ERIC ED330462: Prenatal Cocaine Exposure: The South Looks for Answers. A SACUS Special Report.

25 Pages·1991·1.4 MB·English

by  ERIC

DOCUMENT RESUME
ED 330 462
PS 019 505
AUTHOR
Shores, Elizabeth F.
TITLE
Prenatal Cocaine Exposure: The South Looks for
Answers. A SACUS Special Report.
INSTITUTION
Southern Association on Children Under Six, Little
Rock, Ark.
REPORT NO
ISBN-0-942388-03-8
PUB DATE
91
NOTE
25p.
AVAILABLE FROM
Southern Association on Children Under Six, P.O.
Box
5403, Little Rock, AR 72215-5403 ($6.00).
PUB TYPE
Guides - Non-Classroom Use (055)
EDRS PRICE
MF01 Plus Postage. PC Not Available from EDRS.
DESCRIPTORS
*Cocaine; *Drug Abuse; *Drug Addiction; Early
Childhood Education; Family Programs; Guidelines;
Individual Development; *Infants; Intervention;
*Mothers; Needs Assessment; Parent Responsibility;
Prevention; Program Development; School Role
IDENTIFIERS
*Fetal Drug Exposure
ABSTRACT
This special report provides answers to six
fundamental questions on prenatal cocaine
exposure: (1) What problems
do drug-exposed newborns have? (2) How
many of these children are
there? (3) How do we get pregnant women to avoid
drugs and alcohol?
(4) What should be done to help the families
of substance abusers?
(5) How do drug-exposed children develop? (6)
How should schools
assess and prepare for drug-exposed children? It is
concluded that
careful, developmentally appropriate assessment will
be crucial if
children with prenatal drug exposure are to receive
the best
services. Further, those services will not be
the same for every
child. Fetal cocaine exposure does not create
a uniform set of
delays. The problems it tends to cause can be greatly
exacerbated by
a poor home life. Evaluation is complicated by the
fact that behavior
problems and developmental delays which
seem to indicate prenatal
drug exposure could be the result of other factors,
such as divorce
or death in the family. Nevertheless, many Southerners
are hopeful
that drug-exposed children can succeed in regular
classrooms if
teachers get enough support and training. (RH)
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from the original document,
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U $ OEPARTMENT OF EOUCATION
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ment do not necessarily represent official
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Prenatal Cocaine Exposure
,t(
The South Looks for Answers
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A SACUS SPECIAL REPORT
vapl
"PERMISSION TO REPRODUCE THIS
MATERIAL
IN
MICROFICHE ONLY
HAS I3EF N GRANTED BY
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TO THE EDUCATIONAL RESOURCES
INFORMATION CENTER (ERIC)
2
BEST COPY AVAILABLE
...,
SSR 91-1
Copyright © 1991 by Southern Association on Children Under Six
All rights reserved. This publication may be used in whole or in part by any
person or organization, public or private, for the purpose of fostering public
discussion and debate on any issues contained herein, provided due credit is given
the author and the publisher. SACUS would appreciate notice of the use of this
report in order to assess its impact.
Published by the Southern Association on Children Under Six
P.O. Box 5403, Little Rock, AR, 72215-5403.
Library of Congress Cataloging in Publication Data
Shores, Elizabeth F.
Prenatal cocaine exposure: the south looks for answers
First Edition
Designed by Elizabeth F. Shores
Printed in the United States of America
ISBN 0-942388-03-8
1
CONTENTS
Introduction
PAGE 1
PAGE 4
What problems do drug-exposed newborns have?
Exaggerating the problem PAGE 4
PAGE 4
How many of these children are there?
Drug tests don't deter drug abuse
PAGE 6
PAGE 7
How do we get pregnant women to avoid drugs and alcohol?
Pinellas County, Florida is coordinating services
PAGE 8
PAGE 9
What should be done to help the families of substance-abusers?
"We can be encouraged": A look at Operation PAR in St. Petersburg, Florida
PAGE 10
"Meet Staysha" PAGE 13
PAGE 15
How do drug-exposed children develop?
Active learning, routines help drug-exposed kids
PAGE 16
PAGE
Resources
17
PAGE
How should schools assess and prepare for drug-exposed children?
17
PAGE
Conclusion
19
PAGE
Sources
20
PAGE 21
Acknowledgements and Credits
THE SOUTH LOOKS FOR ANSWERS
Teachers, school administrators and child
care providers a'.:roy, the South are worried about
the "wave of crack babies" they hear is rolling
toward preschool and elementary classrooms.
"We're trying to say to people,
'don't panic.'"
JOAN JORDAN
GEORGIA DEPARTMENT OF EDUCATION
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PHOTOGRAPHS EiY
STORY BY III1A131 111 F. SHORkS
COCINE- FNPo
PRIAA
71tS1 COPY AVAILABLE
3
tine. But cocaine seems "more addic-
tant themes emerge, including the need
In east Texas, for example,
tive". It is the drug they crave most.
for family support and parent training,
teachers have felt "kind of desperate
...
