As the United States faces the repercussions of the current opioid epidemic, it is important for social workers to be able to identify risks for poor birth outcomes in infants with neonatal abstinence syndrome (NAS). Although some studies have identified single risk factors, no studies have tested associations between total amount of risk (that is, cumulative risk) and birth outcomes in infants with NAS. Authors examined 318 mothers who used opioids during pregnancy and their infants' birthweight, length, head circumference, and Apgar scores (which measure overall infant health after birth). All infants were admitted to a neonatal intensive care unit in Appalachia and were diagnosed with NAS. Authors found that high cumulative risk during pregnancy was associated with lower birthweight and Apgar scores one and five minutes after birth as well as shorter length and smaller head circumference at birth. Social workers are encouraged to assess for the quantity of prenatal adversity experienced by the mothers they serve and to consider multicomponent, comprehensive community-based interventions to reduce cumulative risk.

Over 60% of trained social workers provide mental health services in their practices, and in all these settings clients are likely to have experienced trauma influencing their current circumstances, including childhood maltreatment and neglect. The 1998 Adverse Childhood Experiences Study has heightened interest in the long-term effects of trauma, especially early in life. Research has shown that our experiences influence our genes' activity through biochemical changes in what is known as epigenetic marks. Yet social work practice has participated minimally in targeting the influences of genes on behavior for research or intervention, partially because of a lack of scientific knowledge. This systematic review examines published research that investigated the influences of early trauma experiences on changes in gene expression related to emotionality and stress response. Authors conducted a systematic literature review according to the steps outlined by Shuster in Google Scholar, PubMed, and PsycINFO. Collected literature was reduced to 76 peer-reviewed articles after applying exclusion criteria. A strong pattern of relationships emerged from the review. Trauma and early life stress were associated with epigenetic marks in offspring on genes linked to stress reactivity (22 studies) and emotionality (23 studies).

Trauma and related fear exert significant influence on mental and physical health throughout the lifespan and are associated with intergenerational patterns of development, health, and behavior. DNA methylation and gene expression are involved in our developmental adaptations to our experiences and can be influenced by social interventions. Patterns of DNA methylation and expression of a gene involved in neurodevelopment and psychiatric risk (BDNF) have been linked with childhood trauma. Given the intergenerational patterns of health and behavior, and previous links between childhood trauma andBDNFmethylation and expression, this study investigated the potential for maternal history of traumatic experiences to influence development in her newborn, via changes in her newborn’sBDNFmethylation and expression. We found that mothers’ trauma history was associated with epigenetic regulation ofBDNFin their newborns. Moreover, the association between maternal trauma andBDNFmethylation and expression patterns were moderated by newborn sex. Male newborns showed increasedBDNFexpression with maternal exposure to child abuse (p = .001), and increasedBDNFmethylation with greater maternal fear (p = .001). Female newborns showed reducedBDNFexpression with greater maternal fear (p = .004). Practitioners strive to identify prevention and intervention avenues that will reduce the harmful effects of trauma. Future research should consider the potential for maternal historical trauma experiences to influence offspring DNA methylation and gene expression in a manner that could alter development and inform novel prevention strategies.

Stefanie R. Pilkay1*, Terri Combs-Orme2, Frances Tylavsky3, Nicole Bush4, Alicia K. Smith5 1Falk College, School of Social Work, Syracuse University, Syracuse, New York 2College of Social Work, University of Tennessee, Knoxville, Tennessee 3Department of Preventive Medicine, University of Tennesse Health and Science Center, e, Memphis, Tennessee 4Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco, California 5Department of Gynecology and Obstetrics, Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia

The recent article by White and Wastell (2016) poses important questions for the social work profession as we move to integrate scientific knowledge about epigenetics into our knowledge base, arguing that it is too soon to adopt this knowledge and posing ethical questions. In this reply, I take an approach that is more optimistic than that of White and Wastell, emphasising the reversibility of gene expression changes and the importance of social policy and interventions for addressing much of the damage caused by poverty, racismand violence.

Much of our understanding of human behavior and development has a foundation in animal research. However, many social workers do not have experience in biological research methods and therefore may not understand how and why this research is employed, or how it has benefited our practice. The purpose of this manuscript is to (1) discuss the ethical issues involved in research with non-humans; (2) briefly summarize the history, benefits, and limitations of pre-clinical research for knowledge that is critical to social work practice, and (3) illustrate some of the most important current issues involved in the usefulness of animal models of research for social workers, specifically in the areas of maternal care and the childhood experience, and dementia. An understanding of these issues will provide social work researchers, educators, and practitioners a deeper understanding of the meaning and importance of the knowledge produced through animal research, as well as allow them to assess this knowledge more critically.

Programming of the stress response system during gestation has lifelong effects that put the infant at risk for multiple stress-related pathologies. Populations most vulnerable to prenatal stress are African-Americans and individuals of low socioeconomic status. The Pregnancy Risk Assessment Monitoring System (PRAMS) research project, a collaboration between the Centers for Disease Control and Prevention and individual state health departments, was employed for this study. Tennessee data from 2009 were compiled from individual birth certificates and PRAMS questionnaire responses to examine the influence of maternal stressors, race and low income on birth outcomes. The number of stressors was only a significant predictor of having an infant small for gestational age when moderated by Medicaid status. Medicaid status was a positive predictor of both problematic birth and preterm delivery, but did not predict small or large for gestational age. The relationship between race and birth outcomes overall was moderated by age, with young African-American mothers less likely than European-Americans and older African-American mothers to have adverse birth outcomes.

Important findings from neuroscience research provide valuable knowledge for social work practice, and although these findings are already being incorporated into practice in many other disciplines, social work has been slow to integrate this content into foundation professional education. This article describes how one social work program incorporated this knowledge into Human Behavior in the Social Environment courses, noting both challenges and successes over 8 years. The authors include information on content, pedagogical methods, and useful resources.

