Characteristics of attachment organization and play organization in prenatally drug-exposed toddlers

Abstract

Prenatally drug-exposed toddlers were compared to preterm toddlers of similar low socioeconomic status, ethnicity, and single-parent households on intellectual functioning, quality of play, and security of attachment to the primary caregiver. The drug-exposed toddlers had significantly lower developmental scores, less representational play, and the majority had insecure, disorganized, avoidant attachments. In all areas investigated, the prenatally drug-exposed toddlers showed more subtle behavioral deficits within each domain. Although developmental quotients were within the average range, they were significantly lower than the preterm comparison group and did not adequately represent the more evident deficits seen through play in an unstructured situation. Unstructured assessments that required the child's initiation, goal setting, and follow-through were more revealing of developmental disorganization within and among domains than were adult structured assessments such as developmental tests. While modest differences were seen in structured tasks, the marked differences between the drug-exposed and preterm groups were most evident in the unstructured tasks. The lack of coherence across developmental domains was illustrated by the large difference between developmental quotient scores and the poor performance in the cognitive representional competencies demonstrated in play. Insecurity and disorganization in attachment were found to compromise further the development of the drug-exposed toddlers.

Relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome

“…Our findings support previous studies in which global deficits in developmental outcome have been identified in cocaine and polydrug exposed cohorts in the second year of life (Chasnoff, Griffith, Freier, & Murray, 1992;Rodning, Beckwith, & Howard, 1989;Singer, Yamashita, Hawkins, Cairns, Baley, & Kliegman, 1994;Van Baar & De Graaf, 1994). These deficits were found in both cognitive and motor skills, suggesting a biologic impact of cocaine or polydrug exposure on child development, as gross motor skills are not as susceptible to social class or environmental influences as the language and problem solving skills reflected in the MDI (Bendersky & Lewis, 1994;Singer, Yamashita, Lilien, Collin, & Baley, 1997).…”

“…The extreme end of the continuum of dysfunctional parenting in substance abusing populations is apparent in the disproportionately high representation of substance using families among children in out-of-home placements due to child abuse or neglect (Rogosch, Cicchetti, Shields, & Toth, 1995), and in the extraordinarily high rate of foster care placement for infants of cocaine using mothers (Children's Defense Fund, 1990). Direct observations of mother-child interactions have suggested disturbed interpersonal relationships in cocaine exposed, mother-child dyads manifest through insecure and disorganized attachment behaviors (Rodning, Beckwith, & Howard, 1989). Greater comorbid maternal psychopathology, in the form of antisocial personality disorder symptomatology, has been related to poorer maternal child interactions in 2-year-old children whose mothers were on methadone maintenance in one report (Hans, Bernstein, & Henson, 1990).…”

Effects of an energy and micronutrient supplement on play behavior in undernourished children in Indonesia

“…An abundance of expressed negative emotion or the child's inability to self-regulate and to return to a calm state after being frustrated or upset, will interfere with play. Other researchers report that toddlers in at-risk conditions are more likely to have dif®culty with initiating, organizing and sustaining play activities during unstructured free play (Cielinski et al, 1995;Rodning et al, 1989). Results of other home and day care observations within the larger study indicated that children receiving E supplements appeared more socially mature than children in the other groups.…”

“…The play assessment procedures used were those developed by Ungerer, Sigman and colleagues (Beckwith et al, 1991;Rodning et al, 1989;Ungerer & Sigman, 1981. (See Ungerer & Sigman, 1981 for details of the original procedure.)…”

Cocaine differentially inhibits neuronal differentiation and proliferation in vitro.

“…A major difficulty is the presence of confounding variables, such as the effect of other illicit drugs and socioenvironmental factors ( 1,2,7). Also, adverse effects on neurologic and behavioral functions may be delayed for years and may not be easily measured by standardized tests ( 1,3,(8)(9)(10).…”