Complex Developmental Issues of Prenatal Drug Exposure

The polydrug pattern of drug use by pregnant women, combined with the varying purity, dosage, and timing during pregnancy when drugs are taken, makes it very difficult to determine the developmental impact of any specific drug. Nevertheless, studies of drug-exposed newborns suggest an array of behavioral characteristics that make their care challenging, and a few studies indicate that some prenatally substance-exposed infants display developmental problems as toddlers and preschoolers in areas as diverse as language, attachment to primary caregivers, ability to organize behavior, and mental and motor development. Researchers agree, however, that prenatal exposure to drugs is only one, and probably not the most important, of many factors than can influence a child’s development. Postnatal environment is probably more important than prenatal drug exposure in determining outcomes in child development. Intensive intervention efforts are therefore needed now. Early childhood intervention strategies already developed for other vulnerable children can offer guidelines for working with drug-exposed children and their families. Specialized treatment programs, coupled with broad-based family support and parent education services, can ameliorate the negative effects of prenatal drug exposure. T he youngest casualties of the current drug epidemic in the United States are the thousands of infants born each year exposed prenatally to illegal drugs and alcohol. Although media attention has primarily focused on crack cocaine use by pregnant women, that examination ignores the thousands of pregnant women who use and abuse one or more other legal and illegal drugs. Unfortunately, the polydrug nature of most substance use makes it exceptionally difficult to determine the effects of any one drug on subsequent child development. Furthermore, the complexity of the situations in which many drug-using mothers live makes it hard to attribute their children’s developmental lags, when they are observed, to drugs, as opposed to other environmental conditions. In many ways, prenatally drug-exposed children look much like other children who live in similarly chaotic homes