Across the Eastern Band of Cherokee Indians, family has always stepped forward for family. Grandparents, aunts, uncles, older siblings, and cousins often take on the role of caregiver so children can stay connected to their people, their stories, and their land. That strength of kinship has carried this community through many generations.
What is a Brain-Based Lens?
Some children in relative care were exposed to alcohol or drugs before birth. Many caregivers may also carry their own experiences with prenatal exposure, trauma, or substance use in their families. This reality calls for compassion, not blame. A brain-based lens can help you hold that compassion while learning practical tools to support the children whose brains may work differently.
A brain-based lens means understanding that behavior grows from how the brain developed. It helps us move from asking “What’s wrong with this child?” to asking “What does this child’s brain need right now?”
Below are key ideas to guide you in caring for children with prenatal exposure to drugs and alcohol.
1. Prenatal substance exposure can change how the brain functions.
Alcohol and drugs can affect how a baby’s brain forms. This may influence the following:
- memory
- impulse control
- emotional regulation
- learning
- understanding of cause and effect
As a result, some children may quickly forget the rules, struggle to calm down, or repeat the same mistakes. When you look at these behaviors through a brain-based lens, you won’t see them as willful disobedience. They reflect how the child’s brain processes the world.
When you understand this, you can respond with support rather than punishment. This shift reduces shame for the child and for you.
2. Reframing your expectations will support success.
You may be holding onto hope that this child will “grow out of” these brain-based challenges or catch up quickly. But the truth is that prenatal exposure to drugs and alcohol often leads to uneven and long-lasting developmental challenges.
A child might speak like an older child but react emotionally like a much younger one. They may understand instructions one day and seem confused the next.
Seeing this child through a brain-based lens encourages you to match expectations to the child’s developmental level rather than their age. This does not lower your hopes for this child’s future. Instead, it creates realistic conditions that allow them to succeed now, which can build confidence for later growth.
3. Behavior is a signal from their brain.
Children and youth who were exposed during pregnancy to drugs and alcohol often struggle with memory, sensory issues, and regulating their bodies. When they are overwhelmed or uncomfortable, their behavior may look like anger, lying, shutting down, or refusing to cooperate.
When you put on those brain-based glasses, you can see their behaviors as signals that their nervous system is stressed or overloaded. They are not signs that the child is bad or uncaring.
Now, when you see these behaviors, you can ask:
- Is this child anxious or confused?
- Did their brain understand what was expected?
- Do they need help calming their body first?
Looking for the brain’s need that drives their behavior will help you respond in ways that build safety rather than create conflict.
4. Connection helps their brains heal and grow.
Children whose brains process stress differently often need calm, steady relationships more than strict discipline. Connection regulates the nervous system. When a child feels safe with their caregiver, their brain is better able to learn new skills.
A few helpful approaches you should try include:
- Keeping routines predictable
- Using simple, clear instructions
- Offering reminders instead of assuming memory
- Providing quiet spaces or movement breaks
- Staying calm during big emotions
- Repairing the relationship after hard moments
Your presence and steadiness in these approaches are powerful medicine.
5. Honor the child’s strengths, culture, and community.
Putting on a brain-based lens also helps you see what is going right. Many children with prenatal substance exposure are creative, humorous, musical, observant, and deeply connected to people.
Nurturing these strengths builds their identity and sense of belonging. Cultural connections, such as language classes, tribal and family stories, crafts, rituals or ceremonies, and time spent with elders, can work together to strengthen a child’s sense of self and resilience.
It is also important to remember that no one raises a child alone. Cherokee tradition values interdependence, which involves leaning on family, neighbors, and community. Seeking help is not a weakness; it is part of caring for the next generation.
Moving Forward with Compassion
Raising a relative’s child with prenatal exposure to drugs and alcohol may bring moments of grief, frustration, and uncertainty. It may also stir up memories from your own experiences. All of these feelings are human.
A brain-based lens offers you a path forward rooted in understanding rather than blame. It helps you see differences in brain function, respond with support, and build strong, healing relationships.
You do not need to be perfect. What matters most is staying connected, staying curious about what this child’s brain needs, and extending compassion to the child, to their birth parents, and to yourself.
When we can make the shift from judging behavior to understanding the brain, these children feel safer. Our relationships grow stronger. And families create spaces where healing can take root for generations to come.