Contents - NACoA

Contents
A Message to Early Childhood Professionals -------------------------------------------------------------- 1
Core Competencies ------------------------------------------------------------------------------------------------ 3
Helping Children in Your Care -------------------------------------------------------------------------------- 4
The “Seven Cs” --------------------------------------------------------------------------------------------------- 11
Children of Alcoholics: Important Facts------------------------------------------------------------------- 12
Questions and Answers ----------------------------------------------------------------------------------------- 19
To Keep in Mind -------------------------------------------------------------------------------------------------- 21
Additional Resources -------------------------------------------------------------------------------------------- 23
This is the fifth in a series of Kits developed by the National Association for Children of Alcoholics for
professionals who are interested in children and families hurt by alcoholism.
The reproduction of this publication is allowed in the quantities desired.
Recognition of the original source would be appreciated.

A Message to Early Childhood Professionals
You are in a unique position to make a significant contribution in the lives of
children with alcoholic parents. The many hours you spend caring for these children
can have a profound effect on the quality of their lives—now, and in the future.
The National Association for Children of Alcoholics (NACoA) has assembled this
kit to help you learn more about the disease of alcoholism and its effects on children of
alcoholic parents. We want you to have the opportunity to touch these young lives in the
best way possible. This kit—the fifth in a series of publications for children of alcoholics
and the professionals who work with them—contains resources others have found to be
helpful. As you read these materials, keep these things in mind:
Millions of Americans are problem
drinkers or suffer from
the disease of alcoholism. One
in four children in the United
States is growing up in a home
where alcohol abuse or alcoholism
is affecting their lives.
Countless others have parents
who are addicted to other drugs.
Many research studies suggest
that the children of alcohol- and
other drug-dependent parents
are at a great risk for problems
later in life. Children of alcoholics
grow up to become parents
who, if not helped, often carry the
sorrow and uncertainty of their
own childhoods with them.
Alcoholism is a family disease. It
affects all children in an alcoholic
home environment, but some of
them are able to bounce back and
learn to cope with life’s difficulties,
especially if they are given a
little help. Often that help must
come from outside the family. As
caregivers, we can help children
to become more resilient.
Learning about alcoholism and
how it affects family members,
and then discovering resources
in your community to help families
cope with alcohol-related
problems, are good beginning
steps. Armed with knowledge
and information about alcoholism,
and the resources with
which to address it, you can help
reduce the risks of future problems
in children from alcoholic
homes—and help reduce the
confusion and fear they feel now.

While accurate, age-appropriate
information and skill building
help children of alcoholics immeasurably,
perhaps the most
important gift is the bonding
and attachment children attain
in healthy relationships
with you, other caregivers, and
children at your child care site.
Children in alcoholic families
develop a strong “Don’t Trust”
habit because of broken promises,
harsh words, and the threat
of abuse. Silence and isolation
can become their constant companions.
Caregivers spend many hours
with children and have the opportunity
to build trust. As children
learn to trust, they learn to
feel good about who they are and
what they can become. They develop
the ability to make better
decisions, which helps them to
exercise control over their environment.
While early childhood professionals will not ordinarily be a primary source of information
for children about alcoholism, they need to be equipped with good information so
that they can provide the proper support when necessary. Children build strengths and
resilience as a result of the conscious modeling provided by a caring adult.
The power of the caring relationship
with you is tremendous.

Core Competencies
For Involvement of Early Childhood Professionals in the Care of
Children and Adolescents in Families Affected by Alcohol or
Other Drug Abuse
These competencies are presented as a guide to the core knowledge, attitudes,
and skills that are essential to meeting the needs of children and youth affected
by alcohol or drug abuse in families. Developed by a multi-disciplinary professional advisory
group to the National Association for Children of Alcoholics (NACoA), they set forth
a level for the child care professional’s involvement with children who grow up in homes
where alcohol and other drugs are a problem.
It is NACoA’s hope that organizations representing early childhood professionals
will adopt these competencies, or competencies modeled from them. All child care providers
should aspire to these competencies. Resources and programs should be made available
for the necessary training to achieve these competencies.
Be able to articulate a working definition of alcoholism and other drug dependencies
without trying to diagnose this condition in others.
Be aware of the behavioral signs presented by children in families affected by
alcohol or other drug abuse.
Be aware of the potential benefit to both the child and the family of timely and
early intervention.
Be familiar with community resources available for children and adolescents in
families with substance abuse.
Be able to recognize when to seek the advice of a supervisor when a child from a
family with substance abuse has a need beyond your level of expertise.
Be able to communicate an appropriate level of concern in sensitive situations
and offer an appropriate level of support.
Be able to notice and build upon the child’s strengths. Be aware of your routine
behaviors that can assist the child through modeling, consistency, and the setting
of safe boundaries.
Be available to the child or adolescent, as needed, for ongoing care and support.

