PDF“Children who have been affected by prenatal substance abuse can be difficult children to parent, difficult children to get close to, and sometimes difficult children to love. They may find it difficult to love themselves. The reciprocal circle of attachment, so important in adoption, in this case may tilt out of focus not because of abuse or neglect, but because a child’s internal circuitry makes it hard for the child to be able to communicate needs and hard for the adults to be able to satisfy these. It is harder for strong connections to be established or to stay in place.”