Purpose: The purpose of this descriptive qualitative study Was to gain understanding of perceptions of low-income pregnant women and mothers about parenting.Study Design and Methods: Participants were 65 low-income, primarily African American, women in their 20s and 30s who were recruited from a faith-based social service center in Memphis, Tennessee. Interviews were conducted by nursing, social work, and psychology students. The existential phenomenological method was used to analyze verbatim responses of participants to vignettes depicting parenting behaviors of hypothetical mothers.Results: Five global themes were identified: (a) Focus on baby's development: "Because I'm the Mother, I'm the First Teacher"; (b) Focus on baby's safety/security: "The Baby Could Be Hurt"; (c) Focus on conveying love: "She Just Wants the Baby to Feel Her Love"; (d) Focus on learning the rules of good childcare: "It's Important to Know the Do's and Don'ts"; and (e) Focus on doing it differently (better) than parents did: "When You Know Better, You Do Better.'Clinical Implications: Findings suggest that these mothers care deeply about providing a better life for their children than the life they have had. They desire to learn about being the best parents they can be. As nurses, we can help to provide educational opportunities for mothers through a variety of evidence-based interventions delivered across the childbearing years.

It is well documented that children living in poverty experience disadvantages in virtually every area of health and mental health, development, academic achievement, and other areas, compared to their more well-off peers. Mechanisms behind these disadvantages certainly include the lack of resources of all kinds inherent in poverty, including access to health care, high-quality education, safe housing, nutritious food, and many other resources. Less well recognized is the contribution of prenatal stress to these gaps, as poor children’s disadvantages often start early in fetal life due to high stress experienced by their mothers. Animal research and emerging human research demonstrate that stress during pregnancy affects fetal brain development through the mother’s hypothalamic–pituitary–adrenocortical axis, influencing the developing stress system and other parts of the brain of the fetus. Understanding these relationships among poverty, prenatal stress, and child outcomes is important for social workers, whose policy and service provider roles provide opportunities for amelioration at both micro- and macro-levels. This paper elucidates the consequences of prenatal stress, demonstrating that the physiological stress response operates prior to birth and directly influences infant and child biological, psychological, and social well-being. First, we briefly review the well-documented disadvantages experienced by poor children. Then, we describe the physiology of stress, clarifying the often-confusing definitions and elaborating to explain unique physiological aspects of stress during pregnancy. Finally, we discuss the important role social work may play in addressing this important problem.

Abstract Parenting is a key part of social-work practice and research, particularly in the child welfare arena. Despite significant research and theory in other disciplines about the importance of the parent–child relationship to the quality of parenting, the focus of social work appears to lie in narrow goals such as the prevention of abuse and child placement and to employ interventions that lack significant evidence of effectiveness. This entry summarizes social-work practice and research in the area of parenting and reviews the state of the art overall in research and knowledge about parenting.

Despite social work's claim of a bio-psychosocial approach to human behavior and development, the profession fails to incorporate important physiological knowledge into practice, research, and education. This article provides an example of the usefulness of understanding the ontology of early brain development by demonstrating how such knowledge can be integrated into Piaget's theory of cognitive development. We suggest that social work's focus on evidence-based practice demands the incorporation of neuroscience into the profession's body of knowledge.

Almost two-thirds of children in non-relative foster care live in homes headed by married couples. However, the literature includes little about either the role of foster fathers or the complexity and importance of the marital context for fostering. This study examined family functioning, overt interparental hostility, depression, and parental acceptance in a sample of 111 heterosexual foster parent couples and the relationship between family context and potential to foster parent successfully. Latent class analysis revealed three distinct types of foster parent couples, “Good Context” (33%), “Typical” (56%), and “Bad Context-Discordant” (11%) couples. “Bad Context-Discordant” couples are notable for having much lower scores on all context measures, for differences between mothers and fathers, and for the fact that most fathers had depression scores in the clinical range. Finally, results indicated that better family context was related to greater potential to foster successfully and that on three of five dimensions measured mothers exhibited greater potential.

Development of the brain in the first 3 years of life is genetically programmed but occurs in response to environmental stimuli. The brain is organized “from the bottom up,” that is, from simpler to more complex structures and functions, so the experiences and environment that shape early development have consequences that reach far into the future. This entry describes the ontogeny and processes of fetal and infant brain development, as well as major risks to early brain development (during pregnancy and after birth), with emphasis on the factors seen in social-work practice. Neuroscience research is changing social work practice, and understanding early brain development and the contributors to poor development is critical for social workers in medical, mental health, child welfare, and other practice settings.

The current study was designed to explore the cognitions of African-American mothers about the importance of the first 3 years of life for brain development, and to determine the relations between those cognitions and important parenting beliefs. We collected survey data over a 1-week period from a diverse sample of 222 African-American mothers waiting for preventive and minor acute care appointments in six pediatric waiting rooms in Memphis, TN. Latent Class Analysis revealed two groups of mothers: one that was aware of the importance of the first 3 years for brain development (about 56 %), and one that is less aware (about 44 %). Mothers in the two latent classes had significantly different parenting beliefs about spoiling versus nurturing and the importance of stable child care arrangements, but not about corporal punishment of infants. Poverty and education significantly affected latent class membership. Parenting education interventions might be better targeted and more effective when informed by participants’ understanding of early brain development.

Epigenesis is the biochemical process through which some genes are expressed and others remain silent, and it reinforces and explains the powerful impact that the environment has on human development. Epigenetic effects occur not only through diet, chemical exposure, and high levels of environmental stress, but also through chronic poverty and racism. Epigenesis provides a mandate for social workers to intervene at the policy level, both for today's children and for those in future generations.