Getting to them quick
Policy change fosters crucial early intervention for babies born to drug-abusing women
Kim Barker consulted with family members and friends, prayed, swallowed hard and said yes: She and her husband wanted toadopt this yet-unborn child who was about to come into the worlddependent on the drugs her biological mother had abused.
Barker knew that little Olivia Grace likely would remain in the hospital for weeks, if not months, being treated for the gut-wrenching symptoms of withdrawal. And after that?
“Our social worker said to get her assessed,” said Barker, who until then knew nothing about Ohio’s system of early intervention programsfor infants and young children.
Olivia Grace was accepted for services through the Franklin County Board of Developmental Disabilities and soon began receiving the help andtherapy that, her family believes, provided the boost she needed to overcome a rocky start. She’s now 3 years old and thriving.
“They quickly and amazingly worked with her in our home for months and months and months,” said Barker, 36, a former Gahanna resident who now lives in the Sunbury area.“for us, early intervention was huge.”
Diagnoses of cerebral palsy, autism, chromosomal defects andmore than twodozen other conditions, including fetal alcohol syndrome, have long made a child automatically eligible for early intervention programs, which serve more than 21,000 Ohio families with children under the age of 3. But until an Ohio Department of Developmental Disabilitiesrule change took effect this month, neonatal abstinence syndrome — the medical term for withdrawal symptoms suffered by drug-dependent newborns — was not on the list.
Neither was high blood-lead level, a well-established cause of developmental problems.
Now,infants and toddlers don’t necessarily have to show signs of disability or delay due to those conditions before they qualify. A diagnosis of neonatal abstinence syndrome or a blood-lead level of 5 micrograms per deciliter is sufficient.
The policy change “has been sort of a long time coming,” said Shannon Jones, executive director of Groundwork Ohio, a nonprofit organization that advocates for improved early childhood development and learning. “If we’re trying to get these interventions to kids earlier, then we have to ask, ‘What are we doing to reach out and get them connected to the services that matter?’”
Many children with lead poisoning or neonatal abstinence syndrome, including Olivia Grace,already were making their way into the system through referrals, at which point developmental concerns could be identified. Still, Jones said, there have been gaps and costly time delays, especially among children of color and those who live in rural Appalachia.
“With lead, some of these children might have been screened out, because we weren’t seeing the delay right away,” said Kim Hauck, deputy director of policy and strategic direction at the state Department of Developmental Disabilities.
According to the Ohio Department of Health, nearly 3 percent of 0-to-5-year-olds tested in 2016 — about 4,500 children — had bloodlead levels high enough to warrant action.
Neonatal abstinence syndrome has skyrocketed in Ohio and throughout the nation along with the epidemic of opioid addiction. The rate for Ohio newborns was about 140 per 10,000 live hospital births in 2017, more than six times the rate in 2006.
Nearly 2,000 Kim Barker kisses her adopted daughter, Olivia Grace.
newborns had been diagnosed with the condition by the time they left Ohio hospitals in 2017.
“If there’s drug exposure, it might not be recognized in a very small baby as a delay,” said Tammy Nelson, director of early childhood programs at the Scioto County Department of Developmental Disabilities. “Now, with there being a diagnosis, they’ll be eligible.”
Nelson said the number of babies and toddlers served through early intervention in her Appalachian county, one hit hard by addiction, soared to 187 last year, up from 114 in 2015. “And it’s not just the numbers increasing,” she said. “It’s the complexity.”
State officials said the proposed biennial budget contains about $24 million in new investments for early intervention, essentially double the last allocation.
Though she has recovered well and no longer needs services, Olivia Grace clearly benefited from quick intervention, Barker said.
She was born in Florida in December 2015 and came home to Ohio with her adoptive family the next month. The early days were especially rough, Barker said. Olivia’s skin was mottled and she sounded more like a weak kitten than a baby. Doctors discovered tiny holes in her heart.
“Her muscles were tight; she stayed in a fetal position,” Barker said. “She pulled her legs in, her arms in. She wouldn’t release her legs so that you could change her diaper. I kept thinking I was going to break her.”
Barker heldher daughter closeand whispered. “You’re a strong little girl,” she kept saying. “You can do this.”
Back at home, early intervention workers monitored her development and helped Barker learn the best ways to provide comfort, nourishment and care to an easily overstimulated infant. The family started her in preschool at age 2, and she’s still ahead of the curve. Her heart is sufficiently healed.
“God worked his miracle, and she got through,” Barker said. “And we were able to get all the help we needed.”