Objective-This article was designed to investigate effects of prenatal cocaine exposure on motor development of young children from a predominately underprivileged, urban population.Methodology-A total of 260 infants and young children were initially recruited from either the newborn nursery or the at-risk pediatric clinic of an urban teaching hospital. Prenatal history and birth outcomes were collected from medical records. Demographic characteristics and additional drug histories were obtained from the mothers. The 199 subjects (98 cocaine-exposed and 101 unexposed) who returned at age 2 years were assessed by examiners blinded to drug exposure status using the Peabody Developmental Motor Scales.Results-Compared with control subjects, the cocaine-exposed group performed significantly less well on both the fine and the gross motor development indices. Mean scores for both groups were within the average range on the gross motor index, but greater than 1 standard deviation below average on the fine motor index. Differences were significant on the balance and the receipt and propulsion subscales of the gross motor scale, and on the hand use and the eye-hand coordination subscales of the fine motor scale. Cocaine status independently predicted poorer hand use and eye-hand coordination scores. There also was an effect of alcohol exposure on the receipt and propulsion subscale.Conclusions-Findings indicate that deficiencies in motor development remain detectable at 2 years of age in children exposed to drugs prenatally. Although other environmental variables may influence motor development, children exposed to cocaine and to alcohol in utero may encounter developmental challenges that impede later achievement.Although the recent epidemic of cocaine use may have subsided, 1,2 concerns about the development of many children exposed to cocaine in utero remain relevant. There are several possible mechanisms by which cocaine may damage the developing nervous system of the human fetus, 3 suggesting that neural functions associated with movement, such as those regulated by the hypothalamic and extrapyramidal systems, should be examined closely. Specific findings demonstrating a strong and explicit effect of fetal cocaine Copyright © 1999 exposure on infant development, however, have been difficult to confirm, in part because of numerous confounding factors. 4 In particular, many studies had small sample sizes and/or lacked control for the polydrug exposure that is commonly associated with cocaine exposure. Additionally, previous research frequently failed to consider other factors, such as amount of prenatal care, maternal education, and prematurity, that also have been shown to affect developmental outcome. 5,6 Numerous studies have focused on the neurobehavioral sequelae of prenatal cocaine exposure on newborns or young infants, many of which reported significant negative effects of cocaine exposure. Reviews of this literature, however, note several inconsistencies in the nature and extent of the deficits. 7,8 A...

Most existing research on early identification of learning difficulties has examined the validity of methods for predicting future academic problems. The present study focused instead on the sensitivity of kindergarten teachers to learning problems in their students and on the continuity of teacher-identified problems over time. To identify early learning problems, kindergarten teachers in a suburban school district rated student progress toward six academic objectives as satisfactory or unsatisfactory. Twenty percent of the district's 303 kindergarten children received unsatisfactory ratings in at least one area. Thirty-eight of these children (identified group) were matched to 34 children with satisfactory ratings in all areas (nonidentified group). Results of testing conducted during kindergarten revealed poorer academic achievement in identified children than in nonidentified children. Children from the identified group also performed more poorly than children from the nonidentified group on tests of phonological processing and working memory/executive function and were rated by teachers as having more behavior and attention problems and lower social competence. Follow-up of the sample to first grade documented continued learning problems in the identified group. These findings support the use of teacher judgements in early detection of learning problems and argue against reliance on discrepancy criteria.

This study investigated effects of prenatal cocaine exposure on infant sensorimotor development. One hundred and sixty-seven 12-month-olds (74 cocaine-exposed and 93 unexposed) were assessed using the Bayley Scales of Infant Development (BSID). Ninety-seven had previously been evaluated on the Movement Assessment of Infants and the Test of Sensory Functions in Infants at age 4 months. On the BSID, the cocaine-exposed infants performed less well on the Mental portion and were more frequently rated as behaviorally suspect. Cocaine-exposed infants also performed less well at four months on the motor and sensory measures. Early motor performance predicted 12 month BSID mental, motor and behavioral outcomes. Cocaine exposure had an effect independent from confounders on general cognitive and specific motor and behavioral outcomes.

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