Helping Children in Your Care
The Core Competencies in Action
The core competencies give a general direction for our thinking about what skills
are needed for early childhood professionals to be effective with children from
alcoholic homes. In this section and throughout the rest of this booklet, you will learn
practical suggestions that will help you put the core competencies into practice in real
life. We have identified four ways in which a caregiver can help a child whose parent is
an alcoholic:
Be an effective listener and communicator.
It is important to help children express their feelings and thereby deal with their
fears and aspirations. One of the more unfortunate problems experienced by some
children of alcoholics is that they have no one to talk with about their needs, fears, and
hopes.
Within appropriate limits, every caregiver can help children talk about what they
like and dislike about their lives. However, it is important to know when assistance from
other professionals is necessary. In this regard, each caregiver needs to have knowledge
of his or her own competencies and limitations.
Know your limitations
Consider the policies and legal, ethical, and professional obligations established
in your program setting, in addition to your own competencies, in deciding what you
should—and should not—do with children. It is very important that caregivers seek assistance
in areas where they are not authorized to function. Since you are not employed
as a therapist, you should not try to act as one. If there is any doubt about the severity
of a child’s personal or social problems, consult your program supervisor, who might
refer the child to a counselor, your staff psychologist, or a local social
worker who will gladly give their assistance.
When talking with children in your care
A valid concern for caregivers may be how the parents will
react when they learn that their child has confided a family problem
to someone outside the family. Will an irate alcoholic parent
come to the center complaining that you have interfered in
their family’s private business? If you limit your discussions
with a child to their feelings and to an understanding of what
alcoholism is, there probably will be no cause for parental

concern. Furthermore, if care is taken to avoid communicating that the child’s difficulties
are related to his or her parent’s alcoholism, and if you direct attention to the child’s
program and social performance, the parent is very likely to welcome your help.
Since you do not diagnose alcoholism or problem drinking, it is unlikely that alcoholism
will be a part of the discussion when you are talking to parents. Denial of
drinking-related problems is essential to those alcoholic parents who want to continue
drinking. The spouse of an alcoholic may also feel the need to refrain from talking
about drinking-related difficulties. If the topic comes up, it may be best for you to
remain silent on the subject of the parent’s drinking, and concentrate on steps to
help the child cope.
Perhaps your greatest contribution will be in the area of helping children to
discover that their feelings are normal and that it is permissible to be confused
and sometimes upset about one’s home environment. Exploring a child’s feelings
with him or her can help you to obtain a better understanding of the child. More
importantly, an exploration of feelings may allow the child to grow in self understanding.
Encourage children to develop friendships and good social skills.
Some children of alcoholics have difficulty relating to their peers and adults.
Like all children, they need opportunities to participate in primary group activities.
However, many children of alcoholics need help to do so. Early childhood
professionals who lead extracurricular and community-based activities have many
opportunities to assist in fostering quality relationships for boys and girls who
have alcoholic parents. Like others, these children can acquire many benefits from
after-school activities. However, for children of alcoholics, the more obvious benefits
of after-school activities may be secondary to the benefits achieved through
the friendships developed in the program. A child not only learns how to take part
in a sport, publish a newspaper, etc., but also gains a sense of belonging and a role
that he or she values.
Children of alcoholics may take on adult roles and responsibilities in their
families—such as caring for younger children or managing housework—and therefore
they can benefit from situations where there is an adult in
charge. They may also benefit when an adult is supervising
their younger siblings.
You can play a vital role in assisting these
children by getting them involved in other activities.
However, getting children of alcoholics to participate
in group activities may be difficult. Many such
children are not eager to join activity groups. This
is particularly true if they feel that an after-school

