Although widespread use of cocaine by women of child bearing age appears to have stabilized, it remains an intractable problem in some poor, urban populations. One of the major concerns raised by the continued presence of cocaine is the harm fetal cocaine exposure may have on long-term development. Moreover, maternal use of cocaine is associated with numerous environmental risk conditions and altered care giving behavior that can also negatively affect child outcomes. The proposed study aims to assess both fine and gross motor functioning in cocaine exposed, primary school-age children. The proposed study is a continuation of a prospective, longitudinal study of 223 children (99 cocaine exposed, 124 unexposed) recruited from a low income, urban, largely minority population. Of the original cohort, 178 are available for participation. Previous results from assessments in infancy and the preschool period of this sample found significant developmental delays in sensory motor development at 4,12, and 24 months in a cocaine-exposed group, when compared with an unexposed group. We plan to extend the age range of the follow-up to assess neurobehavioral and motor development, behavioral functioning at home and in school, and the potential influences of the care giving environment in drug-exposed and unexposed children at ages 7 and 9 years. The groups will be compared to norms for standardized tests and to each other. Standardized questionnaires assessing maternal psychological status, social supports, quality of care giving and intellectual ability will be administered. Environmental risk, including out of home placement and continued drug use by the caregiver, and characteristics of the home environmental risk, including out of home placement and continued drug use by the caregiver, and characteristics of the home environment will be documented. Data will be evaluated through a series of MANOVAS/MANCOVAS and hierarchical regressions to describe the motor functioning of cocaine-exposed children at early school ages and the impact of prenatal exposure to cocaine and to other drugs on motor, neuromotor, behavioral, and somatic outcomes and to determine the relative influence of caregiver and environmental variables on development and performance in the early school years. Data sets from the prior assessments will be merged with the 7 and 9 year data to assess change over time and predictive models of infant risk. Data obtained can be used to guide programs for cocaine exposed infants and children who require intervention services.
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