Social-Emotional Development in Young Children of Mothers with Substance Use Disorders

Background and Purpose: Social work researchers and practitioners are well aware that families struggling with parental substance misuse are often marginalized and economically challenged. Furthermore, the specific risks are great for young children being parented by mothers with substance use disorders (SUDs) who often have histories of trauma and co-occurring stress and depression (Kaltenbach, 2013; Romanowicz, et al., 2019). Each factor on its own may increase the likelihood of difficulties in children’s social and emotional development (Salo & Flykt, 2013). Yet, given the complex interplay among these challenges and the fact that they often present simultaneously, it remains important to tease out the most significant factors associated with child developmental outcomes in order to develop targeted parenting interventions.

Methods: This study utilized baseline data from a dyadic, trauma-focused and attachment-oriented intervention for mothers and their young children embedded in SUD treatment. The intervention is designed to support optimal parenting capacities, child-parent relationships and child developmental outcomes. The majority of participating mothers (N=39) were predominantly Caucasian, had a mean age of 30 years, histories of heroin/opioid misuse, and many had elevated scores on depression (BSI) and parenting stress inventories (PSI) and low resiliency scores (CD-RISC). Their children’s mean age was 22 months and they had experienced on average four traumatic events (TESI). In order to assess the most salient predictors of parent-reported child social-emotional development (assessed with the initiative and attachment scales on the DECA), data were analyzed using two hierarchical regression models that included measures of child trauma exposure, maternal depression or resilience, and parenting stress as independent variables.

Results: 

All independent variables included in the models were significantly associated with the dependent variable in bivariate analyses. In the first hierarchical regression model predicting child social-emotional development, child trauma exposure and maternal depression were partially mediated by parental stress (R² = .34, p=.002). Similarly, in the second hierarchical regression model predicting child social-emotional development, child trauma and maternal resilience were also partially mediated by parental stress (R² = .36, p=.001). Results in both models demonstrated that parental stress was an important predictor of child social-emotional development partially mediating the impact of the child’s own trauma exposure and maternal mental health.

Conclusions and Implications: Although the sample size is small, this study offers preliminary support for targeting parenting stress, along with other challenges, when developing social work interventions for mothers with SUDs and their young children. Further research should examine the efficacy of these interventions to assess whether the outcomes demonstrate a link between improved parental stress and child developmental outcomes.