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Landi N, Avery T, Crowley MJ, Wu J, Mayes L. Prenatal Cocaine Exposure Impacts Language and Reading Into Late Adolescence: Behavioral and ERP Evidence. Dev Neuropsychol 2017; 42:369-386. [PMID: 28949778 DOI: 10.1080/87565641.2017.1362698] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Extant research documents impaired language among children with prenatal cocaine exposure (PCE) relative to nondrug exposed (NDE) children, suggesting that cocaine alters development of neurobiological systems that support language. The current study examines behavioral and neural (electrophysiological) indices of language function in older adolescents. Specifically, we compare performance of PCE (N = 59) and NDE (N = 51) adolescents on a battery of cognitive and linguistic assessments that tap word reading, reading comprehension, semantic and grammatical processing, and IQ. In addition, we examine event related potential (ERP) responses in in a subset of these children across three experimental tasks that examine word level phonological processing (rhyme priming), word level semantic processing (semantic priming), and sentence level semantic processing (semantic anomaly). Findings reveal deficits across a number of reading and language assessments, after controlling for socioeconomic status and exposure to other substances. Additionally, ERP data reveal atypical orthography to phonology mapping (reduced N1/P2 response) and atypical rhyme and semantic processing (N400 response). These findings suggest that PCE continues to impact language and reading skills into the late teenage years.
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Affiliation(s)
- Nicole Landi
- a Psychological Sciences , University of Connecticut , Storrs , Connecticut.,b Haskins Laboratories , New Haven , Connecticut
| | - Trey Avery
- b Haskins Laboratories , New Haven , Connecticut
| | | | - Jia Wu
- c Yale Child Study Center , New Haven , Connecticut
| | - Linda Mayes
- c Yale Child Study Center , New Haven , Connecticut
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Richardson MA, Grant-Knight W, Beeghly M, Rose-Jacobs R, Chen CA, Appugliese DP, Cabral HJ, Liebschutz JM, Frank DA. Psychological Distress Among School-Aged Children with and Without Intrauterine Cocaine Exposure: Perinatal Versus Contextual Effects. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 44:547-60. [PMID: 26194603 PMCID: PMC4854523 DOI: 10.1007/s10802-015-0052-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Whether intrauterine cocaine exposure (IUCE) explains unique variance in psychiatric functioning among school age children, even after controlling for other biological and social risk factors, has not been fully delineated. As part of a longitudinal birth cohort study of children with and without IUCE, we conducted and analyzed data based on structured clinical interviews with 105 children (57% male) and their caregivers when the child was approximately 8.5 years old; 47% of the children had experienced IUCE. Interviews included past and current major psychological disorders and sub-threshold mental health symptoms. Potential covariates were ascertained by interviews of birth mothers and other caregivers from shortly after the child's birth until the 8.5-year visit. More than one-third of children met DSM-IV criteria for one or more mood, anxiety, attention deficit, or disruptive behavior disorders. IUCE was not significantly associated with children's history of psychological distress, in either bivariate or multiple logistic regressions. In contrast, birth mothers' acknowledgement of greater psychiatric distress at baseline and higher levels of alcohol consumption during pregnancy, and at 8.5 years caregivers' reports of their own psychological distress, and children's lower IQ were predictors of higher rates of psychological morbidity. Findings are consistent with prior reports suggesting that, regardless of IUCE status, children from low-income, urban backgrounds are at heightened risk for psychological distress. Results underscore the need for closer monitoring of the mental health of children living in low-income households, with or without intrauterine substance exposures, to facilitate access to appropriate services.