activity is just another responsibility to endure, rather than a vehicle by which they can
reduce the strain of existing responsibilities. Furthermore, when a child’s feelings of
self-worth are minimal, he or she may feel incapable of contributing anything to a group
and may have to be persuaded that his or her participation is needed.
Involvement in after-school activities can also reduce the time the child of an alcoholic
parent spends in uncomfortable situations. This is a desirable result in itself. Extracurricular
activities also provide more time and opportunities for children to interact
with you and other potential adult role models. In addition, some children may feel that
a caregiver is more approachable than a teacher within a classroom, or that it is more
permissible to discuss personal, “after-school” matters after school than during school
hours.
Carefully observe the child and the situation.
When you are with children, you may observe many details that will give you clues
about their peer relationships, academic interests, achievements, their need to talk to
you or some other trusted adult about their problems, their willingness to share attitudes
and confidences, and their evaluations of their home situation. This last concern
may be reflected more in how they act than in what they say.
When you are working with children, you should be sensitive to a number of physical
and emotional symptoms which may reflect serious home problems. Because of your
training and consistent contact with children, you may be able to detect subtle details
of a child’s appearance beyond the obvious bruises that might suggest parental abuse or
neglect. (If child abuse or neglect is suspected, the law in all 50 states requires immediate
referral of the child in question to an appropriate child protection agency.)
Besides obvious physical abuse and neglect, caregivers will want to take into account
children who exhibit periods of excessive or constant fatigue or strain, frequent headaches
or stomachaches, high levels of confusion or anxiety, fluctuating moods throughout
the week, or being compulsively responsible. You may notice particularly the times
when children show these symptoms. These symptoms may be more obvious on certain
days than others. Recurrent symptoms may reveal a pattern—and for children of alcoholic
parents, these patterns are likely to reflect the occurrence
of conflict within the home. For example, if an alcoholic parent
is a chronic weekend drinker, every Monday the child may be
listless or fall asleep. On Tuesdays through Thursdays the child
may appear to be somewhat energetic, and on Friday he or she
may exhibit high levels of tension, possibly dreading the coming
weekend. Of course, different patterns can occur. In these
situations, collaborating with professional staff for the benefit
of these children could be very helpful. If your program
offers workshops on children of alcoholic parents taught by

trained workers in alcoholism, they will be able to alert you to other symptoms produced
by living in a family with alcoholism.
It is important that you remain alert to the needs of children. If you are accurate in
your observations, you can be of considerable help to them. Your observations may allow
you opportunities to inform parents and colleagues about what they can do to help children,
and when referral to professional counselors may be needed.
Take steps to notice and reinforce a child’s strengths.
While it is important to understand and address the problems faced by children
with alcoholism in their families, never forget the strengths and potential
for resilience that are also characteristic of these children. Many of them develop
ingenious strategies for emotional and physical survival in the face of
overwhelming circumstances. Against all odds, these children find ways to
help themselves, their siblings, and playmates maintain a sense of humor,
a sense of hope, and a sense of purpose in their lives. Notice their acts
of kindness and helpfulness to the other children in your group. Smile
when their humor puts things in perspective and makes the atmosphere
of the day easier and lighter. Give them opportunities to help the
younger ones or support the outcast child. Identify and acknowledge
the acts of generosity and caring they show to others.
The most powerful method for survival available to a
troubled child is to find a caring adult to take an interest in
them. Remember: that adult may be you. Notice and support
the child’s efforts to relate to you, to “be like” you,
and to seek you out for attention. This may be the most
important thing to understand.

If a Child Comes to You for Help,
What Should You Do?
What can I do—and what shouldn’t I do?
The following list of “do’s and don’ts” may be helpful if a child comes to you looking
for help.
1. DO find out who the helping professionals are in your community.
Knowing which organizations have resources to help children will make
it easier when a child comes to you.
2. DO maintain a close working relationship with appropriate helping
professionals that you can turn to when a child comes to you for help.
3. DO follow through if the child asks for help. You may be the only
person the child has approached. Courses of action you might choose
include the following:
· Speak with your supervisor about your concerns.
· If the child’s school has educational support groups for children from
troubled families, assist the school staff responsible for the program
in referring the child to a group.
· Discuss the value of group participation with the child’s parent when
appropriate.
· Encourage the parent to refer the child or speak to an appropriate
professional.
4. DO maintain resources and pamphlets on alcohol-related problems
that have been written for children. Many of these are available at low
or no cost from the National Clearinghouse for Alcohol and Drug Information,
Al-Anon/Alateen, and the National Association for Children of
Alcoholics.
5. DO be aware that children of alcoholics may be threatened by displays
of affection, especially physical contact.
6. DO follow your center’s established procedures if a parent comes to
pick up their child and exhibits behaviors that suggest that they are
intoxicated.

