Prenatal Cocaine and Tobacco Effects on Children's Language Trajectories

Lewis, Barbara; Kirchner, H. Lester; Short, Elizabeth J.; Minnes, Sonia; Weishampel, Paul; Satayathum, Sudtida; Singer, Lynn T.

doi:10.1542/peds.2006-2563

Cited by 45 publications

(36 citation statements)

References 32 publications

(23 reference statements)

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“…Longitudinal studies have reported that prenatal cocaine is associated with impaired language development through early adolescence (Bandstra et al, 2011;Lewis et al, 2007;Lewis et al, 2011). However, some studies suggest a general improvement in receptive language starting in adolescence through age 17 (Betancourt et al, 2011).…”

Section: Cocainementioning

confidence: 99%

“…Children age 6 and younger had decreased receptive language skills (Fried et al, 1992a;Fried and Watkinson, 1990;Lewis et al, 2007), which can contribute to language comprehension deficits. Exposed children also show poorer academic achievement or cognitive scores than peers (Agrawal et al, 2010;Fried et al, 1992a;Fried and Watkinson, 1990).…”

Section: Tobacco/nicotinementioning

confidence: 99%

See 1 more Smart Citation

Developmental Consequences of Fetal Exposure to Drugs: What We Know and What We Still Must Learn

Ross

Graham

Money

et al. 2014

Neuropsychopharmacol

331

241

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Most drugs of abuse easily cross the placenta and can affect fetal brain development. In utero exposures to drugs thus can have long-lasting implications for brain structure and function. These effects on the developing nervous system, before homeostatic regulatory mechanisms are properly calibrated, often differ from their effects on mature systems. In this review, we describe current knowledge on how alcohol, nicotine, cocaine, amphetamine, Ecstasy, and opiates (among other drugs) produce alterations in neurodevelopmental trajectory. We focus both on animal models and available clinical and imaging data from cross-sectional and longitudinal human studies. Early studies of fetal exposures focused on classic teratological methods that are insufficient for revealing more subtle effects that are nevertheless very behaviorally relevant. Modern mechanistic approaches have informed us greatly as to how to potentially ameliorate the induced deficits in brain formation and function, but conclude that better delineation of sensitive periods, dose-response relationships, and long-term longitudinal studies assessing future risk of offspring to exhibit learning disabilities, mental health disorders, and limited neural adaptations are crucial to limit the societal impact of these exposures.

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Section: Cocainementioning

confidence: 99%

Section: Tobacco/nicotinementioning

confidence: 99%

Developmental Consequences of Fetal Exposure to Drugs: What We Know and What We Still Must Learn

Ross

Graham

Money

et al. 2014

Neuropsychopharmacol

331

241

View full text Add to dashboard Cite

show abstract

“…These children may need more special education services in general but not any specific type of service. We had expected more SLS referrals for the PCE children on the basis of previous work 14,[18][19][20][21][22][23][24] ; however, within the IEP group, 95.3% of the PCE group and 91.4% of comparison children also had SLSs, indicating that SLSs are a major area of recognized resource necessity in special education for this population regardless of PCE. …”

mentioning

confidence: 93%

Effects of prenatal cocaine exposure on special education in school‐aged children

Reading¹

2008

Child

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OBJECTIVE-The objective of this study was to evaluate the effects of prenatal cocaine exposure on special education at age 7 with adjustment for covariates.METHODS-As part of the prospective, longitudinal, multisite study of children with prenatal cocaine exposure (Maternal Lifestyle Study), school records were reviewed for 943 children at 7 years to determine involvement in special education outcomes: (1) individualized education plan; (2) special education conditions; (3) support services; (4) special education classes; and (5) speech and language services. Logistic regression was used to examine the effect of prenatal cocaine exposure on these outcomes with environmental, maternal, and infant medical variables as covariates, as well as with and without low child IQ. RESULTS-Completedata for each analysis model were available for 737 to 916 children. When controlling for covariates including low child IQ, prenatal cocaine exposure had a significant effect on individualized education plan. When low child IQ was not included in the model, prenatal cocaine exposure had a significant effect on support services. Male gender, low birth weight, white race, and low child IQ also predicted individualized education plan. Low birth weight and low child IQ were significant in all models. White race was also significant in speech and language services. Other covariate effects were model specific. When included in the models, low child IQ accounted for more of the variance and changed the significance of other covariates.CONCLUSIONS-Prenatal cocaine exposure increased the likelihood of receiving an individualized education plan and support services, with adjustment for covariates. Low birth weight and low child IQ increased the likelihood of all outcomes. The finding that white children were more likely to get an individualized education plan and speech and language services could indicate a greater advantage in getting educational resources for this population. Copyright © 2008 Increased use of cocaine in the United States in the 1980s turned the scientific community toward studying the children of mothers who used cocaine during pregnancy. Initial legal and social stigma attached to mothers who abused cocaine during pregnancy and their "crack kids" who were feared to be "brain damaged"1 ,2 has been tempered by evidence that the risk for serious congenital malformations or medical complications in newborns with prenatal cocaine exposure (PCE) is minimal 3 ; however, little is known about the potential long-term neurodevelopmental effects of PCE. Previous studies revealed varying effects of PCE on behavior4 -6 and cognitive outcomes.7 -13 Longitudinal follow-up studies of the intelligence of these children suggested that cocaine effects are apparent but more subtle than originally feared. 14 Inconsistencies in the cocaine literature have been described and may be attributable to methodologic issues such as small sample size; confounding of cocaine exposure with exposure to other drugs; lack of biochemical verifica...

