Drug abuse among women of child bearing age and has been on the rise, and its consequences for their children, their families and for society in general has become a major problem. This randomized controlled study will test the effectiveness of a comprehensive home and community based intervention for substance abusing mothers on maternal functioning, maternal infant interaction, patterns of drug use and infant developmental. In this collaborative project between the University of Maryland at Baltimore (UMAB) and """"""""Our Friends Place"""""""" (OFP), a Headstart affiliated, community parent support center, 240 substance abusing women will be recruited, over a 30 month period, from the prenatal clinics and obstetrical services of University of Maryland Medical Systems, and randomly assigned to either the study or control group. Families in the study group will receive an in home intervention during the first year by a Parent Advocate from OFP who will visit the mother weekly, and from 12 to 24 months mother & infant will participate 2 days a week at the center which offers a comprehensive enrichment program to both mother and child. The program includes counselling, educational services, parenting classes, job training, and a therapeutic nursery. Both study and control groups will receive primary pediatric care for their infants through special clinics of the department of Pediatrics. All women who enroll will be referred to the alcohol and drug abuse clinic at UMMS, for evaluation and treatment. To prevent attrition monthly tracking will be maintained by an outreach worker. To evaluate the effectiveness of the intervention both groups of mother/infant pairs will be assessed at 2 weeks, 6, 12, 18 and 24 months. Standardized assessment instruments will be used to obtain baseline and follow up data. Maternal outcomes measured will include parental self efficacy, self esteem, social supports and compliance and retention in drug treatment programs. Mother/infant outcomes assessed will include parenting skills, mother/infant interaction, reports to CPS for neglect and abuse and out of home placement. Child outcomes assessed will be growth and development, language development, cognitive development, neurodevelopment, and attachment. We hope that the outcome of this study will provide us with some insight into those elements that are most effective in combatting the negative consequences of drug abuse in women of child bearing age.
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