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Principles of Substance Abuse Prevention for Early Childhood


1. For young children already exhibiting serious risk factors for later drug use, delaying intervention until later childhood or adolescence may make it more difficult to overcome accumulated risk factors and achieve positive outcomes.

A. True

B. False

2. The prenatal, child, and adolescent brain is undergoing rapid and significant change, including the formation of new synapses and, after about age _____, the progressive pruning of unused synaptic connections and reinforcement of major circuits.

A. 5

B. 8

C. 12

D. 15

Principles of Substance Abuse Prevention for Early Childhood

3. Because behaviors are linked to each other, risk factors for substance use may simultaneously put a child at risk for other problems, such as:

A. Mental illness

B. Difficulties in school

C. Both (A) and (B)

D. None of the above

4. Research has shown that the benefits of intervention can affect:

A. Behavioral outcomes

B. Psychological outcomes

C. Physical health

D. All of the above

5. Which of the following is the most important context across all periods of early child development?

A. Risk factors

B. Protective factors

C. The family environment

D. Social interaction

Chapter 1: Why Is Early Childhood Important to Substance Abuse Prevention?

6. How successfully or unsuccessfully a child meets the demands and challenges arising from a given transition, and whether the child meets milestones on an appropriate schedule, can affect his or her future course of development, including risk for drug abuse or other mental, emotional, or behavioral problems during adolescence.

A. True

B. False

7. Which of the following transitions is a prime opportunity to introduce skills, knowledge, and competencies to facilitate development during the transition?

A. Pregnancy

B. Birth

C. Entering preschool or elementary school

D. All of the above

8. Vulnerability to the risk factors for problems such as substance abuse can occur throughout the life course, but it tends to peak during critical life transitions.

A. True

B. False

9. Achieving milestones within the expected time frame is an important signal that development is occurring in the expected manner and timeframe, and offers protection against risk factors for substance abuse and other problems later in development.  Failure to achieve important milestones may indicate the need for early intervention.

A. True

B. False

10. Part of what makes it possible to achieve a milestone at a later time is the ability of the brain to change, adapt, and reorganize, know as:

A. Remodeling

B. Plasticity

C. Resilience

D. Fluidity

11. A past history of substance abuse for which parent may affect their children via changes to gene expression?

A. The mother

B. The father

C. Both the mother and the father

D. Substance abuse does not cause hereditary changes in gene expression

12. Generally, areas at the back and sides of the brain, which handle emotional and behavioral control and other higher order executive functions, are the last to finish developing - only reaching maturity in early adulthood.

A. True

B. False

13. The environment exerts its greatest proportional impact in early childhood and gradually lessens, relative to genetic influences, across later childhood and adolescence, providing an important genetic and neurobiological rationale for intervening in early childhood, when changes in the individual’s environment can have the greatest long-term impact.

A. True

B. False

14. Which of the following contribute to the child’s development once the child is born?

A. The quality of the nutrition and health care provided by the mother and other caregivers.

B. The personality fit between infant and caregivers.

C. The ability of the caregivers to provide warmth and support.

D. All of the above.

15. Which of the following is one of the most crucial factors leading to healthy socialization and self-regulation, which are major protective factors against drug use and other behavioral problems?

A. Secure attachment

B. Genetics

C. Brain development

D. All of the above

16. When a nurturing responsive relationship does not exist, _____ can impede a child’s healthy brain development.

A. Social isolation

B. Elevated levels of stress hormones

C. Parent-child interactions

D. Neglect

Chapter 2: Risk and Protective Factors

17. Protective factors are simply the absence of risk factors.

A. True

B. False

18. Unlike protective factors, which are internal to the child, such as genetics, risk factors are external, arising from the child’s environment.

A. True

B. False

19. Which of the following has been linked to increased risk for slowed fetal growth and low birth weight, stillbirth, pre-term birth, infant mortality, Sudden Infant Death Syndrome, and respiratory problems?