7. DO be sensitive to cultural differences. If the child comes to you from
a different culture, it may be useful to explore the child’s culture to understand
how family structure, values, customs and beliefs may affect
the child’s situation at home.
8. DON’T act embarrassed or uncomfortable when the child asks you for
help. It may be discouraging for the child, and it may increase his or
her sense of isolation and hopelessness.
9. DON’T criticize the child’s alcoholic parent or be overly sympathetic.
The child may gain the greatest benefit just by having you listen.
10. DON’T “get in over your head.” Unless you are a certified psychologist,
social worker, counselor, or health care professional, you are not
prepared to take responsibility for the many difficult issues that may
arise in a counseling situation.
11. DON’T disclose your own personal information to a child, even if you
think it will help. This is often overwhelming to a child and is not appropriate.
12. DON’T share the child’s problems with others who do not have to
know. This is not only important in terms of building trust, but it also
protects the child.
13. DON’T make plans with the child if you can’t follow through. Stability
and consistency in relationships are necessary if the child is to develop
trust.
What helpful messages can I give a child from an alcoholic family?
You can tell the child the following things:
Children
have skills and
strengths which
can help them
when they are
upset.
Get involved
in doing enjoyable things
at school or near home, like the
school band, softball, scouting, or
others. Joining in these types of activities
can help you focus less on the
problems at home. And you could also
learn new things about yourself
and about how other people
live their lives.
Talking
about worries
at home is not
being mean to
your family.
Sharing your
feelings with
someone you
trust can
help you feel
less alone.

When you live
with parents who drink
too much, you may feel
love and hate at the same
time. Having two different
feelings at the same
time is the way many
kids feel about alcoholic
parents.
Remember to
have fun! Sometimes
children with alcoholic
families worry so much
that they forget how to be
“just a kid.” Find a way
to let yourself
have fun.
Develop
a safe place to
call or go when
things are difficult
at
home.
DON’T ride in a car when
the driver has been drinking if you can
avoid it. If you must get in a car with a
drinking driver, sit in the back seat in the
middle. Put on your safety belt, and try
to stay calm and quiet.
Most children feel confused
when there is trouble like alcoholism.
If you feel confused at times, talk to an
adult you can trust.
Because your
parent is an alcoholic
doesn’t mean you will be.
Most children of alcoholics do
not become alcoholic themselves.
Many decide that the best way to
protect themselves from this disease
is not to drink at all. Others
decide to wait until they
are over the age of 21 to evaluate
whether it is safe for them to
use alcohol. Both of these
decisions can protect
against becoming
alcoholic.
You have no control over
someone’s drinking. You didn’t make the problem start, and
you can’t make it stop. What your alcoholic parent does is not
your responsibility or your fault.
When in doubt, you can always remember to teach the “Seven Cs”
NACoA has developed a summary of messages to help early childhood professionals
working with children of alcoholics communicate the main themes these children need
to understand. These basic messages—the “Seven Cs”—are provided on the following
page.
10

The “Seven Cs”
You didn’t CAUSE it
You can’t CURE it
You can’t CONTROL it
You can help take CARE of yourself
By COMMUNICATING your feelings,
Making healthy CHOICES, and
CELEBRATING being yourself
11

Children of Alcoholics:
Important Facts
Alcoholism affects the entire family.
Living with a non-recovering alcoholic can contribute to stress
for all members of a family. Each member may be affected differently.
Not all alcoholic families experience or react to this
stress in the same way. The level of dysfunction or resiliency of
the non-alcoholic spouse is a key factor in the effects of problems
impacting children.
Children raised in alcoholic families have different life experiences
than children raised in non-alcoholic families. Children
raised in other types of dysfunctional families may have similar
developmental losses and stressors as children raised in alcoholic
families.
Children living with a non-recovering alcoholic score lower on
measures of family cohesion, intellectual-cultural orientation,
active-recreational orientation, and independence. They also
usually experience higher levels of conflict within the family.
Many children of alcoholics experience other family members as
distant and non-communicative.
Children of alcoholics may be hampered by their inability to
grow in developmentally healthy ways.
Many people report being exposed to alcoholism in their families.
Seventy-six million Americans, about 43 percent of the U.S. adult population, have
been exposed to alcoholism in the family.
Almost one in five adult Americans (18 percent) lived with an alcoholic while
growing up.
Roughly one in eight American adult drinkers is alcoholic or experiences problems
due to the use of alcohol. The cost to society is estimated at in excess of $166 billion
each year.
There are an estimated 19 million children under the age of 18 in the United
States who live with alcohol abuse or alcoholism in their homes.
12

