This report summarizes a mixed-methods descriptive study of how child welfare agencies identify and support children with prenatal substance exposures (PSE), with a strong focus on exposure to alcohol. Data sources include interviews with state-level child welfare directors, agency-level staff and directors, and local agency staff across 22 sites in 5 states. The study team also connected with caregivers and relevant service providers, and reviewed state- and agency-level policy documents and local agency case files.
Key findings span the following categories:
- Federal and state policies guiding child PSE identification and care
- Child welfare staff awareness and knowledge of PSE and practices to identify affected children and families
- How PSE information is shared and documented
- How child welfare agencies interact with caregivers and allied service providers in supporting children and families
The report also captures facilitators and barriers, potentially promising practices, and perceptions of gaps and needs to enhance child welfare practice. While the study design does not address issues of inequities and disproportionality—particularly among families of color—the team notes the importance of interpreting key findings and implications with an eye to these issues in the child welfare context. An advisory group of diverse stakeholders will help the team develop resources based on the findings.