid exposed infants throughout all of time,
but never a whole generation like what we're seeing now. There's never been a problem as big as
this that had no directions on how to solve it.
That's the little gap we're trying to fill. We're trying to do what we can and help where we can.
And it does sound so hopeful that, you know, you've got some kind of fingers on the pulse.
And because it is such a big problem, it's not just an awareness thing anymore.
It's leading into policy and educational shifts and things like that. So that is very hopeful.
So let's talk directly to the parent or the caregiver who is raising a child with a history of
opioid prenatal exposure. What message of hope would you give them about setting up this child to
thrive in the future? You're on a journey. It's going to be fun. It's going to be bumpy and rocky.
And these kids are wired differently. That's just in the sooner that you can find out where their
strengths are and help support their strengths. And, you know, your life might shift in ways that
you didn't even expect. But, you know, they can bring great joy. You know,
we just need to understand who they are and support who they are. They're all individuals.
One of the things about the constellation of challenges that we've created is that we have 11
different points on this sunshine, but each one has their own combination of strengths and
challenges. And so just understanding your child and what their needs are, because when they're
supported, they can absolutely thrive. That's fantastic. Well, listeners, if you are raising a
child with opiate exposure, please go to generationo.org and check out those constellations of
challenges and where your kid might fall. And look around the site for the support and the
resources that will help you set your child up to thrive. Lynette, thank you so much for your time
today. Thank you for sharing your own life experiences and journey so honestly and practically to
help others learn. And we wish you and your organization a happy second anniversary, but also a
strong, flourishing future. Wonderful. Thank you so much for this opportunity, Tracy.