In a 2004 substance abuse study, an estimated 2.0 million persons (0.8 percent) were current cocaine users; of these, 467,000 used crack during the same time period (0.2 percent). Hallucinogens were used by 929,000 persons (0.4 percent). There were an estimated 166,000 current heroin users (0.1 percent). All of these estimates are similar to estimates for 2003 of substance abuse.

Understanding substance abuse begins with an awareness of the issues a mother and her family face during drug treatment. Substance abuse affects entire families, yet only recently has attention been focused on the needs of children with parents who abuse drugs and/or alcohol. Not only must these children's needs be identified, educators also must recognize that there are gaps to be bridged, particularly in the areas of education and substance abuse treatment.

Historically, women were rarely considered to be substance users. Women do abuse drugs and alcohol, however, and they have gender-specific treatment needs. Recognition of this has triggered a change in treatment methods (Kumpfer, 1991). More recently, a growing understanding that drug abuse affects the entire family (Zuckerman, 1994) has shifted the focus to the specific consequences for children. Children may be at high risk not only because of prenatal exposure, but also because of factors secondary to drug use, such as inconsistent caretaking and physical abuse (Smith, 1992). For example, mounting evidence indicates that some children initially thought to have attention deficit disorder are actually suffering from post-traumatic stress syndrome, displaying symptoms of impulsivity, temper tantrums, aggression, inattention, and hyperactivity (Thomas, 1995).

As treatment programs become more ecological and family-focused (Horn, 1994), it is increasingly important to involve other professionals, including social workers, health care professionals, psychologists, and educators. Educators need to be involved for two reasons. First, teachers need to know what is happening in their students' lives that may influence their attitudes and behaviors in the classroom (Forehand, Armistead, & Klein, 1995). Second, teachers need to share their insights and knowledge with parents and other professionals and thus advocate for the child's best interests.

Within family-focused treatment, multidisciplinary teams composed of professionals and agency representatives work together to develop intervention plans. These "treatment plans" or "individual family service plans" define goals and identify services required to meet the family's needs. Previously, educators had little involvement as part of these teams. If educators are to advocate successfully for the child's education needs and participate effectively as members of interdisciplinary teams, they need to understand addiction, the treatment process, and the various agencies involved with the family.

A woman enters treatment in an effort to control her addiction to drugs. When she begins treatment, she must confront all of the personal and emotional aspects of her life, including the overt and covert reasons for her abuse, as well as the quality of her relationships with family and friends. She brings into treatment her social service system connections, including her involvement with the judicial system and protective services. Increasingly, she is bringing her children to treatment. Many women are required by the court to enter treatment as a condition for retaining (Laken & Hutchins, 1996) or regaining custody of their children (Jones, McCullough, & Dewoody, 1992). In effect, their children may be the reason women enter treatment, the reason they remain in treatment (Howard & Beckwith, 1996; Kauffman, Dore, & Nelson-Zlupko, 1995), and, for those who lose custody of their children, the reason they leave treatment prematurely. All of these factors affect the mother's treatment, her retention in treatment, and her plans for the future.

When entering treatment, a woman faces a multitude of decisions, including: Should she bring her children with her to the treatment facility? What should she do about the children who are not living with her? Should her children in foster placement come with her? What are the best interests of her children? The mother must consider her relationship to each family member, as well as her relationship to her family as a whole. The questions and considerations are myriad, with few clear answers. These are critical issues, not only for the mother, but also for the children. The children are often aware of what is occurring and they can sense the tension. For them, life continues to be unstable and unpredictable. When things are unsettled or tense at home, these tensions often carry over to the classroom.

Until recently, the issue of children in treatment was addressed from the perspective of what to do with the children while the mother is in treatment. Assessing children's needs and providing therapeutic treatment is a relatively new concept.