There is strong, scientific evidence that alcoholism tends to run in families.
Children of alcoholics are more at risk for alcoholism and
other drug abuse than children of non-alcoholics.
Children of alcoholics are four times more likely than other children to develop
alcoholism.
Genetic factors play a major role in the development of alcoholism. There is
an expanding base of literature which strongly supports a heritable basis for
alcoholism and a range of family influences that may direct the development of
children of alcoholics.
Children’s perceptions of parental drinking quantity and circumstances appear
to influence their own drinking frequency.
Children’s alcohol expectancies reflect recognition of alcohol-related norms and a
cognizance of parental drinking patterns by a very early age.
Alcohol expectancies appear to be one of the mechanisms explaining the relationship
between paternal alcoholism and heavy drinking among offspring during
college.
Parental alcoholism and other drug dependencies have an impact upon children’s
early learning about alcohol and other drugs.
Family interaction patterns also may influence the child’s risk for alcohol abuse.
It has been found that families with an alcoholic parent displayed more negative
family interaction during problem-solving discussions than in non-alcoholic families.
Almost one-third of any sample of alcoholics has at least one parent who also was,
or is, an alcoholic.
Children of alcoholics are more likely than other children to marry into families in
which alcoholism is prevalent.
Parental alcoholism influences adolescent substance use through several different
pathways, including stress, negative affect, and decreased parental monitoring.
Negative affect and impaired parental monitoring are associated with adolescents’
joining in a peer network that supports drug-use behavior.
After drinking alcohol, sons of alcoholics experience more of the physiological
changes associated with pleasurable effects compared with sons of non-alcoholics,
although only immediately after drinking.
13

Alcoholism usually has strong negative effects on marital relationships.
Separated and divorced men and women were three times as likely as married
men and women to say they had been married to an alcoholic or problem drinker.
Among adults under age 46, almost two-thirds of separated and divorced women
and almost half of separated or divorced men have been exposed to alcoholism in
the family at some time.
Alcohol is associated with a substantial proportion of human violence, and
perpetrators are often under the influence of alcohol.
Alcohol is a key factor in 68 percent of manslaughters, 62 percent of assaults, 54
percent of murders and attempted murders, 48 percent of robberies, and 44 percent
of burglaries.
Studies of family violence frequently document high rates of alcohol and other
drug involvement.
Children of alcoholics may be more likely to be the targets of physical abuse and
to witness family violence.
Compared with non-alcoholic families, alcoholic families demonstrate poorer
problem-solving abilities, both among the parents and within the family as a
whole. These poor communication and problem-solving skills may be mechanisms
through which lack of cohesion and increased conflict develop and escalate in alcoholic
families.
Children of alcoholics are more at risk for disruptive behavioral problems and are
more likely than others to be sensation-seeking, aggressive, and impulsive.
Based on clinical observations and preliminary research, a relationship between
parental alcoholism and child abuse is indicated in
a large proportion of child abuse cases.
A significant number of children in this country are being raised by addicted parents.
With more than 1 million children confirmed each year as victims of child
abuse and neglect by state child protective service agencies, state welfare records
have indicated that substance abuse is one of the top two problems exhibited by
families in 81 percent of the reported cases.
Studies suggest an increased prevalence of alcoholism among parents who
abuse children.
14

Existing research suggests alcoholism is more strongly related to child abuse than
are other disorders, such as parental depression.
Although several studies report very high rates of alcoholism among the parents
of incest victims, much additional research is needed in this area.
Children of alcoholics exhibit symptoms of depression and
anxiety more than children of non-alcoholics.
In general, children of alcoholics appear to have lower self-esteem than others in
childhood, adolescence and young adulthood.
Children of alcoholics exhibit elevated rates of psychopathology. Anxiety, depression,
and externalizing behavior disorders are more common among children of
alcoholics than among children of non-alcoholics.
Young children of alcoholics often show symptoms of depression and anxiety such
as crying, bed wetting, not having friends, being afraid to go to school, or having
nightmares. Older youth may stay in their rooms for long periods of time and not
relate to other children, claiming they “have no one to talk to.” Teens may show
depressive symptoms by being perfectionistic in their endeavors, hoarding, staying
by themselves, and being excessively self-conscious. Teenage children of alcoholics
may begin to develop phobias.
Children of alcoholics experience greater physical and
mental health problems and higher health care costs than
children from non-alcoholic families.
Inpatient admission rates for substance abuse are triple that of other children.
Inpatient admission rates for mental disorders are almost double that of other
children.
Injuries are more than one and one-half times greater than those of other children.
The rate of total health care costs for children of alcoholics is 32 percent greater
than children from non-alcoholic families.
Children of alcoholics score lower on tests measuring verbal ability.
Children of alcoholics tend to score lower on tests that measure cognitive and ver-
15

