Recovering Motherhood

Esther M. Bauer
June 2, 2003

Synthia Moss and her daughter.

Babies exposed to illicit drugs before birth can and do suffer withdrawal symptoms after they are born. Not surprisingly, for a mother struggling to end her own drug dependency the responsibilities of parenting a cranky newborn in the throes of withdrawal can be overwhelming.

At New Connections, a Dallas, Texas program operated by the University of Texas Southwestern Medical Center with funding from the Texas Commission on Alcohol and Drug Abuse, mothers like these find intensive, non-judgmental support. The program also helps mothers and their children by finding services in cases where the child is suffering developmental delays linked to parental drug or alcohol abuse.

Hard-to-Parent Infants

Babies affected by drugs such as crack, other forms of cocaine or marijuana may not show very clear withdrawal symptoms at birth. However, when these babies are taken home they often become distressed and constantly tense. By the time they are one or two months old, some have developed such tenseness and stiffness in their legs and hips that with support, they can stand upright.

"You don't have to be a development psychologist to realize that there is something wrong there," says Toosje Van Beveren, Ph.D., a developmental psychologist at New Connections. Initially, says Van Beveren, the moms misinterpret their baby's stiffness and crankiness to mean that "their child doesn't like them. Well, if you think your newborn baby doesn't like you, that isn't very beneficial for the attachment process."

To help, New Connections takes a dual approach—aimed at both mothers (plus a few fathers) and their children. The program is geared to infants and children up to the age of five who suffer developmental delays arising from either prenatal drug abuse or from living in an environment where drug and alcohol substance abuse is present.

Solving Problems & Strengthening Family Ties

Since the program's inception in 1996, more than 1,100 children and 700 parent/caregivers have been admitted to the 120-hour, 12-week course.

Each group meets for five hours a day, twice a week. The mothers receive parenting and behavior modification classes geared to teach them how to be better parents and to develop new ways to deal with their own anger and frustration instead of abusing drugs or alcohol. While they are in class, their children are tested for developmental problems, which can then be addressed by a psychologist, therapists and the staff of child-care coordinators. The infants are massaged, talked to, and held. The staff also guides toddlers and preschoolers through games and art activities designed to address any learning delays.

The course asks a lot of the parents, and only about half of those who start the program complete it. But pre- and post-tests of graduates show remarkable gains in the emotional maturity of the parents along with developmental improvements in their children, according to outcome measurements required by the Texas Commission on Alcohol and Drug Abuse.

The program's focus is on finding solutions, not placing blame for the children's problems. The youngsters are assessed, treated, and if necessary referred to specialists. Their mothers are taught how to aid in their child's recovery, and in the process they learn parenting skills that seek to boost their self-esteem, allay self-contempt and deepen the bond with their child.

Physical, speech and occupational therapists may also work with the children. Older children in the program often have speech delays, in part because the parents haven't been talking, singing and reading to them. For infants, a common problem is delayed gross motor physical development due to their stiffness. The babies often have feeding difficulties, too.

Most problems are correctable but require a parental commitment that the parenting and child-care staff zealously try to engender.

Older children with speech delays will require the help of therapists, but mothers with babies are simply taught to coo and sing to their babies to encourage language development. Mothers also learn to massage their infants to relieve stiffness so the babies can relax.

"It helps the child, but it also helps the relationship between the mother and child, which is much more important. A number of our moms have guilt feelings and are in denial about their child's problems. But when she has an activity or an exercise that helps her child, it helps her with those feelings, too," Van Beveren says.

Keeping Parents and Children Together

The program has transformed 24-year-old Moneshi Henderson into "a better mom than what she may have ever intended to be," says Henderson's mother Vivian Usatorre.

Monesha Henderson and her daughter.

Henderson, who graduated from a recent 12-week class with her 3-month-old daughter, Jamia, had smoked marijuana through almost all of her pregnancy. She was referred to New Connections by Child Protective Services after a positive drug test.

"They inspired her to be in that program. She is trying to do everything she can do to be the best for her baby," Usatorre says.

The Dallas County division of the state's Child Protective Service program refers most of the mothers. Parkland Memorial Hospital, the nearby public hospital where at least two dozen heroin- or methadone-addicted babies are born annually, also makes referrals.

Child Protective Services sent Synthia Moss, 28, to the program after transferring custody of her infant daughter and 5-year-old son to Moss's mother. Moss needs to complete the program to regain custody.

Moss, now clean and sober, admits to being addicted to marijuana since she was a teenager. She initially resented the intervention.

Synthia Moss holding daughter.

"I had the attitude that no one can tell me how to be a parent. When you come into this program, you think these people are going to think they are better than you. They might be better in certain areas, but they really try to come down to your level so they can then bring you up to their level. They are not judgmental at all," says Moss.

"They talk about everything and do a lot of it one on one. They are there to help you and your kids—you to be a better adult and for you to raise a better adult so that your kids don't make the same mistakes that you made."

Helping the Whole Family

About five percent of New Connections graduates stay in touch with the program by attending annual reunions. Some stop by regularly. One alumna credited the program, in a Dallas Morning News Letter to the Editor, for her 17 months of sobriety and for teaching her "invaluable life and parenting skills," which she wrote, "renewed my faith in both myself and my community." Others regularly call Jaquita Johnson, the program's parenting educator and licensed chemical dependency counselor, seeking advice.

"In this group of people, a lot of the behaviors they exhibit are learned. It is intergenerational and difficult to change, because you cannot change anything overnight that you have lived all of your life," Johnson says.

"If they come here kicking and screaming, it isn't until the eleventh or twelfth week that they begin thinking, 'Hey, I like this program; I enjoy this program; I've learned so much.' Well, it took most of those 12 weeks just getting them to see there is a problem. This is a time- and labor-intensive program. It takes a significant amount of time to affect people's lives."

For the children, early intervention is the primary need. For the parents, however, needs run the gamut of developing new skills, methods, options and ideas that "they have never tried or even thought of in terms of assisting their children to become capable individuals," says program director Emily West.

What the Future Holds

"Rigorous testing shows tremendous gains across the board for families that complete the program. We would like to know if these positive impacts last five years down the road, or when these kids get to school, or when the next baby is born into this family. That is what we don't have funding for," West says.

With the state's lingering budget crisis, the likelihood of funding for long-term testing is nil, and West worries the program's $435,000 annual budget is itself at risk of cutback. Only its category as a high- performer will save it from significant cuts, she says.

The program, which costs an average $3,600 per family completing the program, is the only one of its kind in Texas, West says. She was recently contacted by a researcher from the Substance Abuse & Mental Health Services Administration. "She was trying to find information about programs that serve families throughout the country—looking for programs that truly serve families, not just serve kids or parents, who come once a month to a parents' meeting," says West. "Ours was one of the few she has been able to find."

"We need to continue what we are doing, but we also need to do long-term follow-up of program participants to find out if the significant progress our parents see while they are with us is maintained. What goes on here in 12 weeks just begs the question, does it stick afterwards?"


Esther Bauer is a Dallas-based freelance writer and the former vice president of corporate communications at Parkland Health & Hospital System in Dallas. She and her writer-husband operate E.B. Writers of Dallas.