Children's Cognitive-Behavioral Functioning at Age 6 and 7: Prenatal Drug Exposure and Caregiving Environment

• Published in: Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association Vol. 8; no. 3; pp. 154 - 162
• Main Authors: Nair, Prasanna, MBBS, MPH, Black, Maureen M., PhD, Ackerman, John P., PhD, Schuler, Maureen E., PhD, Keane, Virginia A., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2008; Elsevier Science Ltd
• Subjects: Behavior; Birth weight; Child; Child Development; Children & youth; Cognition - physiology; Cohort Studies; Drug use; Female; gender; Humans; Intensive care; low income; Male; Parenting; Pediatrics; Pregnancy; prenatal drug exposure; Prenatal Exposure Delayed Effects - psychology; Prenatal Exposure Delayed Effects - therapy; Psychological Tests; Risk Factors; school age children; Sex Factors; Socioeconomic Factors; Substance-Related Disorders - psychology; Substance-Related Disorders - therapy; low income; prenatal drug exposure; gender; school age children
• ISSN: 1530-1567; 1876-2859; 1539-4409; 1876-2867
• DOI: 10.1016/j.ambp.2008.02.002

Objective The aim of this study was to examine how prenatal drug exposure (PDE) and caregiving environment relate to cognitive, academic, and behavioral performance at ages 6 and 7. Methods A longitudinal follow-up was conducted of 111 children with PDE and a community cohort of 62 non–drug-exposed children (N = 173). Children completed standardized tests of cognition (Stanford-Binet Intelligence Scales, Fourth Edition [SB-IV]) and academic performance (Wide Range Achievement Test 3). Caregivers completed ratings of child behavior problems (Child Behavior Checklist [CBCL]). Multivariate analyses were conducted, adjusting for gender, prenatal tobacco exposure, number of caregiver placement changes, and 3 caregiver variables assessed at age 7, including depressive symptoms, employment status, and public assistance status. Results After adjusting for perinatal and environmental variables, there were no significant exposure-group differences in cognition, academic performance, or behavior problems. In comparison with males, females had higher scores on overall IQ and 4 of 8 SB-IV subtests, fewer caregiver-reported attention and aggression problems, and higher reading achievement scores. There were no significant gender-by-group interactions. Conclusion When analyses were adjusted for perinatal and environmental variables, most associations between PDE and cognitive-behavioral functioning were attenuated. Regardless of drug exposure history, males performed more poorly than females on multiple cognitive-behavioral indices. Both exposed and nonexposed children were from low-income families and obtained scores substantially below normative expectations.