Prenatal cocaine exposure and child development: what do we know and what do we do?

The literature remains unclear about the effects of prenatal cocaine exposure on child development. Meanwhile, the implications for public policy and treatment and for our scientific understanding of the toxicity of cocaine are substantial. In this article we describe; (1) our current understanding of the effects of prenatal cocaine use and child outcome, (2) the issues that need to be investigated, and (3) implications for treatment of cocaine exposed children. Findings from our database of the published literature shows that our knowledge is still limited, scattered, and compromised by methodological problems that mitigate any conclusions about whether or not or how prenatal cocaine exposure affects child outcome. The cocaine problem is more complicated than first envisioned--it is a multifactorial problem including the use of other drugs, parenting, and environmental lifestyle issues. However, we also show that, even though the effects may be more subtle than initially anticipated, prenatal cocaine exposure will substantially increase in the number of school age children who will need special education services. Clinicians working with these children and families need to be prepared to address psychosocial and environmental issues, as well as developmental performance, in order to optimize their assessment and intervention.