Developmental and Education Concerns. Maternal substance abuse affects the children from both a biological perspective (for example, prenatal exposure) and an environmental perspective (Brooks, Zuckerman, Bamforth, Cole, & Kaplan-Sanoff, 1994). The literature and clinical observations indicate that children's speech development (Rivers & Hedrick, 1992), motor development, social and emotional development (Hawley, Halle, Drasin, & Thomas, 1995), and cognitive processing (Guo, Spencer, Suess, Better, & Herning, 1994) may be affected as a result of living in a drug-abuse environment. Furthermore, problematic family situations may lead to difficulties in school achievement (Sawyer & Dubowitz, 1994; Waters, Roberts, & Morgen, 1997; Zill, 1996) and peer relationships (Gustavsson & Rycraft, 1994). The effects of these sequelae will not be felt by the children alone. They will have a bearing on teaching, classroom needs, and the school environment.

Environmental Influences. Children growing up in environments in which they are exposed to active substance use also may be exposed to transient living conditions (e.g., residential hotels and homeless shelters); varied, inconsistent caregiving arrangements; and a lack of stability and order in daily activities. Inconsistent and chaotic environments affect children's ability to form attachments, their psychological and emotional development, and their ability to learn (Howard, 1994). Many children in these circumstances are often at risk of exposure to violence, from within the family and from the community as well (for example, from drive-by shootings, fights, and drug busts [Osofsky, 1995]). The multiple effects of violence on children's long-term development have only begun to be explored (Osofsky, 1995; Scheeringa & Zeanah, 1995). From an educational perspective, both proximal and distal violence can affect children's ability to pay attention and function appropriately in school (Zuckerman, 1994).

Role Reversal. Role reversal involves family interaction patterns in which children manifest behaviors usually associated with parents (Bavelok, 1984). For example, the child may comfort the distressed parent or do all of the cooking. "Maturity" in young children may not always be a good thing; it may mean that the child is taking on too much responsibility at home. As a consequence of having to raise themselves and act as a caretaker to their parents, children may form skewed relationships within the family and the outside world. These characteristics can have long-term effects on development, attachment, and interaction patterns between the child and parent (Jurkovic, 1997).

Out-of-Home Placement. Parental neglect and maltreatment, often linked with substance abuse, can result in removal of the children from the home (Azzi-Lessing & Olsen, 1996). When children are placed in foster or kinship care, they experience disruptions in their attachments with their primary caregivers, siblings, schools, and communities. All too often, the child may experience multiple placements before a longterm solution is reached. Repeated separations may affect their behavior and academic achievement. One study found that children in foster care have low levels of achievement, and are at increased risk for school suspension or placement in alternative school programming (Poulsen, 1995).

What can educators do? Even before substance abuse was identified as a major family concern, educators were addressing and intervening in home/school issues (Shartrand, Kreider, & Erickson-Warfield, 1994). To respond to changing societal and student needs, curricula in the 1960s and 1970s began to address some children's limited life skills and low self-esteem, which interfered with academic work (Steinberg, 1996). Concomitantly, the impact of parents--their parenting styles, ability to listen, and ability to model learning behavior--was recognized as important to the child's ability to learn and succeed in school (Scott-Jones, 1995). An educator's intervention, therefore, can be pivotal.

The teacher's role is integral; studies indicate that psychological and social problems can interfere with children's ability to become involved in their education (Steinberg, 1996). The teacher can help to bridge home and school by understanding what is happening in the child's home life. For example, a teacher who is an active part of a treatment team can correct a common oversight by ensuring that the children's education needs are incorporated in the family treatment plan.

As drug abuse often affects several generations, many mothers in recovery may not know how to support their children's learning. They may need to learn or relearn how to provide positive, nurturing interactions, as well as how to work with teachers and their children in school. Schools and teachers can create and foster involvement opportunities for parents with special needs. A mother may feel more welcomed and secure when invited to participate in a classroom activity if someone familiar, such as her child's teacher, is a member of the treatment planning team.

Family-focused treatment programs involve a number of agencies. Educators who become active participants in developing collaborative interactions with other agencies can significantly affect children's academic outcomes. Linking the education service delivery system with the other intervention systems (such as social services, health services, and the criminal and judicial systems) promotes continuity of care for the recovering woman and her children. The need for continuity is increasingly acknowledged in the literature (e.g., Ackatz & Jones, 1992; Finkelstein, 1994). It is time for education to become a part of the continuum of services working with and for families and children.