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Affiliation(s)
- Mark A Richardson
- Division of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
- Department of Psychological and Brain Sciences, Boston University, 648 Beacon Street, 2nd floor, Boston, MA, 02215, USA.
| | | | - Marjorie Beeghly
- Department of Psychology, Wayne State University, Detroit, MI, USA
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Ruth Rose-Jacobs
- Division of Developmental and Behavioral Medicine, Boston Medical Center, Boston, MA, USA
- Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA
| | - Clara A Chen
- Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA
| | - Danielle P Appugliese
- Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA
| | - Howard J Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jane M Liebschutz
- General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - Deborah A Frank
- Division of Developmental and Behavioral Medicine, Boston Medical Center, Boston, MA, USA
- Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA
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Abstract
This was a prospective longitudinal multisite study of the effects of prenatal cocaine and/or opiate exposure on temperament in 4-month-olds of the Maternal Lifestyle Study (N = 958: 366 cocaine exposed, 37 opiate exposed, 33 exposed to both drugs, 522 matched comparison). The study evaluated positivity and negativity during The Behavior Assessment of Infant Temperament (Garcia Coll et al., 1988). Parents rated temperament (Infant Behavior Questionnaire; Rothbart, 1981). Cocaine-exposed infants showed less positivity overall, mainly during activity and threshold items, more negativity during sociability items, and less negativity during irritability and threshold items. Latent profile analysis indicated individual temperament patterns were best described by three groups: low/moderate overall reactivity, high social negative reactivity, and high nonsocial negative reactivity. Infants with heavy cocaine exposure were more likely in high social negative reactivity profile, were less negative during threshold items, and required longer soothing intervention. Cocaine- and opiate-exposed infants scored lower on Infant Behavior Questionnaire smiling and laughter and duration of orienting scales. Opiate-exposed infants were rated as less respondent to soothing. By including a multitask measure of temperament we were able to show context-specific behavioral dysregulation in prenatally cocaine-exposed infants. The findings indicate flatter temperament may be specific to nonsocial contexts, whereas social interactions may be more distressing for cocaine-exposed infants.
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Eom S, Fisher B, Dezort C, Berg AT. Routine developmental, autism, behavioral, and psychological screening in epilepsy care settings. Dev Med Child Neurol 2014; 56:1100-5. [PMID: 24861272 DOI: 10.1111/dmcn.12497] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2014] [Indexed: 11/29/2022]
Abstract
AIM Screening for cognitive impairment, developmental delay, and neuropsychiatric problems is not always performed in children with epilepsy. The aim of this study was to assess the value of this screening and its validity for determining previously unidentified ('actionable') problems in children with epilepsy. METHOD New and existing patients with epilepsy were recruited from a hospital-based epilepsy center. The parent of the child completed screening evaluations for development (Ages and Stages Questionnaire [ASQ], 0-66mo), autism (Modified Checklist for Autism in Toddlers [mCHAT], 16-30mo), social communication (Social Communication Questionnaire [SCQ], ≥4y), and psychiatric concerns (Strengths and Difficulties Questionnaire [SDQ], 4-17y). RESULTS We screened 236 children overall (136 males [58%], 100 females [42%]; mean age [SD] 6y 7mo [4y 6mo]). Of these, 176 children (75%) had established epilepsy diagnoses and 60 (25%) were patients with new-onset epilepsy. Of those with new-onset disease, 22 (37%) were determined not to have epilepsy. Positive findings by test were 82% (ASQ), 54% (mCHAT), 15%, (SCQ), and 58% (SDQ). Findings were actionable in 46 children (20%): 18% of findings in children with established epilepsy and 23% of findings in patients with new-onset epilepsy. Of the 46 children for whom further referrals were made, the parents of 28 (61%) have pursued further evaluations. INTERPRETATION In this study, children with existing and new-onset diagnoses of epilepsy had actionable screening findings. These findings support the development of systematic screening of comorbidities for children with epilepsy.