They turn to other drugs only when
the need for drug treatment programs
They thought, 'I'm losing my mind
they cannot get cocaine, according to
designed for women with children, and
because I can't deal with these chil-
Todd.
the danger of mislabeling drug-exposed
dren, and I've dealt with every kind of
Second, "crack" has acquired
children. Many experts stress that the
child in the world.' If we were sitting in
a reputation as a drug that damages
approaches which SACUS has always
no man's land in northeast Texas and
babies so severely that they will cause
developmentally appro-
advocated
we felt the need, (there must be) a lot of
severe disruption in classrooms and
priate classrooms, curricula, assessment
need," according to Patty Florey.
grow up to be a generation of social
are even more impor-
and evaluation
Florey is a ottlg education manager for
deviates. Keith Turner, a special educa-
tant for children who suffer various de-
the Region VIII Education Service
tion professor at the University of
velopmental delays and may live in ter-
Center.
Texas, says the media has reported only
rifying, chaotic homes. Finally, we
But is there really a "wave" of
half of the story.
found widespread need for intensive
drug-exposed children about to crush
"What's so exciting is there is
training to prepare classroom teachers
early childhood teachers and classes?
potential
Are these children's problems as clear
for chil-
for
dren with
as television, newspaper and magazine
interven-
reports imply? And if so, what must
prenatal
tion that's
"There is potential fr intervention that's not
substance
teachers and caregivers do?
not getting
abuse.
Physicians, social workers and
y the (lamas e" d on e
gettingtbesameheaci;
r
s
the same
early childhood specialists at North-
by matental cocaine abuse.
headlines
ICBM TURNER
Maternal
western University in Chicago, Illinois
UNIVERSITY OF TEXAS
as the
substance
and at the University of California at
damage"
abuse is
Los Angeles have led the way in study-
done by
not a new
ing the effects of prenatal cocaine ex-
maternal
problem.
posure. The Northwestern group, led by
cocaine abuse, Turner says.
Alcohol remains the most significant
pediatrician Ira J. Chasnoff, has done
Florida's Stone traces the
threat to children. Michael T. Stone is a
extensive studies of the effects on
problem of maternal substance abuse to
program consultant with the Juvenile
newborns and toddlers but has not re-
childhood itself. Girls who suffer
Welfare Board of Pinellas County,
leased a follow-up study of preschool-
physical and sexual abuse or neglect
Florida, which is developing some of
ers. The U.C.L.A. group has reported
may enter sexual relationships very
the South's most comprehensive serv-
one comparison study of 18 18-month-
early in life, in a desperate search for
ices to pregnant addicts and their chil-
olds with cocaine exposure.
affection and security. As poor, single
dren. He describes how Pinellas County
But as abuse of cocaine, and
mothers, they sink deeper into poverty,
policy has shifted "away from the issue
particularly its smokable derivative,
until drugs like alcohol and cocaine
of 'cocaine babies' and expanded (its
"crack", spread to the South, Southern-
seem to offer the only escape from
scope) to mammal substance abuse."
ers also took up the task of helping
wretched lives.
Yet a focus on maternal abuse
"crack babies". Around the region,
If Stone is right, then a re-
of cocaine still seems valuable for two
teachers, pediatricians, social workers
gional commitment to young children
reasons. First, it is not clear yet that
and teacher educators have been asking
and to the mental health, stability
cocaine's effects on babies and families
important questions about the problem
and financial security of their families
are just like those of other drugs. Mary
of prenatal substance abuse. SACUS
will be vital in preventing maternal
Todd, a medical social worker in Mem-
went to them to find out what they are
substance abuse.
phis, Tennessee concedes that the
learning about these children and what
pregnant women and mothers she tries
they are doing for them.
to help typically abuse various drugs,
Our report summarizes their
including alcohol, caffeine and nico-
questions and findings. Several impor-
THE SOUTH LOOKS FOR ANSWERS
4
delays in infants are also well docu-
Question: What problems do drug-
of the easily-recognized
mented.
Many
exposed newborns have?
problems which tiatse children suffer at
Answer: Many researchers have
birth seem to disappear in the first
reported premature births, low birth
months of life. But researchers warn
weights, reduced head circumference,
that cocaine's effects on fetuses' brains
awed,.
congenital defects and extreme
,
may cause permanent brain damage
(or this repast said the newitneOn
irritability among cocaine-exposed
tot
and behavior problems and learning
newborns.
disabilities later on (Schneider et al,
pie.* tOciine inpOitice:: The
35). The problems that cocaine-ex-
The problems that cocaine-
.101tiOsited
posed children exhibit will be described
exposed newborns exhibit have been
teleViiion end in neWn
in more detail later in this report.
widely-documented by medical re-
164 Iiii.51:41Pett:-.i.hliFeiAisilinierni
searchers. Although the babies com-
tenchot*arid school idintaiintitore.