al skills. Their ability to express themselves may be impaired, which can impede
their school performance, peer relationships, ability to develop and sustain intimate
relationships, and hamper performance on job interviews.
Low verbal scores, however, should not imply that children of alcoholics are intellectually
impaired.
Children of alcoholics often have difficulties in school.
Children of alcoholics often believe that they will be failures even if they do well
academically. They often do not view themselves as successful.
Children of alcoholics are more likely to be raised by parents with poorer cognitive
abilities and in an environment lacking stimulation. A lack of stimulation in the
rearing environment may account in part for the pattern of failure found in children
of alcoholics compared with other children.
Preschool-aged children of alcoholics exhibited poorer language and reasoning
skills than did other children, and poorer performance among the children of alcoholics
was predicted by the lower quality of stimulation present in the home.
Children of alcoholics are more likely to be truant, drop
out of school, repeat grades, or be referred to a school
counselor or psychologist. This may have little to do
with academic ability; rather, children of alcoholics may
have difficulty bonding with teachers and other students
at school; they may experience anxiety related to performance;
or they may be afraid of failure. The actual
reasons have yet to be determined.
There is an increasing body of scientific evidence indicating
that risk for later problems—and even alcoholic outcomes—is
detectable early in the life course and, in some
instances, before school entry.
Children of alcoholics have greater difficulty with abstraction and
conceptual reasoning.
Abstraction and conceptual reasoning play an important role in
problem solving, whether the problems are academic or are situation-related
to the problems of life. Therefore, children of alcoholics
might require very concrete explanations and instructions.
16

Children of alcoholics may benefit from adult efforts which help them to:
Develop autonomy and independence.
Develop a strong social orientation and social skills.
Engage in acts of “required helpfulness.”
Develop a close bond with a caregiver.
Cope successfully with emotionally hazardous experiences.
Perceive their experiences constructively, even if those experiences cause pain or
suffering; and gain, early in life, other people’s positive attention.
Develop day-to-day coping strategies.
Children can be protected from many problems associated with
growing up in an alcoholic family.
If healthy family rituals or traditions (such as vacations, mealtimes,
or holidays) are highly valued and maintained; if the active
alcoholic is confronted with his or her problem; if there are
consistent significant others in the life of the child or children;
and if there is moderate to high religious observance—then
children can be protected from many of the consequences
of parental alcoholism.
Maternal alcohol consumption during any time of pregnancy can cause
alcohol-related birth defects or alcohol-related neurological deficits.
The rate of drinking during pregnancy appears to be increasing.
Prenatal alcohol effects have been detected at moderate levels of alcohol consumption
by non-alcoholic women. Even though a mother is not an alcoholic, her child
may not be spared the effects of prenatal alcohol exposure.
Cognitive performance is less affected by alcohol exposure in infants and children
whose mothers stopped drinking in early pregnancy, despite the mothers’ resumption
of alcohol use after giving birth.
One analysis of six-year-olds, with demonstrated effects of second-trimester alcohol
exposure, had lower academic achievement and problems with reading, spelling,
and mathematical skills.
17

Approximately 6 percent of the offspring of alcoholic women have fetal alcohol
syndrome (FAS); the FAS risk for offspring born after an FAS sibling is as high as
70 percent.
Those diagnosed as having fetal alcohol syndrome had IQ scores ranging from 20
to 105, with a mean of 68. Subjects also demonstrated poor concentration and attention.
People with fetal alcohol syndrome demonstrate growth deficits, morphologic
abnormalities, mental retardation, and behavioral difficulties. Secondary effects
of FAS among adolescents and adults include mental health problems, disrupted
schooling (dropping out or being suspended or expelled), trouble with the law,
dependent living as an adult, and problems with employment.
Citations to reference sources for these facts are available from the National Association
for Children of Alcoholics (www.nacoa.org).
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Questions and Answers
About Alcohol Problems
What is alcoholism?
Alcoholism is a disease. People who have the disease have lost control
over their drinking and are not able to stop without help. They also lose
control over how they act when they are drunk.
How does alcoholism start?
Doctors don’t know all the reasons why people become alcoholics.
Some start out drinking a little bit and end up hooked on alcohol. A person
might begin drinking to forget problems or to calm nerves, but then ends
up needing alcohol to feel normal. Once a person loses control over drinking,
he or she needs help to stop drinking.
If the alcoholic is sick, why doesn’t he or she just go to the doctor?
At first, the alcoholic is not aware that he or she is ill. Even when the
alcoholic becomes aware that something is wrong, he or she may not believe
that alcohol is the problem. They might keep blaming things on other
people, or might blame their job, or the house, or whatever. But, really, it’s
the alcohol that’s the biggest problem.
How can I identify a typical alcoholic among the parents of the
children in my program?
You can’t. There is no such person as the average alcoholic. Alcoholics
can be young, old, rich, poor, male, or female. Sometimes the condition is
not noticeable to people outside the family until the person is into advanced
stages of the disease.
19