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Affiliation(s)
- Soyong Eom
- Epilepsy Center, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Lewis BA, Minnes S, Short EJ, Min MO, Wu M, Lang A, Weishampel P, Singer LT. Language outcomes at 12 years for children exposed prenatally to cocaine. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2013; 56:1662-76. [PMID: 24149136 PMCID: PMC4131682 DOI: 10.1044/1092-4388(2013/12-0119)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
PURPOSE In this study, the authors aimed to examine the long-term effects of prenatal cocaine exposure (PCE) on the language development of 12-year-old children using a prospective design, controlling for confounding prenatal drug exposure and environmental factors. METHOD Children who were exposed to cocaine in utero (PCE; n = 183) and children who were not exposed to cocaine (i.e., no cocaine exposure [NCE]; n = 181) were followed prospectively from birth to 12 years of age and were compared on language subtests of the Test of Language Development-Intermediate, Third Edition ( Hammill & Newcomer, 1997b), and phonological processing as measured by the Comprehensive Test of Phonological Processing ( Wagner & Torgesen, 1999). The authors evaluated the relationship of PCE to language development through a multivariate analysis of covariance and regression analyses while controlling for confounders. RESULTS Results show that PCE has small effects on specific aspects of language, including syntax and phonological processing. The caregiver variables of lower maternal vocabulary, more psychological symptoms, and a poorer home environment also had consistent effects on language and phonological processing scores. CONCLUSIONS These findings suggest that PCE continues to have small, subtle effects on specific aspects of language at age 12 years. Phonological processing skills were significantly related to the reading outcomes of letter-word identification, reading fluency, and reading comprehension, indicating that PCE also has small but lasting effects on the language skills that are related to later literacy skills.
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Richardson GA, Goldschmidt L, Larkby C, Day NL. Effects of prenatal cocaine exposure on child behavior and growth at 10 years of age. Neurotoxicol Teratol 2013; 40:1-8. [PMID: 23981277 DOI: 10.1016/j.ntt.2013.08.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 08/12/2013] [Accepted: 08/13/2013] [Indexed: 10/26/2022]
Abstract
We examined physical growth and behavioral outcomes in 226 10-year-old children who were participants in a longitudinal study of prenatal cocaine exposure (PCE), while controlling for other factors that affect development. During the first trimester, 42% of the women used cocaine, with use declining across pregnancy. At the 10-year follow-up, the caregivers were 37years old, had 12.8years of education, and 50% were African American. First trimester cocaine exposure predicted decreased weight, height, and head circumference at 10years. First trimester cocaine use also predicted maternal ratings of less sociability on the EAS Temperament Survey and more withdrawn behavior problems on the Child Behavior Checklist, more anxious/depressed behaviors on the Teacher Report Form, and more self-reported depressive symptoms on the Children's Depression Inventory. In addition, exposure to violence mediated the effect of PCE on child and teacher reports of depressive symptoms, but not of maternal reports of sociability and withdrawn behaviors. These behaviors may be precursors of later psychiatric problems.
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Affiliation(s)
- Gale A Richardson
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, United States.
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Bennett DS, Marini VA, Berzenski SR, Carmody DP, Lewis M. Externalizing problems in late childhood as a function of prenatal cocaine exposure and environmental risk. J Pediatr Psychol 2012; 38:296-308. [PMID: 23248347 DOI: 10.1093/jpepsy/jss117] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To examine whether prenatal cocaine exposure (PCE) predicts externalizing problems in late childhood. METHODS Externalizing problems were assessed using caregiver, teacher, and child ratings and a laboratory task when children (N = 179; 74 cocaine exposed) were aged 8-10 years. PCE, environmental risk, sex, neonatal health, other prenatal exposures, and foster care history were examined as predictors of externalizing problems. RESULTS Multiple regression analyses indicated that PCE, environmental risk, and male sex explained significant variance in externalizing problems in late childhood. Models varied by source of information. PCE predicted externalizing problems for child laboratory behavior and interacted with sex because males with PCE reported more externalizing problems. PCE did not predict caregiver or teacher ratings of externalizing problems. CONCLUSIONS The effect of PCE on externalizing problems may persist into late childhood. The findings highlight the potential importance of including child-based measures of externalizing problems in studies of prenatal exposure.
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Affiliation(s)
- David S Bennett
- Drexel University College of Medicine, Philadelphia, PA 19144, USA.
