MORGANTOWN – The nation’s ongoing opioid crisis has increased the prevalence of infants born with Neonatal Abstinence Syndrome (NAS), especially in rural states.
WVU Medicine Children’s and IMPACT WV – a program of the WVU Center for Excellence in Disabilities – have teamed to create a new clinic to provide medical care and social services for children affected by NAS and their families, including caregivers, whether they be biological, foster or kinship.
What is NAS? The Cleveland Clinic refers to it as Neonatal Opioid Withdrawal Syndrome and defines it as “a condition that affects newborns who receive opioids or addictive substances through the placenta during pregnancy. Babies have withdrawal symptoms during their first few days of life.”
Lesley Cottrell, director of the Center for Excellence in Disabilities, said the CDC has ranked West Virginia as highest in the nation for NAS prevalence, at 33.4 per 1,000 live births – 3.34%, compared to 1% nationwide. But more accurate statistics through state collaboratives have demonstrated that 5.2% of all babies born in West Virginia are diagnosed with NAS.
IMPACT WV is a program designed to help providers and NAS-affected children and families. The clinic was launched in April, Cottrell said.
More research is needed on the long-term effects of NAS, she said. But it can affect executive functions – limited attention span, short-term memory limitations, potentially more hyperactivity, possibly some delays in assessments for schooling. They’re not sure about physical delays but they do look at that in the clinic. And learning more is part of the clinic’s function.
The clinic is in its early stages, Cottrell said, meeting with an initial handful of families one day a week. Visits take about 90 minutes. There’s the medical monitoring and assessment aspect through WVU Children’s, and the social services aspect offer through IMPACT WV.
Services can include dental care for the mom or caregiver; basic needs such as a crib for the baby, diapers and formula; and covering fees for substance use recovery and treatment, transportation to treatment. It can also offer guidance on child growth and development, nutrition, vision, behavior, bonding, lactation and more.
The clinic started with infants with the most severe NAS symptoms at birth, she said, and they’re seeing children ages 1-3, but it’s available up through age 5, as the kids transition to school.
The clinic is currently offered one Wednesday every two weeks at the Health Sciences Center and they’re seeing about three to four families each time, she said.
For the caregiver, the clinic team reviews goals, interests in employment and other training, and the home environment to ensure daily needs are met. If substance treatment is still desired or needed, the team works with the caregiver to make contact, complete the referrals, and attempt to receive those services.
For the infant, the clinic team assesses physical growth, development (cognitive, motor, language), and exposure to violence. Feeding and swallowing issues are included. Occupational and physical therapy assessments are completed for those identified, and speech issues are assessed regularly over time.
The goal, she said, is to expand the clinic over the next nine months – more days, more families, perhaps streamlining the process to allow more families to be served by offering the medical portion at Children’s and the social services portion at the CED on Hartman Run Road.
As they move forward and develop a better understanding of NAS, Cottrell said, policy changes might flow from that. “What do families need when they’re experiencing this? They’re already vulnerable.”
In the past, she said, it was the practice to separate the mom and baby, and treat them separately, but nationally some models favor keeping them together. “We’ve come a long way and there’s more to go.”
Email: dbeard@dominionpost.com
