Language Outcomes at 12 Years for Children Exposed Prenatally to Cocaine
Publication: Journal of Speech, Language, and Hearing Research
Volume 56, Number 5
Pages 1662-1676
Abstract
Purpose
In this study, the authors aimed to examine the long-term effects of prenatal cocaine exposure (PCE) on the language development of 12-year-old children using a prospective design, controlling for confounding prenatal drug exposure and environmental factors.
Method
Children who were exposed to cocaine in utero (PCE; n = 183) and children who were not exposed to cocaine (i.e., no cocaine exposure [NCE]; n = 181) were followed prospectively from birth to 12 years of age and were compared on language subtests of the Test of Language Development—Intermediate, Third Edition (Hammill & Newcomer, 1997b), and phonological processing as measured by the Comprehensive Test of Phonological Processing (Wagner & Torgesen, 1999). The authors evaluated the relationship of PCE to language development through a multivariate analysis of covariance and regression analyses while controlling for confounders.
Results
Results show that PCE has small effects on specific aspects of language, including syntax and phonological processing. The caregiver variables of lower maternal vocabulary, more psychological symptoms, and a poorer home environment also had consistent effects on language and phonological processing scores.
Conclusions
These findings suggest that PCE continues to have small, subtle effects on specific aspects of language at age 12 years. Phonological processing skills were significantly related to the reading outcomes of letter–word identification, reading fluency, and reading comprehension, indicating that PCE also has small but lasting effects on the language skills that are related to later literacy skills.
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References
Ackerman, J. P., Riggins, T., & Black, M. M. (2010). A review of the effects of prenatal cocaine exposure among school-aged children. Pediatrics, 125, 554–565.
Anday, E. K., Cohen, M. E., Kelley, N. E., & Leitner, D. S. (1989). Effect of in utero cocaine exposure on startle and its modification. Developmental Pharmacology and Therapeutics, 12, 137–145.
Angelilli, M., Fischer, H., Delaney-Black, V., Rubinstein, M., Ager, J. W., & Sokol, R. J. (1994). History of in utero cocaine exposure in language-delayed children. Clinical Pediatrics, 33, 514–516.
Avants, B. B., Hurt, H., Giannetta, J. M., Epstein, C. L., Shera, D. M., Rao, H., & Gee, J. C. (2007). Effects of heavy in utero cocaine exposure on adolescent caudate morphology. Pediatric Neuorology, 37, 275–279.
Bandstra, E. S., Morrow, C. E., Accornero, V. H., Mansoor, E., Xue, L., & Anthony, J. C. (2011). Estimated effects of in utero cocaine exposure on language development through early adolescence. Neurotoxicology and Teratology, 33, 25–35.
Beeghly, M., Martin, B., Rose-Jacobs, R., Cabral, H., Heeren, T., Augustyn, M., & Frank, D. A. (2006). Prenatal cocaine exposure and children's language functioning at 6 and 9.5 years: Moderating effects of child age, birthweight and gender. Journal of Pediatric Psychology, 31, 98–115.
Bender, S. L., Word, C. O., DiClemente, R. J., Crittenden, M. R., Persaud, N. A., & Ponton, L. E. (1995). The developmental implications of prenatal and/or postnatal crack cocaine exposure in preschool children: A preliminary report. Journal of Developmental and Behavioral Pediatrics, 16, 418–424.
Betancourt, L. A., Yang, W., Brodsky, N. L., Gallagher, P. R., Malmud, E. K., Giannetta, J. M., & Hurt, H. (2011). Adolescents with and without gestational cocaine exposure: Longitudinal analysis of inhibitory control, memory, and receptive language. Neurotoxicology and Teratology, 33, 36–46.
Bland-Stewart, L. M., Seymour, H. N., Beeghly, M., & Frank, D. A. (1998). Semantic development of African-American children prenatally exposed to cocaine. Seminars in Speech and Language Disorders, 19, 167–187.
Caldwell, B., & Bradley, R. (1984). Home Observation for Measurement of the Environment (Revised ed.). Little Rock: University of Arkansas Press.
Catts, H. W., Fey, M. E., Zhang, X., & Tomblin, J. B. (1999). Language basis of reading and reading disabilities: Evidence from a longitudinal investigation. Scientific Studies of Reading, 3, 331–362.