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Mactutus CF, Harrod SB, Hord LL, Moran LM, Booze RM. Prenatal IV Cocaine: Alterations in Auditory Information Processing. Front Psychiatry 2011; 2:38. [PMID: 21747770 PMCID: PMC3128243 DOI: 10.3389/fpsyt.2011.00038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Accepted: 06/11/2011] [Indexed: 01/24/2023] Open
Abstract
One clue regarding the basis of cocaine-induced deficits in attentional processing is provided by the clinical findings of changes in the infants' startle response; observations buttressed by neurophysiological evidence of alterations in brainstem transmission time. Using the IV route of administration and doses that mimic the peak arterial levels of cocaine use in humans, the present study examined the effects of prenatal cocaine on auditory information processing via tests of the auditory startle response (ASR), habituation, and prepulse inhibition (PPI) in the offspring. Nulliparous Long-Evans female rats, implanted with an IV access port prior to breeding, were administered saline, 0.5, 1.0, or 3.0 mg/kg/injection of cocaine HCL (COC) from gestation day (GD) 8-20 (1×/day-GD8-14, 2×/day-GD15-20). COC had no significant effects on maternal/litter parameters or growth of the offspring. At 18-20 days of age, one male and one female, randomly selected from each litter displayed an increased ASR (>30% for males at 1.0 mg/kg and >30% for females at 3.0 mg/kg). When reassessed in adulthood (D90-100), a linear dose-response increase was noted on response amplitude. At both test ages, within-session habituation was retarded by prenatal cocaine treatment. Testing the females in diestrus vs. estrus did not alter the results. Prenatal cocaine altered the PPI response function across interstimulus interval and induced significant sex-dependent changes in response latency. Idazoxan, an α(2)-adrenergic receptor antagonist, significantly enhanced the ASR, but less enhancement was noted with increasing doses of prenatal cocaine. Thus, in utero exposure to cocaine, when delivered via a protocol designed to capture prominent features of recreational usage, causes persistent, if not permanent, alterations in auditory information processing, and suggests dysfunction of the central noradrenergic circuitry modulating, if not mediating, these responses.
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Affiliation(s)
- Charles F. Mactutus
- Behavioral Neuroscience Program, Department of Psychology, University of South CarolinaColumbia, SC, USA
| | - Steven B. Harrod
- Behavioral Neuroscience Program, Department of Psychology, University of South CarolinaColumbia, SC, USA
| | - Lauren L. Hord
- Behavioral Neuroscience Program, Department of Psychology, University of South CarolinaColumbia, SC, USA
| | - Landhing M. Moran
- Behavioral Neuroscience Program, Department of Psychology, University of South CarolinaColumbia, SC, USA
| | - Rosemarie M. Booze
- Behavioral Neuroscience Program, Department of Psychology, University of South CarolinaColumbia, SC, USA
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Richardson GA, Goldschmidt L, Leech S, Willford J. Prenatal cocaine exposure: Effects on mother- and teacher-rated behavior problems and growth in school-age children. Neurotoxicol Teratol 2010; 33:69-77. [PMID: 20600846 DOI: 10.1016/j.ntt.2010.06.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Revised: 03/24/2010] [Accepted: 06/20/2010] [Indexed: 11/19/2022]
Abstract
In this longitudinal study of prenatal cocaine exposure (PCE), school-age physical and cognitive development and behavioral characteristics were examined, while controlling for other factors that affect child development. At this follow-up phase, children were on average 7.2 years old, and their caregivers were 33.7 years old, had 12.5 years of education, and 48% were African American. During the first trimester, 20% of the women were frequent cocaine users (≥1 line/day). First trimester cocaine exposure predicted decreased weight and height at 7 years. There was no significant relationship between PCE and the cognitive and neuropsychological measures. Third trimester cocaine use predicted more total and externalizing behavior problems on the Child Behavior Checklist (Achenbach, 1991 [3]) and the Teacher Report Form (Achenbach, 1991 [4]), and increased activity, inattention, and impulsivity on the Routh Activity (Routh et al., 1974 [67]) and SNAP scales (Pelham and Bender, 1982 [55]). Children who were exposed to cocaine throughout pregnancy had more mother- and teacher-rated behavior problems compared to children of women who stopped using early in pregnancy or who never used cocaine prenatally. These detrimental effects of PCE on behavior are consistent with other reports in the literature and with the hypothesis that PCE affects development through changes in neurotransmitter systems. These school-age behaviors may be precursors of later adolescent behavior problems.