A. Using alcohol during pregnancy

B. Smoking during pregnancy

C. Use of illicit drugs during pregnancy

D. Use of some types of prescription drugs during pregnancy

20. When children fail to _____, they may perceive that the world is unsafe and eventually mistrust other people and distrust their own abilities to master the environment.

A. Develop secure attachments to their parents

B. Achieve milestones within the expected time frame

C. Both (A) and (B)

D. None of the above

21. Good quality parenting is only possible when parent/child characteristics and experiences match up.

A. True

B. False

22. Some children who experience a lot of stress early in life, even during the prenatal period, are more susceptible to the effects of later stressful life circumstances than other people.

A. True

B. False

23. Children who have experienced abuse or neglect by parents or caregivers are at greater risk for substance abuse and other mental, emotional, and behavioral problems than other children.

A. True

B. False

24. Secondhand smoke exposure in children is linked to impaired executive brain function, which manifests most clearly as behavioral problems and an increased risk of:


B. Anxiety

C. Depression

D. Aggressive disruptive behavior

25. Children are less likely to smoke, drink alcohol, or use other drugs when parents are clear that they do not want their children to do so, unless the parents use substances themselves.

A. True

B. False

26. Adolescent use of _____ may trigger psychosis in individuals with a genetic vulnerability for schizophrenia.

A. Tobacco

B. Alcohol

C. Marijuana

D. Cocaine

27. Parents and educators should understand that most young people with risk factors for substance abuse go on to develop drug problems or other mental, emotional, or behavioral problems.

A. True

B. False

28. Highly responsive parenting is a protective factor particularly important during which developmental period?

A. Prenatal period

B. Infancy and Toddlerhood

C. Preschool

D. Transition to school

29. All of the following are internal factors that offer protection across all ages, except for:

A. Intelligence

B. Easy temperament

C. Consistency

D. All of the above internal factors offer protection

30. Just as having many risk factors does not make substance abuse inevitable, having many protective factors does not ensure an absence of problems.

A. True

B. False

Chapter 3: Intervening in Early Childhood

31. The proximal environment during very early development is _____, and is therefore often the focus of prevention interventions for the prenatal through infancy and toddlerhood periods.

A. School / daycare

B. Family

C. Health care

D. All of the above

32. Even when children are progressing along the normal course of physical, cognitive, social, and emotional development and achieving age-appropriate milestones, improvements in their proximal environment can further their development.

A. True

B. False

33. Difficulties in which of the following during the early elementary years is a strong risk factor for school failure and later drug use?

A. Reading

B. Math

C. Science

D. All of the above

34. Which of the following is an approach used in programs that address social skills development?

A. Group practice

B. Playground and free play monitoring

C. Rewarding good behavior

D. All of the above

35. A notable characteristic of programs targeting children transitioning to elementary school is the use of techniques, such as:

A. Role-playing

B. Guided play sessions

C. Small-group practice

D. All of the above

36. Research has demonstrated that which of the following is more successful?

A. Interactive techniques

B. Lecture

C. Informational

D. All of the above are equally successful

37. Which of the following is a core element of a school-based early childhood intervention?

A. Training teachers to establish clear rules and rewards for compliance.

B. Teach interactively.

C. Promote cooperative learning in small groups.

D. All of the above.

38. The core element approach for school-based early childhood intervention is designed to:

A. Provide teachers with the skills for managing child behavior.

B. Provide teachers with activities for teaching children to manage their own emotions and behaviors.

C. Both (A) and (B).

D. None of the above.

39. A program to reduce aggressive behavior in children entering school could include:

A. Activities and training in classroom management for teachers.

B. Instruction in supportive, consistent, contingent-responsive parenting strategies for parents and other caregivers.

C. Child-oriented program components aimed at increasing the child’s attention and self-regulation within the classroom environment.

D. All of the above.

40. While most children and families benefit from interventions, generally children benefit the most from early childhood interventions who are at increased risk for later substance abuse due to all of the following, except:

A. Insecure attachment

B. Early aggressive behavior

C. Poor emotional control

D. Extreme poverty

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