Cone-Wesson, B. (2005). Prenatal alcohol and cocaine exposure: Influences on cognition, speech, language, and hearing. Journal of Communication Disorders, 38, 279–302.
Delaney-Black, V., Chiodo, L. M., Hannigan, J. H., Greenwald, M. K., Janisse, J., Patterson, G., & Sokol, R. J. (2011). Prenatal and postnatal cocaine exposure predict teen cocaine use. Neurotoxicology and Teratology, 33, 110–119.
Delaney-Black, V., Covinton, C., Templin, T., Kershaw, T., Nordstrom-Klee, B., Ager, J., & Sokol, R. J. (2000). Expressive language development of children exposed to cocaine prenatally: Literature review and report of a prospective cohort study. Journal of Communication Disorders, 33, 463–481.
Derogatis, L. (1992). The Brief Symptom Inventory: Administration, scoring, and procedures manual—II. Baltimore, MD: Clinical Psychometric Research.
Dow-Edwards, D. L., Benveniste, H., Behnke, M., Bandstra, E. S., Singer, L. T., Hurd, Y. L., & Stanford, L. R. (2006). Neuroimaging of prenatal drug exposure. Neurotoxicology and Teratology, 28, 386–402.
Dunn, L. M., & Dunn, D. M. (1997). Peabody Picture Vocabulary Test—III. Circle Pines, MN: AGS.
Espy, K. A., Kaufmann, P. M., & Glisky, M. L. (1999). Neuropsychologic function in toddlers exposed to cocaine in utero: A preliminary study. Developmental Neuropsychology, 15, 447–460.
Hammill, D. D., & Newcomer, P. L. (1997a). Examiner's manual: Test of Language Development—Intermediate (Third Edition). Austin, TX: Pro-Ed.
Hammill, D. D., & Newcomer, P. L. (1997b). Test of Language Development—Intermediate, Third Edition. Austin, TX: Pro-Ed.
Harvey, J. A. (2004). Cocaine effects on the developing brain: Current status. Neuroscience Biobehavioral Review, 27, 751–764.
Hawley, L. T., Halle, T. G., Drasin, R. E., & Thomas, N. G. (1995). Children of addicted mothers: Effects of the ‘crack epidemic’ on the caregiving environment and the development of preschoolers. American Journal of Orthopsychiatry, 65, 364–379.
Hayward, D. V., Stewart, G. E., Phillips, L. M., Norris, S. P., & Lovell, M. A. (2008). Language, phonological, and reading test directory. Edmonton, Alberta: Canadian Centre for Research on Literacy & Canadian Language and Literacy NetworkRetrieved from www.ualberta.ca
Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, § 110 Stat. 19361996.
Hobel, C. J., Hyvarinen, M. A., Okada, D. M., & Oh, W. (1973). Prenatal and intrapartum high-risk screening, I: Prediction of the high-rish neonate. American Journal of Obstetrics and Gynecology, 117, 1–9.
Hoffman, L. M., Loeb, D. F., Brandel, J., & Gillam, R. B. (2011). Concurrent and construct validity of oral language measures with school-age children with specific language impairment. Journal of Speech, Language, and Hearing Research, 53, 1597–1608.
Hollingshead, A. B. (1975). Four factor index of social status. Unpublished manuscript. Department of Social Work, Yale University, New Haven, CT
Hurt, H., Malmud, L., Betancourt, N. L., Brodsky, N. L., & Giannetta, J. A. (1997). A prospective evaluation of early language development in children with in utero cocaine exposure in control subjects. Journal of Pediatrics, 130, 310–312.
Jacobson, J. L., & Jacobson, S. W. (1995). Strategies for detecting the effects of prenatal drug exposure: Lessons from research on alcohol. InLewis, M., & Bendersky, M. (Eds.), Mothers, babies, and cocaine: The role of toxins in development (pp. 111–128). Hillsdale, NJ: Erlbaum.
Johnson, J. M., Seikel, A., & Madison, C. L. (1997). Standardized test performance of children with a history of prenatal drug exposure to multiple drugs/cocaine. Journal of Communication Disorders, 31, 231–244.