To maximize collaboration, professionals need to develop common goals and language. Just as educators have an "alphabet soup" of abbreviations to which they refer (e.g., IEP and ADA), so do the other disciplines. Developing a shared language will facilitate communication and the development of common goals and objectives.

Teachers are in a position to act as "resiliency mentors." Resilience has been defined as "the ability to bounce back from adversity and adapt successfully" (Weinreb, 1997, p. 15). Weinreb suggests that protective buffers can be incorporated into classrooms and curricula that emphasize self-esteem, encourage development of untapped skills and interests, foster parent contact and participation, and support community efforts. While teachers cannot expect to effect change by themselves, they can promote ongoing positive interventions by incorporating a resiliency perspective in teaching.

The teacher can play an essential role in the lives of children growing up in families that abuse drugs and/ or alcohol. As educators increase their understanding of substance abuse and treatment, they will be better able to advocate for children's needs. With the support of teachers and the education system, these children will have a better chance to succeed in school.

Recommendations: Next Steps for Educators and Administrators

* Become resiliency mentors. Acknowledging and understanding the difficulties faced by children of drug-abusing parents enables teachers to identify protective buffers. Teachers can foster resiliency by modeling appropriate behaviors, using a proactive curriculum, and promoting interactions, both individually and with social service delivery systems, that are in the best interests of children.
* Incorporate curriculum that includes all families, and begin to build abuse prevention into the curriculum. Examples include using a bibliotherapy approach, including such books as Daddy Doesn't Have To Be a Giant Anymore (Thomas, 1996), and offering curriculum-based substance abuse prevention program for young children (e.g., Jones, 1990).
* Provide inservice training for teachers. Teachers need inservice training to help identify children and parents in high-risk situations, the needs of these families, and intervention strategies based on resiliency models. This enables educators to incorporate the skills needed to work more effectively with at-risk children and parents.
* Provide supportive services to the teachers. Teachers involved with high-risk children require support. On-site or referral resources for support services should be available to teachers working with children and families involved with drug and/or alcohol abuse.
* Provide supportive services to families. Teachers also must recognize that working with high-risk families that are experiencing multiple crises can be stressful and, at times, overwhelming. Teachers need access to appropriate support, as well as to resources for students and families at risk.
* When providing training on parenting skills, incorporate information on school support and participation. Many women in recovery need education and support in the areas of parenting and child development. Parent participation in the schools often is neglected. Barriers to parental involvement include parents' lack of knowledge about school systems, and their discomfort interacting with school personnel or other people. Mothers may need help to learn how to assist their children at home and in the classroom, and to learn how to express their concerns appropriately and effectively.
* Create systems within and among schools and districts that facilitate continuity of records, communication among teachers, and transfer of information. Ease the transition for children in out-of-home care by facilitating the transfer of records and promoting communication among teachers. Children's resiliency can be enhanced and their risks lessened when they have a sense of support and caring during difficult periods in their lives.
* Promote interagency, intersystem, and interdisciplinary collaboration and planning, to help ensure continuity of care. Best practice in all service delivery areas focuses on ways to achieve seamless models of care. Developing these models requires knowledge of the other systems (primarily, social services and health care) in order to promote continuity, cooperation, and participation. All levels of the education system, from superintendents to teachers, need to support participation in multidisciplinary team meetings for families at risk.
* Provide teachers with classes on high-risk issues, or integrate these issues within the core curriculum at the preservice education level. As more children are identified as being high-risk, whether from living in substance-abusing environments, or as a result of poverty, teen pregnancy, parental mental illness, or environmental violence, it is essential that preservice teachers pursue a proactive education approach that encompasses all children and their families.
* Encourage and support research addressing the needs of school-age children from families involved in substance abuse. More studies are needed on addressing the needs of school-age children from substance-abusing environments, and on learning how schools and teachers can intervene to assist these children.