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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Four-year language outcomes of children exposed to cocaine in utero
Barbara A Lewis1, Lynn T Singer, Elizabeth J Short
1Department of Pediatrics, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA. bxl@po.cwru.edu
Insights
Children exposed to cocaine in utero show poorer language skills by age 4. However, an enriched environment, like adoptive care, may improve language development in these children.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Prenatal exposure to substances can impact child development.
- Cocaine use during pregnancy is a significant public health concern.
- Understanding long-term effects on language is crucial for early intervention.
Purpose of the Study:
- To investigate the long-term effects of prenatal cocaine exposure on child language development.
- To compare language abilities in cocaine-exposed versus non-exposed children.
- To identify factors that may modify these effects.
Main Methods:
- Prospective longitudinal study of children from birth to 4 years.
- Comparison of 189 cocaine-exposed children with 185 non-exposed children.
- Assessment using the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P).
Main Results:
- Cocaine-exposed children had poorer expressive and total language scores.
- Mild receptive language delays and fewer high expressive abilities were observed in exposed children.
- Maternal factors and other prenatal exposures (alcohol, marijuana, tobacco) were controlled for.
Conclusions:
- Prenatal cocaine exposure has a specific negative effect on early childhood language skills.
- Environmental factors, such as placement in foster or adoptive care, can positively influence language outcomes.
- Intervention strategies focusing on enriched environments may mitigate cocaine's impact on language development.
Abstract:
A large cohort of children exposed to cocaine in utero (n=189) were followed prospectively from birth to 4 years of age and compared to nonexposed children (n=185) on the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P), a measure of receptive and expressive language abilities. Children exposed to cocaine in utero performed more poorly on the expressive and total language measures than nonexposed children after controlling for confounding variables, including prenatal exposure to alcohol, marijuana, and tobacco, as well as medical and sociodemographic variables. Children exposed to cocaine had more mild receptive language delays than nonexposed children and were less likely to have higher expressive abilities. Also, maternal factors such as language ability, performance IQ, race, and education correlated with child language abilities. Prenatal cigarette and marijuana exposure were related to deficits in specific language skills. Children placed in adoptive or foster care who were cocaine exposed demonstrated superior language skills compared to children exposed to cocaine who remained in biological relative or mother's care. These findings support a cocaine-specific effect on language skills in early childhood that may be modified with an enriched environment.
