Meeting the Needs of Children in the Opioid Epidemic

Conversations between Practitioners and Researchers

The second in a series of researcher-practitioner conversations was held on May 3, 2018.

When: Thursday, May 3, 2018
Where: University of Massachusetts Medical School, South Street Campus
333 South Street, Shrewsbury, MA

Time: 5:30 pm – 7:30 pm

Hosted by: Massachusetts Association for Infant Mental Health

A panel discussion of what we know (and don’t know) about the effects of opioid exposure on newborns and young children, and an example of a clinical practice model.


  • Jayne Singer (practitioner)
  • Anat Weisenfreund (practitioner)
  • Ruth Paris (researcher)
  • Clinician involved in Project BRIGHT

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Synopsis of Event

As Past and Acting President of MassAIMH, Jayne Singer, PhD, faculty, Brazelton Touchpoints Center, Children’s Hospital, Boston, previewed the event with opening comments about “Hope in the Face of Adversity: Use of the Newborn Behavioral Observations system (NBO) to support mother-infant emotional health in the context of Substance Use Disorders (SUD).” This was a call to action for Infant and Early Childhood Mental Health researchers and practitioners to promote non-pharmaceutical interventions for enhancing care and outcomes for addicted or recovering birthing mothers and the youngest survivors of the SUD epidemic: the newborn infants born with Neonatal Abstinence Syndrome and ongoing effects of intrauterine substance exposures. Key points included a need in the field to target whole family systems as the focus of treatment. Dr. Singer called for us to robustly address every missed opportunity for intervening in the earliest stage of infant-parent attachment in service of optimizing infant developmental potential, and enhancing birth mothers’ future-orientation and motivation for treatment in order to be able to have their infant returned to their care. Dr. Singer shared specific details of the Newborn Behavioral Observations system (NBO) as a unique vehicle by which the mother with SUD is drawn into emotional attachment with their infant as a primary motivator for recovery.

Anat Weisenfreund, M.S., Chair of the Massachusetts Head Start Association, presented her NICU based work in the early 1990’s at a large urban teaching hospital with opioid-exposed infants and their caregivers. She first reviewed broad differences and similarities between the crack epidemic of the 1990s and the present opioid crisis with an analysis of the intersections of race, class and criminalization of women, and summarized both short and longer-term developmental outcomes for opioid exposed infants. She then detailed the development and implementation of the Parent and Newborn Development and Assessment (PANDA) Program, with its whole system approach, using strength based assumptions and focus on facilitating typical developmental process for both infants and their caregivers.

Ruth Paris, PhD, faculty at Boston University School of Social Work, presented a summary of the work of Project BRIGHT, a SAMHSA/NCTSN funded program focused on parents with substance use disorders and their young children (PI: Norma Finkelstein, Institute for Health and Recovery). She described the foci of the 3 BRIGHT grants, in family residential treatment, opioid treatment, and outpatient settings and additionally shared findings from an evaluation study. Dr. Paris then showed a video of a BRIGHT client she interviewed describing her experiences misusing substances and the placement of her young child in child welfare custody for a period of time. Another video was shown with the aforementioned mother and her child in an interactive play session.

Christine Trendell provided a description of SSTAR Birth in Cranston, RI: the women that receive treatment there, services provided, length of stay and the referral/screening process to Project BRIGHT. She then discussed the services that Project BRIGHT provides and how it is integrated into the SSTAR Birth milieu and the unique challenges/advantages that are provided. Ms. Trendell also discussed how the mothers are able to access services and the issues that emerge in relation to the opioid crisis in RI and MA currently, and how “success” can be measured by small steps unique to each woman and dyad.