Prenatal alcohol exposure (PAE) can alter brain development and impact mental health outcomes, and often occurs in conjunction with postnatal adversity (e.g., maltreatment). However, it is unclear how postnatal adverse exposures may moderate mental health and brain outcomes in children with PAE. T1‐weighted and diffusion magnetic resonance imaging were obtained from 66 participants aged 7–16 years. Twenty‐one participants had PAE and adverse postnatal exposures (PAE+), 12 had PAE without adverse postnatal exposures (PAE−), and 33 were age‐ and gender‐matched controls unexposed to either prenatal alcohol or postnatal adversity. Internalizing and externalizing mental health symptoms were assessed using the Behavioral Assessment System for Children II, Parent‐Rating Scale. ANCOVAs were used to compare mental health symptoms, limbic and prefrontal cortical volumes, and diffusion parameters of cortico‐limbic white matter tracts between groups, and to assess brain‐mental health relationships. Both PAE groups had worse externalizing behavior (higher scores) than controls. The PAE− group had lower fractional anisotropy (FA) in the bilateral cingulum and left uncinate fasciculus, and smaller volumes in the left anterior cingulate cortex than controls and the PAE+ group. The PAE− group also had higher mean diffusivity (MD) in the left uncinate than the PAE+ group, and smaller right anterior cingulate and superior frontal gyrus volumes than controls. These findings show different brain structure and mental health symptom profiles in children with PAE with and without postnatal adversity, highlighting the need to consider adverse postnatal exposures in individuals with PAE.

Background: Attachment theory is an established theoretical understanding of the intimate relationships between parental figures and children. The theory frames the ways in which a child can be supported to develop within a secure base that prepares them for adulthood, including entering into and sustaining intimate relationships. The theory, built on the work of John Bowlby following World War II, has extensive literature supporting its application across multiple cultures and nations, although its roots are heavily tied to Eurocentric familial understandings. However, the theory has also been heavily criticized as not being appropriate for child intervention decision-making. Further, its application to Indigenous caregiving systems is also under question. Yet courts rely heavily on applying the theory to questions of sustaining Indigenous children in non-Indigenous care when return to biological parents is deemed impossible. Methods: This article draws upon the consistent arguments used in leading Canadian child welfare legal decisions and case examples to show how Attachment Theory is applied relative to Indigenous children and families. Results: Attachment Theory drawing upon Eurocentric framing, and as applied in Canadian child protection systems, as seen in precedent court decisions, is given priority over living in culture. This occurs even though the research reviewed has shown that the traditional dyadic version of the theory is not valid for Indigenous peoples. Conclusions: While all children will attach to a caregiver or caregiving system, such as kinship or community, leading legal decisions in Canada tend to rely on Eurocentric versions of the theory, which is contrary to the best interests of Indigenous children. Child protection needs to reconsider how attachment can be used from appropriate cultural lenses that involve the communal or extended caregiving systems common to many Canadian Indigenous communities. Child protection should also recognize that there is not a pan-Indigenous definition of attachment and child-rearing, so efforts to build working relationships with various Indigenous communities will be needed to accomplish culturally informed caregiving plans. In addition, continued advocacy in Canada is needed to have child protection decision-making conducted by the Indigenous communities, as opposed to Eurocentric provincial or territorial agencies.

Prenatal alcohol exposure (PAE) can lead to altered brain function and structure, as well as lifelong cognitive, behavioral, and mental health difficulties. Previous research has shown reduced brain network efficiency in older children and adolescents with PAE, but no imaging studies have examined brain differences in young children with PAE, at an age when cognitive and behavioral problems often first become apparent. The present study aimed to investigate the brain's functional connectome in young children with PAE using passive viewing fMRI. We analyzed 34 datasets from 26 children with PAE aged 2-7 years and 215 datasets from 87 unexposed typically-developing children in the same age range. The whole brain functional connectome was constructed using functional connectivity analysis across 90 regions for each dataset. We examined intra- and inter-participant stability of the functional connectome, graph theoretical measurements, and their correlations with age. Children with PAE had similar inter- and intra-participant stability to controls. However, children with PAE, but not controls, showed increasing intra-participant stability with age, suggesting a lack of variability of intrinsic brain activity over time. Inter-participant stability increased with age in controls but not in children with PAE, indicating more variability of brain function across the PAE population. Global graph metrics were similar between children with PAE and controls, in line with previous studies in older children. This study characterizes the functional connectome in young children with PAE for the first time, suggesting that the increased brain variability seen in older children develops early in childhood, when participants with PAE fail to show the expected age-related increases in inter-individual stability.

Simulation learning plays an important role in social work education, allowing students to explore how theory and practice parameters can be integrated into actual situations they are likely to experience in the field. The arrival of COVID-19 and the sudden cessation of in-field practicum opportunities raised challenges for students to gain needed practice experience. Simulation offers an opportunity to enhance learning in place of some direct experience when that is not available. This paper reports on a simulation development practicum, where students, not able to be in an agency, sought out ways to achieve learning through the development and implementation of simulation learning. This was combined with a literature review. Results showed that student-generated simulation could be used to support direct practice learning. This project also illustrated that social work simulation can be used to help students safely explore areas of practice that they may not be exposed to in practicum through scenarios that cause them to examine how to work with clients where cross-cultural needs exist, and challenge ethical dilemmas in a ‘real-world’ situation while being required to face their biases.

Prenatal alcohol exposure (PAE) negatively affects brain development and increases the risk of poor mental health. We investigated if brain volumes or magnetic susceptibility, an indirect measure of brain iron, were associated with internalizing or externalizing symptoms in youth with and without PAE. T1-weighted and quantitative susceptibility mapping (QSM) MRI scans were collected for 19 PAE and 40 unexposed participants aged 7.5–15 years. Magnetic susceptibility and volume of basal ganglia and limbic structures were extracted using FreeSurfer. Internalizing and Externalizing Problems were assessed using the Behavioural Assessment System for Children (BASC-2-PRS). Susceptibility in the nucleus accumbens was negatively associated with Internalizing Problems, while amygdala susceptibility was positively associated with Internalizing Problems across groups. PAE moderated the relationship between thalamus susceptibility and internalizing symptoms as well as the relationship between putamen susceptibility and externalizing symptoms. Brain volume was not related to internalizing or externalizing symptoms. These findings highlight that brain iron is related to internalizing and externalizing symptoms differently in some brain regions for youth with and without PAE. Atypical iron levels (high or low) may indicate mental health issues across individuals, and iron in the thalamus may be particularly important for behavior in individuals with PAE.