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Affiliation(s)
- Gale A Richardson
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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Abstract
The purpose of this article was to review follow up studies of children with prenatal drug exposure from preschool through adolescence. Specifically, the authors focus on the effects of prenatal exposure to cocaine, methamphetamine, and opiates on behavior and development. The largest number of studies have examined cocaine-exposed children. The authors identified 42 studies that suggest that there are unique effects of prenatal cocaine exposure on 4- to 13-year-old children, particularly in the areas of behavior problems, attention, language, and cognition. In addition, studies make reasonable attempts to control for possible confounding factors. Systematic research on the long-term effects of prenatal methamphetamine exposure is just beginning but seems to be showing similar effects to that of cocaine. The literature on the on the long-term effects of children with prenatal opiate exposure is more substantial than the methamphetamine literature but it is still relatively sparse and surprising in that there is little recent work. Thus, there are no studies on the current concerns with opiates used for prescription mediation. There is a growing literature using neuroimaging techniques to study the effects of prenatal drug exposure that holds promise for understanding brain/behavior relationships. In addition to pharmacological and teratogenic effects, drugs can also be viewed from a prenatal stressor model. The author discuss this "fetal origins" approach that involves fetal programming and the neuroendocrine system and the potential implications for adolescent brain and behavioral development.
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Affiliation(s)
- Barry M Lester
- Brown Center for the Study of Children at Risk, The Warren Alpert Medical School of Brown University, Women and Infants Hospital of Rhode Island, Providence, RI 02905, USA.
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Ackerman JP, Riggins T, Black MM. A review of the effects of prenatal cocaine exposure among school-aged children. Pediatrics 2010; 125:554-65. [PMID: 20142293 PMCID: PMC3150504 DOI: 10.1542/peds.2009-0637] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
CONTEXT Studies through 6 years have shown no long-term direct effects of prenatal cocaine exposure (PCE) on children's physical growth, developmental test scores, or language outcomes. Little is known about the effects of PCE among school-aged children aged 6 years and older. OBJECTIVE We reviewed articles from studies that examined the effects of PCE on growth, cognitive ability, academic functioning, and brain structure and function among school-aged children. METHODS Articles were obtained by searching PubMed, Medline, TOXNET, and PsycInfo databases from January 1980 to December 2008 with the terms "prenatal cocaine exposure," "cocaine," "drug exposure," "substance exposure," "maternal drug use," "polysubstance," "children," "adolescent," "in utero," "pregnancy," "development," and "behavior." Criteria for inclusion were (1) empirical research on children aged 6 years and older prenatally exposed to cocaine, (2) peer-reviewed English-language journal, (3) comparison group, (4) longitudinal follow-up or historical prospective design, (5) masked assessment, (6) exclusion of subjects with serious medical disabilities, and (7) studies that reported nonredundant findings for samples used in multiple investigations. Thirty-two unique studies met the criteria. Each article was independently abstracted by 2 authors to obtain sample composition, methods of PCE assessment, study design, comparison groups, dependent variables, covariates, and results. RESULTS Associations between PCE and growth, cognitive ability, academic achievement, and language functioning were small and attenuated by environmental variables. PCE had significant negative associations with sustained attention and behavioral self-regulation, even with covariate control. Although emerging evidence suggests PCE-related alterations in brain structure and function, interpretation is limited by methodologic inconsistencies. CONCLUSIONS Consistent with findings among preschool-aged children, environmental variables play a key role in moderating and explaining the effects of PCE on school-aged children's functioning. After controlling for these effects, PCE-related impairments are reliably reported in sustained attention and behavioral self-regulation among school-aged children.
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Affiliation(s)
- John P. Ackerman
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Tracy Riggins
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Maureen M. Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
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Kurtz PF, Chin MD, Rush KS, Dixon DR. Treatment of challenging behavior exhibited by children with prenatal drug exposure. RESEARCH IN DEVELOPMENTAL DISABILITIES 2008; 29:582-594. [PMID: 18037269 DOI: 10.1016/j.ridd.2007.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2007] [Revised: 05/25/2007] [Accepted: 05/30/2007] [Indexed: 05/25/2023]
Abstract
A large body of literature exists describing the harmful effects of prenatal drug exposure on infant and child development. However, there is a paucity of research examining strategies to ameliorate sequelae such as externalizing behavior problems. In the present study, functional analysis procedures were used to assess challenging behavior exhibited by two children who were prenatally exposed to drugs of abuse. Results for both children indicated that challenging behavior was maintained by access to positive reinforcement (adult attention and tangible items). For one child, challenging behavior was also maintained by negative reinforcement (escape from activities of daily living). Function-based interventions were effective in reducing challenging behavior for both children. Implications for utilizing methods of applied behavior analysis in research with children with prenatal drug exposure are discussed.
