LSHSS Clinical Forum Collaborative Services: Children Experiencing Neglect and the Side Effects of Prenatal Alcohol Exposure Diana L. Rogers-Adkinson Shannon K. Stuart University of Wisconsin–Whitewater S peech-language pathologists (SLPs) currently find themselves working with an increasing population of children who have experienced either caregiver neglect or fetal alcohol spectrum disorder (FASD) (Sokol, Delaney- Black, & Nordstrom, 2003). Working with these children can present unique challenges as, in addition to the typical special education team, the child will often be served in the child welfare system. One such challenge is understanding how changes in public law affect child welfare service delivery, especially in regard to young children who are experiencing prenatal alcohol exposure or maltreatment within the home setting. Also, these families often present with complex his- tories and cultural perspectives. It is imperative for SLPs to have an understanding of these families’ complex needs and the role that the social welfare system plays in the collaborative intervention process. To this end, we provide a brief history of the U.S. child welfare system and offer an overview of the current welfare system. We then examine the collaborative roles that SLPs, special education services, and others may play with children who have been mal- treated or who may have FASD. FASD and neglect have been defined previously within this forum. In general, we apply the medical definition for FASD, which is a condition resulting from prenatal exposure to alcohol caused by maternal alcoholism or heavy drinking (including episodic or “ binge” drinking during pregnancy. FASD is diagnosed based upon four criteria: 1. growth retardation, (that is, below the tenth percentile for weight, height or head circumference at some point during development) 2. characteristic facial dysmorphia, including absent or indistinct philtrum (groove in the upper lip), thinned upper vermillion (lip), and shortened palpebral fissures (eye openings) 3. damage to the central nervous system, manifested as developmental delays, and mental retardation and cognitive and/or behavioral problems 4. evidence of maternal drinking during gestation. (Coles, 2003, p. 1) ABSTRACT: Purpose: The purpose of this article is to provide critical knowledge regarding children who are served by the child welfare system and how these children’s specialized needs affect speech-language services. Specifically, the structure of social services system models is presented, with an emphasis on the cultural and systemic interactions between service providers and families. In addition, the role of special education for children who have experienced abuse, neglect, and prenatal drug or alcohol exposure is presented, with an emphasis on social service and special education legal issues. Method: This article provides a critical analysis of the research literature to date regarding effective tools for providing collabo- rative intervention to children who are experiencing fetal alcohol syndrome disorder or abuse and/or neglect. Clinical Implications: This article provides suggestions about the collaborative roles that speech-language pathologists should integrate into treatment milieu when delivering therapy to children with histories of abuse, neglect, and prenatal drug or alcohol exposure. KEY WORDS: collaboration, fetal alcohol spectrum disorder, child abuse LANGUAGE,SPEECH, AND HEARING SERVICES IN SCHOOLS • Vol. 38 • 149–156 • April 2007 * American Speech-Language-Hearing Association 0161-1461/07/3802-0149 149