Kilbride, H. W., Castor, C. A., & Fuger, K. L. (2006). School-age outcome of children with prenatal cocaine exposure following early case management. Developmental and Behavioral Pediatrics, 27, 181–187.
Landi, N., Crowley, M. J., Wu, J., Bailey, C. A., & Mayes, L. C. (2011). Deviant ERP response to spoken non-words among adolescents exposed to cocaine in utero. Brain and Language. Advance online publication. doi:10.1016/j.bandl.2011.09.002
Lester, B. M., & Lagasse, L. L. (2010). Children of addicted women. Journal of Addictive Diseases, 29, 259–276.
Lester, B. M., LaGasse, L. L., & Seifer, R. (1998, October 23). Cocaine exposed children: The meaning of subtle effects. Science, 282, 633–634.
Lewis, B. A., Kirchner, H. L., Short, E. J., Minnes, S., Weishampel, P., Satayathum, S., & Singer, L. T. (2007). Prenatal cocaine and tobacco effects on children's language trajectories. Pediatrics, 120, e78–e85.
Lewis, B. A., Minnes, S., Short, E. J., Weishampel, P., Satayathum, S., Min, M. O., & Singer, L. T. (2011). The effects of prenatal cocaine exposure on language at 10 years of age. Neurotoxicology and Teratology, 33, 17–24.
Lewis, B. A., O'Donnell, B., Freebairn, L., & Taylor, H. G. (1998). Spoken language and written expression: Interplay of delays. American Journal of Speech-Language Pathology, 7, 66–73.
Lewis, B. A., Singer, L. T., Short, E. J., Minnes, S., Arendt, R., Weishampel, P., & Min, M. O. (2004). Four-year language outcomes of children exposed to cocaine in utero. Neurotoxicology and Teratology, 26, 617–627.
Lombardino, L. J., Riccio, C. A., Hynd, G. W., & Pinheiro, P. B. (1997). Linguistic deficits in children with reading disabilities. American Journal of Speech-Language Pathology, 6, 71–78.
Madison, C. L., Johnson, J. L., Seikel, J. A., Arnold, M., & Schultheis, L. (1998). Comparative study of the phonology of preschool children prenatally exposed to cocaine and multiple drugs and nonexposed children. Journal of Communication Disorders, 31, 231–243.
Malakoff, M. E., Mayes, L. C., Schottenfeld, R. S., & Howell, S. (1999). Language production in 24-month-old inner-city children of cocaine-and-other-drug-using mothers. Journal of Applied Developmental Psychology, 20, 159–180.
Mansoor, E., Morrow, C. E., Accornero, V. H., Xue, L., Johnson, A. L., Anthony, J. C., & Bandstra, E. S. (2012). Longitudinal effects of prenatal cocaine use on mother-child interactions at 3 and 5 years. Journal of Developmental and Behavioral Pediatrics, 33, 32–41.
Mentis, M., & Lundgren, K. (1995). Effects of prenatal exposure to cocaine and associated risk factors on language development. Journal of Speech and Hearing Research, 38, 1303–1318.
Minnes, S., Singer, L. T., Arendt, R., Farkas, K., & Kirchner, H. L. (2005). Effects of cocaine/poly drug use on maternal-infant feeding interaction over the first year of life. Journal of Developmental and Behavioral Pediatrics, 26, 194–200.
Morrow, C. E., Bandstra, E. S., Anthony, J. C., Ofir, A. Y., Xue, L., & Reyes, M. B. (2003). Influence of prenatal cocaine exposure on early language development: Longitudinal findings from four months to three years of age. Developmental and Behavioral Pediatrics, 24, 39–50.
Morrow, C. E., Vogel, A. L., Anthony, J. C., Ofir, A. Y., Dausa, A. T., & Bandstra, E. S. (2004). Expressive and receptive language functioning in preschool children with prenatal cocaine exposure. Journal of Pediatric Psychology, 29, 543–554.
Nathan, L., Stackhouse, J., Goulandris, N., & Snowling, M. J. (2004). The development of early literacy skills among children with speech difficulties: A test of the “critical age” hypothesis. Journal of Speech, Language, and Hearing Research, 47, 337–361.
Nelson, N. W., & Van Meter, A. (2007). Measuring written language abilities in narrative samples. Reading and Writing Quarterly, 23, 287–309.