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“…A growing body of results from several large well-designed, covariate-controlled prospective studies suggests that IUCE may be linked to mild but persistent language delays in preschool, school-aged, and early adolescent children, although specific findings vary [10,12,13,79,80]. Bandstra and colleagues [10] evaluated the developing language skills of a large urban sample of cocaine-exposed and unexposed children at 3, 5, and 12 years of age using an age-appropriate version of a single standardized assessment, the Clinical Evaluation of Language Fundamentals (CELF) [120].…”

Section: Introductionmentioning

confidence: 99%

“…In a longitudinal analysis of children's standardized receptive, expressive, and total language scores during the first six years of life, Lewis and colleagues [79] reported a stable negative effect of IUCE on all language measures; however, prenatal tobacco exposure and environmental measures also accounted for significant, unique variance in language outcomes. In a follow-up of this cohort at age 10, Lewis et al[80] found that IUCE was associated with mild compromise on specific rather than general measures of language, including syntax, semantics, and phonological processing.…”

Section: Introductionmentioning

confidence: 99%

Level of intrauterine cocaine exposure and neuropsychological test scores in preadolescence: subtle effects on auditory attention and narrative memory

Rose-Jacobs

Martin

Cabral

et al. 2014

Neurotoxicology and Teratology

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Neuropsychological processes such as attention and memory contribute to children's higher-level cognitive and language functioning and predict academic achievement. The goal of this analysis was to evaluate whether level of intrauterine cocaine exposure (IUCE) alters multiple aspects of preadolescents' neuropsychological functioning assessed using a single age-referenced instrument, the NEPSY: A Developmental Neuropsychological Assessment (NEPSY) [71], after controlling for relevant covariates. Participants included 137 term 9.5-year-old children from low-income urban backgrounds (51% male, 90% African American/Caribbean) from an ongoing prospective longitudinal study. Level of IUCE was assessed in the newborn period using infant meconium and maternal report. 52% of the children had IUCE (65% with lighter IUCE, and 35% with heavier IUCE), and 48% were unexposed. Infants with Fetal Alcohol Syndrome, HIV seropositivity, or intrauterine exposure to illicit substances other than cocaine and marijuana were excluded. At the 9.5-year follow-up visit, trained examiners masked to IUCE and background variables evaluated children's neuropsychological functioning using the NEPSY. The association between level of IUCE and NEPSY outcomes was evaluated in a series of linear regressions controlling for intrauterine exposure to other substances and relevant child, caregiver, and demographic variables. Results indicated that level of IUCE was associated with lower scores on the Auditory Attention and Narrative Memory tasks, both of which require auditory information processing and sustained attention for successful performance. However, results did not follow the expected ordinal, dose-dependent pattern. Children's neuropsychological test scores were also altered by a variety of other biological and psychosocial factors.

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Prenatal Cocaine and Tobacco Effects on Children's Language Trajectories

Cited by 45 publications

References 32 publications

Developmental Consequences of Fetal Exposure to Drugs: What We Know and What We Still Must Learn

Developmental Consequences of Fetal Exposure to Drugs: What We Know and What We Still Must Learn

Effects of prenatal cocaine exposure on special education in school‐aged children

Level of intrauterine cocaine exposure and neuropsychological test scores in preadolescence: subtle effects on auditory attention and narrative memory

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