The objective of this competing renewal is to delineate the effects of in utero cocaine exposure on integrated neuropsychological, behavior/emotional and academic functioning during the preschool and school-aged-years in a 90% retained cohort of 476 African American children enrolled prospectively at birth. A burgeoning literature has proved inconsistent in characterizing specific impairments related to prenatal cocaine exposure. Our own studies of cocaine exposed infants in the first two years of life have identified only transient findings of questionable clinical significance. Converging research in neuropsychology, however, strongly suggests that prenatal and early childhood neurological insults may only become evident as the brain matures functionally. This position has been particularly well articulated for frontal lobe development, an area potentially influenced by cocaine exposure during neuronal differentiation. Accordingly, it is hypothesized that cocaine exposed children will exhibit functional neurobehavioral deficits that emerge with development in the following domains: fine and gross motor function, language development, learning, memory, and aspects of frontal lobe function including affective/behavioral regulation, attentional prosessing, and emerging executive functions. In addition, it is postulated that prenatal cocaine exposure will increase risk for poorer outcome on global outcomes such as academic achievement and emotional/behavioral adjustment. The potential interactive role of continual exposure to a substance abusing parent is also recognized, and prenatally exposed children reared in such environments are hypothesized to exhibit poorer outcomes than other prenatally exposed and unexposed children reared in healthier environments. Family mechanisms hypothesized to characterize substance abusing families include impaired parenting, dysfunctional family interactions, and increased exposure to domestic and community violence. We will employ a longitudinal research design with an emphasis on comprehensive assessment of the child, mother/caregiver, and family to investigate these hypotheses. At yearly intervals, the neurobehavioral domains previously noted will be thoroughly assessed, with an emphasis on evaluating neuropsychological processing over time. On two separate occasions family interactions will also be formally observed in relationship to the variables of interest. Maternal/caregiver substance abuse will be characterized through yearly interviews and the use of hair analysis as a biologic marker. Additional confounding variables such as chronic medical illnesses, anemia, lead exposure, and maternal polydrug use will be considered in all analyses. The effects of pre- and postnatal cocaine exposure remain a significant public policy concern as many of these children reach school age, yet well controlled studies are lacking. The present proposed study benefits from the methodological strengths of our initial prospective design, and is in the unique position to begin characterizing the direct and indirect neurobehavioral effects of cocaine exposure in conjunction with other risk factors, as well as the transactional effects of chronic maternal/caregiver substance abuse and family dysfunction on the developing child.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (SRCD (31))
Program Officer
Borek, Nicolette T
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Miami School of Medicine
Schools of Medicine
United States
Zip Code
Messiah, Sarah E; Ludwig, David A; Vidot, Denise C et al. (2015) Prenatal Cocaine Exposure and Cardiometabolic Disease Risk Factors in 18- to 20-Year-Old African Americans. Ethn Dis 25:419-26
Mansoor, Elana; Morrow, Connie E; Accornero, Veronica H et al. (2012) Longitudinal effects of prenatal cocaine use on mother-child interactions at ages 3 and 5 years. J Dev Behav Pediatr 33:32-41
Bandstra, Emmalee S; Morrow, Connie E; Accornero, Veronica H et al. (2011) Estimated effects of in utero cocaine exposure on language development through early adolescence. Neurotoxicol Teratol 33:25-35
Accornero, Veronica H; Anthony, James C; Morrow, Connie E et al. (2011) Estimated effect of prenatal cocaine exposure on examiner-rated behavior at age 7 years. Neurotoxicol Teratol 33:370-8
Bandstra, Emmalee S; Morrow, Connie E; Mansoor, Elana et al. (2010) Prenatal drug exposure: infant and toddler outcomes. J Addict Dis 29:245-58
Morrow, Connie E; Xue, Lihua; Manjunath, Sudha et al. (2009) Estimated Risk of Developing Selected DSM-IV Disorders Among 5-Year-Old Children with Prenatal Cocaine Exposure. J Child Fam Stud 18:356-364
Accornero, Veronica H; Amado, Alfred J; Morrow, Connie E et al. (2007) Impact of prenatal cocaine exposure on attention and response inhibition as assessed by continuous performance tests. J Dev Behav Pediatr 28:195-205
Morrow, Connie E; Culbertson, Jan L; Accornero, Veronica H et al. (2006) Learning disabilities and intellectual functioning in school-aged children with prenatal cocaine exposure. Dev Neuropsychol 30:905-31
Accornero, Veronica H; Anthony, James C; Morrow, Connie E et al. (2006) Prenatal cocaine exposure: an examination of childhood externalizing and internalizing behavior problems at age 7 years. Epidemiol Psichiatr Soc 15:20-9
Morrow, Connie E; Vogel, April L; Anthony, James C et al. (2004) Expressive and receptive language functioning in preschool children with prenatal cocaine exposure. J Pediatr Psychol 29:543-54

Showing the most recent 10 out of 24 publications