Question: How many of these children
areraidds:with.
monly suffer from other prenatal disad-
are there?
vantages, including poor nutrition and
vid.fl:aisoOnt
Answer: Counting drug-exposed
'Oita the
abuse of various other drugs and
,
children is a difficult and perhaps
alcohol, cocaine has been isolated in
irrelevant undertaking. Urine tests can
some studies as the cause of significant
be unreliable and the isolated factor of
problems (Oro & Dixon, 571, 576).
prenatal substance abuse may not
Some studies have found that
news
predict developmental problems.
many of these children are born prema-
sheelit not isie all :all* igin4,tOr
.
Estimates vary. At Grady Hospital in
turely (Feig, 4), with low birth weights
e*eginiating the
...;
Atlanta, 30% of newborns in intensive
itinek:babieir:- Ifs group
(Zuckerman, 762, 766), and smaller
care have been exposed to alcohol or
head circumference (Bingol, 93).
Umverslty
learthers at
illicit drugs.
:..lettntO.(00tarloo 4040 is
Smaller head circumference can
indicate a smaller brain, which in turn
nt,441-litetittuO
Joan Jordan,E,d.D., director of
can lead to Sudden Infant Death
4::.elented toward aca.mtnteOt
ly
the Georgia Department of Education's
:
Syndrome (SIDS). One study found
.
Division for Exceptional Students,
They sr.04
that the rate of SIDS among cocaine-
explains that "we don't have clear data
exposed infants was 15%, while the
effeiti of
aiai óOcslne enpoeure
on how many kids there are. ... We're
lathintween 1985 and 1989:-.
rate among all babies is just .5%
trying to say to people, 'don't panic."
Sãcletyof ?WOW; Resest4
(Janke, 76).
to,
Around the South, hospitals
Cocaine-exposed newborns
/*possible plegeladen et a 1,41-
are attempting to measure the extent of
have also displayed auditory system
sk4eitifie *dins. Anteng,58 OAT':
maternal substance abuse, including
deficits (Shih et al. 251), malformations
cocaine abuse, through prevalence
of the genitals and urinary tract
studies. At the University of Arkansas
(Chasnoff. Chisum & Kaplan, 201),
for Medical Sciences in Little Rock, the
and congenital heart defects (Little,
obstetrics and gynecology department
160).
In*
in February. 1991 tested the urine of all
The most common adverse
women admitted in labor, looking for
outcomes involve the newborns'
w4g.
signs of drugs and alcohol. Because the
inability to cope with external stimuli,
4 it Britlikjour....
r
urine screens were anonymous. the
phenomenon usually called "poor state
Arkansas High Risk Pregnancy Project
control". Uncontrollable crying or ex-
did not have to tell patients about the
tremely deep sleep are two ways in
tests. The goal of the month-long
which these babies react to stimuli as
survey was to judge the need for
simple as their mothers' touch. Motor
PRENATAL COCAINE EXPOSURE
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THE SOI.;TII LOOKS FOR ANSWERS
r.:.,EST COPY AVAILABLE
6
clinical services and drug treatment for
pregnant womcn in Arkansas (Cindy
Drug tests don't deter drug abuse
Crone, personal communication, Feb.
15. 1991).
mother during the pregnancy. We
Georgia Rep, Ralph
ATLANTA
In Florida, where many social
wanted to get to the mother before she
David Abernathy III used to believe
services for pregnant addicts and their
gets pregnant," Abernathy said. His
maternal substance abuse was a
children have been established, sonic
shift in thiiiking may foreshadow
crime. But hc now thinks prevention
hard numbers are available. Between
policy around the region.
and intervention to help mothers and
July, 1987 and June, 1989, 5,370 drug-
Some states, including Flor-
children is a better approach.
exposed newhorns were identified and
ida and Oklahoma in the South, re-
Abernathy, son of the promi-
reported to a network of child abuse
quire hospitals to report to law en-
nent figure in the Southern civil tights
prevention services (Stone, 1990, 1).
forcement agencies any pregnant
movement, introducM a bill in an
ear-
The Texas Commission on
women found to be using il!ngal drugs
session of the Georgia legislature
lier
Alcohol and Drug Abuse recently sur-
(ACOG Newsletter, 11). But many
that imposed criminal sanctions on
veyed births to 1,600 women over a 10-
observers condemn such mandatory
women using illegal drugs while
day period in hospitals in Houston,
reporting as a deterrent to prenatal
pregnant. Pressure from women's
Dallas, San Antonio and El Paso, with
care. The Southern Regional Project
groups persuaded him to change his
findings to he released in March.
