Date of Award

2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Clinical Psychology (PhD)

Department

Clinical Psychology

First Advisor/Committee Member

Jenny Lee Vaydich

Second Advisor/Committee Member

Munyi Shea

Third Advisor/Committee Member

Michelle Kuhn

Abstract

Prenatal alcohol and/or substance exposure (PA/SE) affects an estimated 6% to 23% of the U.S. population and is associated with complex neurodevelopmental profiles impacting cognitive, adaptive, and behavioral domains. Children with PA/SE frequently experience co-occurring early adversity, face significant diagnostic complexity, and encounter challenging systems of care. This often leads to individuals with PA/SE and their caregivers navigating substantial barriers to care, including stigmatizing experiences and fragmented service systems. The Specialized Neurodevelopmental Assessment and Consultation Service (SNACS) clinic addresses these needs through an FASD-informed model that integrates therapeutic assessment techniques within a brief, multi-session evaluation process. While prior research has demonstrated the feasibility of this model with children with prenatal alcohol exposure, its acceptability and effectiveness had not yet been examined. This dissertation serves as a program evaluation of the SNACS model as applied to a broader PA/SE population, assessing feasibility, acceptability, and initial effectiveness within a children’s hospital autism center. Using a pre-post time series design, data were collected from 30 caregiver-child dyads served between 2023 and 2025. Feasibility was evaluated through referral appropriateness, session completion, and model adherence. Acceptability was assessed through qualitative content analysis of caregiver-identified needs and quantitative ratings of needs met. Effectiveness was measured through pre-post change in caregiver self-efficacy and targeted indicators of therapeutic assessment elements. Results indicated strong feasibility, with high completion rates and evidence of diagnostic clarification across assessments. Acceptability findings demonstrated close alignment between caregiver-identified needs and perceived improvements following participation. Although global caregiver self-efficacy did not change significantly, caregivers reported meaningful gains in understanding their child's brain-based differences and knowing how to respond to dysregulation, both meaningful changes within a family system. Findings offer preliminary support for SNACS as a feasible, acceptable, and effective integrative model of care, underscoring the value of embedding intervention-oriented techniques within neurodevelopmental assessment for families affected by PA/SE.

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