A prospective, longitudinal research project, beginning in pregnancy and continuing until the children are 2 years, 9 months of age, will evaluate the efficacy of a continuum of clinical services reduce drug abuse in addicted women and improve the outcomes for their children by reducing the number of biological and environmental risk factors present in substance-abusing families. Of 2 recruited English-speaking, Medi-Cal-eligible, non-teenaged substance-abusing women, 90 will be randomly assigned to the experimental group receiving the continuum of intervention, and 110, comparable with respect to socioeconomic status, ethnicity, years of education, maternal age, parity and marital status, will be randomly assigned to the control group receiving referrals to exist community programs. The continuum of care provided to the intervention group will be extensive. (1) Each mother will have an assigned Primary Counselor who will nurture her in an ongoing relationship; provide assistance with housing, food, and legal problems; and act as liaison among the family, the Project, a any community agencies with which the family may be involved. Additionally, a comprehensive support service program, provided at the UCLA site, will include (2) prenatal care; (3) a minimum 18 months' drug treatment; (4) a support group to enhance self-esteem, relationships, and daily organization, as well as increase internal locus of control; (5) beginning at 4 months and continuing to 3 years of age, a center-based child development program serving the infants and mothers, provide parent education for the mothers. Through the child development program, staff will model behavior towards children and provide training in child care, as well as facilitate group discussion of observations, experiences, beliefs, and child-rearing attitudes. Transportation will be provide for all UCLA visits. The effectiveness of clinical services will be evaluated in terms of their influence both on the women and on their children.There will be 6 laboratory data collection periods (prenatal, neonatal and 6, 15, 24, and 33 months),and 3 home observations (at 3, 12, and 30 months). The women's drug use, stability of lifestyle, and attitudes pre- and post-intervention will be assessed by urine toxicology screens and standardized measures of their locus of control, social supports, and quality of relationships. The mothers' relationships with their children will be measured through home observations and by the quality of the children's attachment to them. Since previous research has indicated deficits in play and language skills, the children will be assessed not only as to perinatal status, physical health, and developmental status, but at ages 2 and 3 to quality of play and language acquisition.
| Swanson, K; Beckwith, L; Howard, J (2000) Intrusive caregiving and quality of attachment in prenatally drug-exposed toddlers and their primary caregivers. Attach Hum Dev 2:130-48 |
| Beckwith, L; Howard, J; Espinosa, M et al. (1999) Psychopathology, mother-child interaction, and infant development: substance-abusing mothers and their offspring. Dev Psychopathol 11:715-25 |
| Fineman, N R; Beckwith, L; Howard, J et al. (1997) Maternal ego development and mother-infant interaction in drug-abusing women. J Subst Abuse Treat 14:307-17 |
| Tyler, R; Howard, J; Espinosa, M et al. (1997) Placement with substance-abusing mothers vs. placement with other relatives: infant outcomes. Child Abuse Negl 21:337-49 |
| Beckwith, L (1996) Measurement of the early rearing environment: caregiver-child interaction. NIDA Res Monogr 166:205-24 |
