LAUSR

BACKGROUND The relationship between behavior difficulties and parenting self-efficacy in children with in-utero opioid exposure (IOE) remains a significant gap that needs to be addressed for providers to better understand the mental health trajectories of children with IOE and help these families. AIMS In this study, caregivers' perception of their child's behavior and potential relationships between parenting self-efficacy, child temperament, and behavior difficulties were investigated. METHODS A descriptive survey design with a convenience sample of 143 caregivers of 2- to 7-year-old children with IOE who had follow-up visits in a Neonatal Abstinence Syndrome (NAS) clinic was used for this study. Data were collected using a survey of demographics, the Children's Behavior Questionnaire, the Strengths and Difficulties Questionnaire, and the Parenting Sense of Competence Scale. RESULTS The overall sample scored in the average range of behavior difficulties, but a subgroup of children with very high difficulties was identified who exhibited a negative temperament, and caregivers reported a lower sense of parenting competence. There were no differences between groups on demographic variables. CONCLUSIONS High negative affect and low effortful control are predictive of later internalizing and externalizing problems, as well as broader problems in self-regulation, school readiness, and socioemotional competence. Thus, although a large percentage of children treated for NAS appear to be functioning at the same level as their peers, a subset of children appears to be at higher risk. Child behavior as well as caregiver self-efficacy should be assessed during all provider encounters.