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Affiliation(s)
- Patricia F Kurtz
- Kennedy Krieger Institute, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
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Dixon DR, Kurtz PF, Chin MD. A systematic review of challenging behaviors in children exposed prenatally to substances of abuse. RESEARCH IN DEVELOPMENTAL DISABILITIES 2008; 29:483-502. [PMID: 18037268 DOI: 10.1016/j.ridd.2007.05.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2007] [Revised: 05/25/2007] [Accepted: 05/30/2007] [Indexed: 05/25/2023]
Abstract
A review of the existing literature on the occurrence of challenging behavior among children with prenatal drug exposure was conducted. While a large number of studies were identified that evaluated various outcomes of prenatal drug exposure, only 37 were found that directly evaluated challenging behaviors. Of the 37 studies, 23 focused on prenatal cocaine exposure, and 14 focused on prenatal alcohol exposure; most studies relied on broadband measures such as the CBCL for the assessment of challenging behavior. Among the 37 studies, a clear role for the postnatal environment on developing challenging behaviors was evident; however, prenatal alcohol exposure showed a much clearer independent effect upon challenging behaviors than was noted in the prenatal cocaine studies. Additionally, only 3 of the 37 studies addressed interventions for challenging behaviors, each of which showed an improvement in child behavior or parent-child interactions. As researchers have continued to show the importance of the postnatal environment, it is likely that interventions addressing specific environmental risk factors will be helpful to reduce or prevent challenging behaviors among this population.
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Affiliation(s)
- Dennis R Dixon
- Kennedy Krieger Institute, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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Kable JA, Coles CD, Lynch ME, Platzman K. Physiological responses to social and cognitive challenges in 8-year olds with a history of prenatal cocaine exposure. Dev Psychobiol 2008; 50:251-65. [DOI: 10.1002/dev.20285] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Bada HS, Das A, Bauer CR, Shankaran S, Lester B, LaGasse L, Hammond J, Wright LL, Higgins R. Impact of prenatal cocaine exposure on child behavior problems through school age. Pediatrics 2007; 119:e348-59. [PMID: 17272597 DOI: 10.1542/peds.2006-1404] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE We examined the trajectory of childhood behavior problems after prenatal cocaine exposure. METHODS The Maternal Lifestyle Study, a longitudinal cohort study, enrolled children between 1993 and 1995 at 4 centers. Prenatal cocaine exposure was determined from mothers who admitted use and/or meconium results. Exposed children were matched with a group of nonexposed children within site and by gestational age, gender, race, and ethnicity. The study began at the 1-month corrected age with a total of 1388 children enrolled. A total of 1056 were assessed for internalizing, externalizing, and total behavior problems at ages 3, 5, and 7 years using the Child Behavior Checklist. Longitudinal hierarchical linear models were used to determine the effect of prenatal cocaine exposure on behavior problem trajectories while controlling for other prenatal exposures; time-varying covariates, including ongoing caregiver use of legal and illegal substances; demographic factors; family violence; and caregiver psychological distress. RESULTS High prenatal cocaine exposure was associated with the trajectory of internalizing, externalizing, and total behavior problems; these effects were independent of and less than the significant combined effect of prenatal and postnatal tobacco and alcohol exposures. Caregiver depression and family violence had independent negative influence on all behavior outcomes. CONCLUSIONS Prenatal cocaine exposure has a negative impact on the trajectories of childhood behavior outcomes. When they co-occur with prenatal cocaine exposure, prenatal and postnatal tobacco and alcohol exposures have added negative effects on behavior outcomes.
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Affiliation(s)
- Henrietta S Bada
- Department of Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
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