Regardless of the timing of the exposure, parental EB is detrimental and has long-term negative impacts on child development that can manifest in serious behavior problems, including patterns of alcohol use necessitating medical intervention and treatment. That these impacts were seen as early as ages 19 to 24 in the children of parents with EB suggests that swift and early family-based intervention is warranted to help curtail the inter-generational transmission of externalizing and substance use disorders, and that these interventions are important in all developmental stages.