Published online July 2, 2007
PEDIATRICS Vol. 120 No. 1 July 2007, pp. e78-e85 (doi:10.1542/peds.2006-2563)
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ARTICLE

Prenatal Cocaine and Tobacco Effects on Children's Language Trajectories

Barbara A. Lewis, PhDa, H. Lester Kirchner, PhDa, Elizabeth J. Short, PhDb, Sonia Minnes, PhDc, Paul Weishampel, MAa, Sudtida Satayathum, MSa and Lynn T. Singer, PhDa,c

Departments of a Pediatrics
b Psychology
c General Medical Sciences, Case Western Reserve University, Cleveland, Ohio

OBJECTIVE. The objective of this study was to examine the effects of prenatal cocaine and polydrug exposure on language development of preschool children using a prospective longitudinal model, controlling for confounders.

METHODS. Children who were exposed to cocaine in utero (n = 209) and nonexposed children (n = 189) were followed prospectively at birth and at 1, 2, 4, and 6 years of age and were compared on receptive, expressive, and total language scores across time using random coefficient models, controlling for confounders.

RESULTS. A significant, stable effect of cocaine exposure on language development was observed over time for all language domains, with cocaine exposure related to poorer language performance. Cigarette exposure was related to lower receptive language scores. Environmental influences on language scores were also observed. Both the cocaine-exposed and nonexposed children declined in language performance over time.

CONCLUSIONS. Prenatal cocaine exposure has a stable negative effect on language skills during the first 6 years of life. Both cocaine-exposed and nonexposed children showed decreased language growth over time; however, cocaine-exposed children demonstrated linguistic deficits compared with nonexposed peers and did not catch up. Cigarette and environmental influences were also noted.

Key Words: cocaine • longitudinal language outcomes • home environment • gender • tobacco • teratology

Abbreviations: CE—cocaine exposed • NCE—non–cocaine exposed • BZE—benzoylecgonine • M-OH-BZE—meta-hydroxybenzoylecgonine • PPVT-R—Peabody Picture Vocabulary Test, Revised • WAIS-R—Wechsler Adult Intelligence Scale, Revised • HOME—Home Observation for Measurement of the Environment • SES—socioeconomic status

Accepted Dec 12, 2006.


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