The Committee on Substance Abuse of the American Academy of Pediatrics recommends that pediatricians include substance abuse in their anticipatory guidance to all children and adolescents. The committee's guidelines reiterate that practitioners should possess the skills necessary to recognize risk factors and signs of substance abuse in their patients, and should be able to evaluate the nature and extent of alcohol use and to offer appropriate counseling or referral. These measures include screening of all children and adolescents and the utilization of brief counseling and referral as needed. Clearly, there is a need to extend these recommendations to include the identification of alcohol and other drug related problems in the family. Discussions about prevention of alcohol abuse and related problems should begin with the prenatal visit by focusing on the responsibility of parents, parental lifestyle, and effects of parental alcohol use on the fetus, infant, child and adolescent.
Parents serve as important role models for their children.
Children's attitudes and beliefs regarding alcohol develop early in life, often by age 7 or 8. Parents need to be aware that their attitudes and beliefs can strongly influence and play a major role in shaping their child's behavior. Hence, it is important for the health provider to explore the attitude of the family toward alcohol use and provide basic education appropriate to the age and development of the child. Anticipatory guidance about alcohol use should begin early in childhood when family standards and values are being assimilated. Well-child visits during the early school years provide many opportunities to discuss alcohol.