What is the cure for alcoholism?
There is no cure for alcoholism except stopping the disease process
by stopping the drinking. People with alcoholism who have completely
stopped drinking are called “recovering alcoholics.” Recovering alcoholics
can lead healthy, happy, productive lives.
Can family members make an alcoholic stop drinking?
No. It is important to know that an alcoholic needs help to stop
drinking, but no one can be forced to accept the help, no matter how
hard you try or what you do. It is also important to know that family
members by themselves cannot provide the help that an alcoholic needs.
An alcoholic needs the help of people trained to treat the disease.
How many children in the United States have at least one alcoholic parent?
One in four children in our country is growing up with alcoholism or
alcohol abuse in the home. Countless others are hurt by parental use
of other drugs. There are probably a few of those children in your early
childhood education program or group right now. And remember, some
adults grew up with alcoholic parents, too.
20

To Keep in Mind
What about other drugs besides alcohol?
This booklet focuses on the issues impacting children who live in homes
with an alcoholic parent, parents, or primary caregiver. Many of the behaviors
and dynamics exhibited by these young people are also exhibited by
children living with parents who abuse, and are addicted to, other drugs.
Please feel free to modify language in the booklet to best address the
needs of the young people you are serving.
What if I am an adult child of an alcoholic?
Like all human services professionals, early childhood professionals
have their share of adult children of alcoholics among their ranks. If you
are willing to learn about the family dynamics of alcoholism in the light of
your own history, you may be able to help yourself as well as the children in
your child care center. Finding good information and support for your own
issues is recommended.
Our early childhood education program sounds different
from the way child care is presented in this booklet.
The authors of this booklet wish to acknowledge that early childhood
programs are provided by many diverse groups and take place in many different
settings, including schools, churches, private homes, and other settings
in the community. There is a wide variety of training and professional
support services available to early childhood educators in various settings.
Every effort was made to present material that is relevant to the needs of
this wide audience. If this booklet has neglected an issue that is specific to
your situation, please feel free to request more information from the National
Association for Children of Alcoholics (see the “Additional Resources
” section for contact information).
21

How can I help infants and very young children
who come from alcoholic families?
The age ranges of children who receive child care and the specific
needs of each age range are vast. This booklet focuses primarily on children
who are old enough to use language. While the principles presented
here are intended to apply to caregivers for children in all age ranges,
specific presentation of behavioral signs of distress for infants and very
young children require consultation from a professional with expertise
in early child development.
What do I do when an intoxicated parent comes to pick up a child?
The laws in every state differ about detaining a child; follow the
guidance of your supervisor and your state licensing agency. It is an
early childhood professional’s responsibility to know the procedure.
Review your agency’s existing policy and procedures for such incidents
with your supervisor. Help the child to keep calm.
22

Additional Resources
Books and videos for children and adults
For young children:
Al-Anon Family Groups. Courage To Be Me. Al-Anon Family Group Headquarters,
Virginia Beach, VA, 1996.
Al-Anon Family Groups. What’s “Drunk,” Mama? Al-Anon Family Group
Headquarters, Virginia Beach, VA, 1977.
Black, Claudia. My Dad Loves Me, My Dad Has a Disease. (Revised) MAC
Publishing, Bainbridge Island, WA, 1996.
Brown, Cathey, Elizabeth LaPorte, and Jerry Moe. Kids’ Power Too! Words
To Grow By. Imagin Works, Dallas, TX, 1996.
Krull, Kenny, Kevin, and Helen. Sometimes My Mom Drinks Too Much.
Raintree Children’s Books, Milwaukee, WI, 1980.
Mercury, Catherine. Think of Wind. One Big Press, Rochester, NY, 1996.
For adolescents:
Brooks, Cathleen. The Secret Everyone Knows. Hazelden Educational Materials,
Center City, MN, 1981.
Seixas, Judith. Living With a Parent Who Drinks Too Much. Greenwillow
Books, New York, NY, 1979.
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For adults:
Black, Claudia. It Will Never Happen to Me. MAC Publishing, Bainbridge
Island, WA, 2001.
Video resources:
National Association for Children of Alcholics (NACoA). Poor Jennifer,
She’s Always Losing Her Hat. Overview of issues of parental alcoholism.
1991. Available through the National Clearinghouse
for Alcohol and Drug Information – 1-800-729-6686. Cost: $6.50;
includes video user’s guide.
NACoA. You’re Not Alone. Video for children from alcoholic families
about support groups. 1998. Available through NACoA – 1-888-55-
4COAS. Cost: $39.00; includes video guide.
NACoA. End Broken Promises, Mend Broken Hearts. Video for educators,
early childhood professionals, faith community leaders, and
other youth-serving organizations on support groups for children
from alcoholic and addicted homes. 1998. Available through NA-
CoA
1-888-55-4COAS. Cost: $79.00; includes video guide.
Purchase You’re Not Alone and End Broken Promises, Mend Broken
Hearts together for $98.
24

