Ongoing Maternal Drug Use, Parenting Attitudes, and a Home Intervention: Effects on Mother-Child Interaction at 18 Months

Abstract

This prospective study examined the effects of ongoing maternal drug use, parenting attitudes, and a home-based intervention on mother-child interaction among drug-using women and their children. At 2 weeks postpartum, mothers and infants were randomly assigned to either an Intervention (n = 67) or Control (n = 64) Group. Intervention families received weekly visits until 6 months postpartum and biweekly visits from 6 to 18 months by trained lay visitors. The home intervention was designed to increase maternal empowerment and promote child development. Control families received brief monthly tracking visits. Mother-child interaction was evaluated at 18 months through observation of play. Mothers who continued to use cocaine and/or heroin had lower competence scores (p < .05); poor parenting attitude was also associated with lower competence scores during mother-child interaction (p < .05). Although the intervention had no measured effect, ongoing maternal drug use and poor parenting attitudes were associated with less optimal maternal behavior during mother-child interaction.The focus of much of the research on drug-using mothers and their infants has been on the short-and long-term effects of prenatal drug exposure. However, recent research 1 indicates that developmental and behavioral outcomes once thought to be specific to prenatal cocaine exposure are actually associated with other factors, such as the quality of the child's environment. Drug-exposed children raised in homes with ongoing parental drug use are more likely to display problems in cognitive development than drug-exposed children raised in drug-free environments. 2,3 Women who continue to use drugs after the infants are born are often unable to provide a stable, consistent, nurturing environment for their children. [4][5][6] Maternal drug use is associated with higher parenting stress 7 and poorer parenting attitudes, 8,9 and poor parenting attitudes such as a belief in harsh discipline were associated with less optimal maternal behavior during a parent-child observation session. 10 Factors such as ongoing maternal drug use and poor parenting attitudes may be associated with less optimal maternal and child behavior during mother-child interaction among substanceabusing mothers and their drug-exposed children.Home-intervention programs have often been used with drug-using women and their children. Using community health nurses, one home-based program provided health education and a child-development curriculum over the first 12 months postpartum. 11 Although the number of home visits varied by family, the intervention led to better motherinfant interaction at 3 months postpartum. Another home-based program using community nurses provided a child-development curriculum and maternal support during biweekly home visits (mean number of visits = 12) over the first 18 months postpartum. 12 Infants in the Intervention Group had higher cognitive scores and a more stimulating and responsive Copyright © 2002 home environment in comparison with Con...

Relational Psychotherapy Mothers' Group: A randomized clinical trial for substance abusing mothers

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