Nulman, J., Rovet, D., Altmann, G., Bradley, G., Einarson, G., & Koren, G. (1994). Neurodevelopment of adopted children exposed in utero to cocaine. Canadian Medical Association Journal, 15, 1591–1597.
Potter, S. M., Zelazo, P. R., Stack, D. M., & Papageorgiou, A. N. (2000). Adverse effects of fetal cocaine exposure on neonatal auditory information processing. Pediatrics, 105, e40.
Pulsifer, M. B., Butz, A. M., Foran, M. O., & Belcher, H. M. E. (2008). Prenatal drug exposure: Effects on cognitive functioning at 5 years of age. Clinical Pediatrics, 47, 58–65.
Scarborough, H. (2005). Developmental relationships between language and reading: Reconciling a beautiful hypothesis with some ugly facts. InCatts, H. W., & Kamhi, A. G. (Eds.), The connections between language and reading disabilities (pp. 3–24). Mahwah, NJ: Erlbaum.
Scott, C. M., & Nelson, N. W. (2009). Sentence combining: Assessment and intervention applications. Perspectives on Language Learning and Education, 16, 14–20.
Scott, C. M., & Stokes, S. L. (1995). Measures of syntax in school-age children and adolescents. Language, Speech, and Hearing Services in Schools, 26, 309–319.
Semel, E., Wiig, E. H., & Secord, W. A. (1995). Clinical Evaluation of Language Fundamentals—Third Edition. Austin, TX: Psychological Corp.
Siefer, R., LaGasse, L. L., Lester, B., Bauer, C. R., Shankaran, S., Bada, H. S., & Liu, J. (2004). Attachment status in children prenatally exposed to cocaine and other substances. Child Development, 75, 850–868.
Singer, L. T., Arendt, R., Minnes, S., Salvator, A., Siegel, C., & Lewis, B. A. (2001). Developing language skills of cocaine-exposed infants. Pediatrics, 107, 1057–1064.
Singer, L. T., Minnes, S., Short, E., Arendt, R., Farkas, K., Lewis, B., & Kirchner, H. L. (2004). Cognitive outcomes of preschool children with prenatal cocaine exposure. JAMA, 291, 2448–2456.
Singer, L. T., Nelson, S., Short, E., Min, M. O., Lewis, B., Russ, S., & Minnes, S. (2008). Prenatal cocaine exposure: Drug and environmental effects at 9 years. Journal of Pediatrics, 153, 105–111.
Tan-Laxa, M. A., Sison-Switala, C., Rintelman, W., & Ostrea, E. M. (2004). Abnormal auditory brainstem response among infants with prenatal cocaine exposure. Pediatrics, 113, 357–360.
Trigueiros-Cunha, N., Leão, P., Renard, N., Tavares, M. A., & Eybalin, M. (2006). Prenatal cocaine exposure accelerates morphological changes and transient expression of tyrosine hydroxylase in the cochlea of developing rats. Brain Research, 1086, 55–64.
Uhlhorn, D. S., Messinger, D. S., & Bauer, C. R. (2005). Cocaine exposure and mother-toddler play. Infant Behavior and Development, 28, 62–73.
Wagner, R., & Torgesen, J. (1999). Comprehensive Test of Phonological Processing. San Antonio, TX: Pro-Ed.
Wechsler, D. (1989). Wechsler Adult Intelligence Scale—Revised. San Antonio, TX: The Psychological Corporation.
Woodcock, R. W., McGraw, K. S., & Mather, N. (2001). Woodcock–Johnson—III. Itasca, IL: Riverside.
Zimmerman, I. L., Steiner, V. G., & Pond, R. E. (1992). Preschool Language Scale—3. San Antonio, TX: The Psychological Corporation.
Information & Authors
Information
Published In
Journal of Speech, Language, and Hearing Research
Volume 56 • Number 5 • October 2013
Pages: 1662-1676
PubMed: 24149136
Copyright
Copyright © 2013 American Speech-Language-Hearing Association.
History
- Received: Apr 12, 2012
- Revised: Aug 20, 2012
- Accepted: Jan 16, 2013
- Published in issue: Oct 1, 2013
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