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Mentors: M. Cameron Hay, Ph.D., Elizabeth Kiel Ph.D.

Neonatal Opioid Withdrawal Syndrome (NOWS) results from prenatal exposure to opioids and other related substances. The prevalence of NOWS in children has increased 6-fold in the state of Ohio since 2006 (ODH 2019). Studies show that NOWS has long-term consequences and significantly impacts physical, emotional, and neurocognitive development throughout childhood (Fill 2018; Boggess and Risher 2022). Our preliminary survey study of children with NOWs aged 2-7 found that a subgroup of children with high difficulties deviated from others, expressing more negative affect and less effortful control, and their caregivers had a lower sense of parenting competence (Arter et al. 2022). Effortful control is a component of self-regulation and comprises capacities for inhibiting a dominant response to achieve a goal, orienting and shifting attention, and planning. Parents whose children are high in emotionality and have difficulty with self-regulation report more parenting stress (Berryhill et al., 2016). Parents are especially likely to find parenting stressful when their children have special needs and socioemotional difficulties (Schuiringa et al., 2015), both of which characterize children with NOWS. The sensory sensitivities associated with these difficulties have been specifically linked to parenting stress (Epstein et al., 2008). The few studies examining long-term outcomes of children with NOWS emphasize that high-stress home environments are associated with poorer outcomes (Grossman & Berwitt, 2019) however however, there has been no research conducted within the home environments of opioid-exposed children. A critical gap remains in understanding social and environmental factors, including environmental stress, that may affect their long-term developmental outcomes.