Language Functioning in 5-Year-Old Children Exposed Prenatally to Cocaine

Abstract 1390 Poster Session III, Monday, 5/3 (poster 20)

The objective of this longitudinal study is to determine the long-term effects of in utero cocaine exposure on language development. Study participants were 476 full-term, inner-city, African-American infants, enrolled prospectively at birth and categorized into cocaine-exposed (COC) and comparison (COMP) groups. Cocaine exposure was defined by a combination of maternal report and/or positive urine or meconium toxicology assays. Of the 223 infants in the COMP group, 147 were determined to be drug-free by self-report/toxicology; the remainder were exposed to varying combinations of nicotine, alcohol, and marijuana with no cocaine exposure. The Clinical Evaluation of Language Fundamentals-Preschool (CELF-P) and Woodcock Johnson-Revised (WJ-R) Auditory Processing subtests were administered to children at approximately 5 years, 6 months of age. The groups did not differ in average test age. A total of 406 children were seen (86% of the total sample). Of these, six children were untestable due to extremely severe cognitive or behavioral deficits (COC=4 and POLY=2). These numbers were too small for statistical analysis but suggest a disproportionate number in the COC group. Maternal education was not significantly different among the groups. A general linear model analysis revealed significant differences on both the CELF-P and WJ-R Standard Scores (n=400) after adjusting for the effects of prenatal tobacco, alcohol, and marijuana exposure. Children with prenatal cocaine exposure exhibited lower mean language functioning on 3 of the 4 language measures. After controlling for the effects due to language stimulation as measured by the Caldwell HOME Scale, only the Auditory Processing scores remained significantly different. Findings indicate general expressive/total language skills were influenced by group differences in language stimulation at home. Prenatal cocaine exposure appears to have an adverse effect on auditory processing, a neuropsychological process, independent of the effects of other drugs or home environment. Adjusted means and standard errors are reported below: (Table)

Table 1 No caption available

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