Organizations with additional resources and information
National Association for
Children of Alcoholics (NACoA)
11426 Rockville Pike, Suite 301
Rockville, MD 20852
1-888-55-4COAS
Fax: 301-468-0987
www.nacoa.org
NACoA is the membership and affiliate organization that advocates for children
with alcoholic or other drug addicted parents, the youth who are at highest risk
for substance abuse and child abuse. Services include a bi-monthly newsletter, videos,
books, and other educational training tools for therapists, educators, parents, clergy and
other youth-serving adults.
SAMHSA’s National Clearinghouse for
Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847
800-729-6686
301-468-2600
Fax: 301-468-6433
www.health.org
The National Clearinghouse for Alcohol and Drug Information (a program of the
U.S. Substance Abuse and Mental Health Services Administration) is the nation’s premier
supplier of relevant materials covering the entire gamut of alcohol- and drug-related
issues. Its Web site has an extensive section for young people and for those in positions
to help them. Many materials are free and can be ordered through an 800 number
or over the Internet.
National Council on Alcoholism and Drug Dependence, Inc. (NCADD)
22 Cortland Street, Suite 801
New York, NY 10007
212-269-7797
Fax: 212-269-7510
www.ncadd.org
NCADD fights the stigma and the disease of alcoholism and other drug addiction and
has 100 affiliates throughout the country.
25

Community Anti-Drug Coalitions of America (CADCA)
625 Slaters Lane, Suite 300
Alexandria, VA 22314
1-800-54-CADCA
Fax: 703-706-0565
www.cadca.org
CADCA has a membership of 5000 anti-drug coalitions, each working to
make their community safe, healthy, and drug-free. Contact CADCA to connect
with a coalition in a community near you.
Organizations providing help for families with alcohol problems
Addresses for national offices of the following organizations are provided to
help you find a local affiliate group near you. Many local groups can be found
through your telephone directory.
Al-Anon
Family Group Headquarters
1600 Corporate Landing Parkway
Virginia Beach, VA 23462
757-563-1600
1-888-425-2666 (Meeting Information)
www.al-anon.org
Al-Anon is an organization for spouses and other relatives and friends
of alcoholics. The Al-Anon groups help families and friends cope with the
problems that result from another’s drinking, and help foster understanding
of the alcoholic through sharing experiences. Local groups are listed in your
telephone directory under “Al-Anon Family Groups.” Al-Anon Family Group
Headquarters can assist you in finding a nearby group meeting.
26

Alateen
c/o Al-Anon Family Group Headquarters
1600 Corporate Landing Parkway
Virginia Beach, VA 23454
1-888-425-2666
www.alateen.org
Alateen, a part of Al-Anon, is for young people whose lives have been
affected by the alcoholism of a family member or close friend. Members of
Alateen fellowships help each other by sharing their experiences and their
strength. Alateen is listed in some telephone directories, or information may
be obtained by contacting local Al-Anon groups. If you are having trouble
locating an Alateen group near you, contact Al-Anon Family Group Headquarters
at the address listed above.
Alcoholics Anonymous (AA)
General Service Office
P.O. Box 459
Grand Central Station
New York, NY 10163
(212) 686-1100
www.aa.org
Alcoholics Anonymous is a voluntary fellowship open to anyone who wants
to achieve and maintain sobriety and is an important adjunct to many treatment
programs. The fellowship was founded in 1935 by two individuals in an effort
to help others who suffer from the disease of alcoholism. AA is the oldest of the
organizations designed to help alcoholics help themselves. It is estimated that
there are more than 2 million members in local AA groups worldwide. For further
information, look under “Alcoholics Anonymous” in your telephone directory.
The Alcoholics Anonymous General Service Office can help in locating a
nearby group meeting.
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28
Notes