on Infant Mortality has called on
position. During the current session,
Regional Medical Center in
Southern states to bar "the use of
Abernathy has imrodueed a new bill
Memphis identified 570 drug-ahusing
pregnancy-related tests and care that
giving pregnant women priority in
pregnant women last year. About 93
reveals substance abuse as evidence
state-supported drug treatment
percent of them used cocaine. Two-
in criminal prosecutions". Some
programs.
thirds of the women admitted their drug
hospitals only perform anonymous
"If we are not going to incar-
use in interviews; the others were iden-
without even telling
urine assays
cereate these women, we should do
tified through urine tests. Another esti-
in order to
the pregnant women
something to rehabilitate them,"
mate is that 4,000 children have heen
avoid frightening them from getting
Abernathy said recently.
horn to cocaine-ahusing women in
care.
The legislator orgenized a
surrounding Shelby County over the
A philosophical disagree-
conference on prenatal drug exposure
past few yews.
ment underlies this policy dilemma. Is
last year. Nearly 2,000 persons at-
In Atlanta. a city that probably
the woman who uses illegal drugs
tended, developing various recom-
has one of the South's highest rates of
during pregnancy a criminal or a
mendations for preventing maternal
cocaine abuse, 833 children horn at
victim? Wendy Chavkin of the Co-
substance abuse.
Grady Hospital, a huge indigent care
lumbia University School of Public
"We didn't just deal with the
medical center, during 1989 were iden-
Health argues that "if psychoactive
tified as cocaine-exposed through urine
substance dependency is acknowl-
screens of the mothers or babies. Ilos-
edged to be a compulsive medical
pital officials reported that in the same
disorder, then it (is) logical that crimi-
year almost 30'4 of 'N.thies admitted to
nal sanctions alone cannot deter this
its neonatal intensive care unit are k-rn
behavior" (Chavkin, 485). And
to women using illicit substances or
Sharon L. Dooley of the American
alcohol. A total figure for 1990 is not
College of Obstetricians and Gyne-
available. but monthly reports sert:
cologists has said states should be
comparable to 1989 figures.
constructive rather than punitive as
Although th,: federal govern-
they plan services for drug-exposed
Men( has made some attempts to
children and their families (ACOG
RALPH DAVID ABERNATHY III
estimate the number of childrt.m v. ho
5/90).
Newsleuer,
natal cocaine exposure.
suffer pre
Expostio.
PRIAA
7
Question: How do we get pregnant
women to avoid drugs and alcohol.?
;
"r177:777,1-..t.
.
Answer: Residential drug ,reatment
*
imam,
programs may be the hest war to
;
rescue women and children _from
add-tton.
-
Most observers believe that
A
%
drug-dependent women and their chil-
'44
dren need years. rather than weeks or
-:-.144
months, of treatment and help in order
to function.
"We need to place these moth-
ers and then children in drug rehab
programs. They tend to he women who
already have one or two children and
started their lives as teenaged mothers.
They are now in their mid- to late-20s,-
Walter F. Lambert, a pediatrician and
medical director of" the University of
Miami Child Projection Team, argues.
With meaningful killow-up treatment
and counseling, the children and their
families can thrive, he says.
"Cocaine babies whom I
fol-
low. who are growing up with their
natural parents who are in the process
of recovering
(from
drug addiction)
...
these children at three and four years
old appear to me. a developmental pe-
diatrician. to he normal.-
Ideally. pregnant women re-
veal that they are abusing drugs to a
physician or clinic worker and immedi-
ately receive counseling and preventive
independent experts reject IL findings
90). NAPARE analyied data from hos-
services. In this way. the el fects of
as too l( )w (GAO. 6/90: Associated
pitals in Pinellas County, Florida, con-
drugs such as cocaine on their rouses
Press, 12/20/90). The U.S. National
are reduced. Bin in fact, few drug
cluding that the rates of cocaine abwc
Drug Control Strategy recently revtsed
among black and white women and
treatment programs make- room for
earlier estimates to speculate that 1.7
pregnant drug-abuser who come fcrth.
among middle-class and poot wonien
million Americans currently use
do not significantly differ (Chasnolt,
Drug treatmew programs ior
cocaine (Associated Press, 2/6/91).
pregnant women should include prena-
I .andress & Barrett, 1205). That 1989
Meanwhile, the National As-
tal care and parent training, so th,:re is
study discounted earlier assumptions
sociation for Perinatal Addiction Re-
some continuity of assistance to the
that piegnant cocaine addicts were
search and Education (NAPARE) esti-
found pi imarily i
women before and after they delivei
inner-city slums.
mates that 3750)0 cocaine-exposed
their babies. These women, with
children are horn each year (GAO, (i/
chronic medical and psvchosocial
Till'. SOUTH LOOKS FOR ANSWFRS
BEST COPY AVAILABLE