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An Open Letter
from Mary McEvoy, Susan
Hupp, and Scott McConnell
There is a growing concern among educators and other
professionals about the developmental outcomes of young children
exposed prenatally to drugs or alcohol. In fact, the Government
Accounting Office in their report, Drug-Exposed Infants: A
Generation at Risk, states that this population is growing
rapidly and at extraordinarily high risk for poor physical,
behavioral, or developmental outcomes. This problem has been
given much attention in the popular press as well as professional
and empirical publications, and questions about the design and
evaluation of services for children exposed prenatally to drugs
or alcohol and their families are of pressing importance.
Existing evidence of developmental outcomes for children
exposed to drugs appear to indicate that drug exposure in and of
itself may not be the only cause for concern (see Rinkel article,
this issue).
In fact, it appears that the interaction of prenatal drug or
alcohol exposure and other factors including poverty, abuse, and
neglect may place children at greatest risk for developmental
delays. Given the multiple risk factors, it is important to note
that there is no one profile of a child exposed prenatally to
cocaine or alcohol. Thus, early intervention programs must design
and implement programs for these children based on their
individual needs, and not on the fact that they were exposed
prenatally to drugs or alcohol. In addition, Haydens article
notes that we must make sure our service and research programs
are culturally sensitive and non-biased.
While it is not clear just what the exact components of a
model education program for children exposed to drugs or alcohol
should be, we believe that an essential component is the
inclusion of the family in the design and implementation of
individualized plans. In this issue of Early Report, articles by
Smith and Faison-Smith & Hupp provide information about what
concerns mothers and fathers have. Parent involvement is
particularly critical with this population because they most
often have contact with a number of different social and medical
services including pediatricians, social workers, public health
officials, early childhood special educators, etc. Given such
multi-agency involvement, we believe programs for children
exposed to drugs or alcohol will not be successful unless they
include family services as a critical and significant part of a
child's service plan.
It is our hope that this issue of Early Report encourages
service providers, researchers, and parents to continue to look
for effective ways to positively impact the lives of children who
have been exposed prenatally to drugs and alcohol. We must
continue to work together to meet the challenge of issues
surrounding substance exposure.
Cultural Sensitivity in
Research
by Joyce Hayden
Cultural sensitivity in research is an issue that must be kept
in mind from the time a research idea is conceived right through
the dissemination of the findings. Without this sensitivity, the
likelihood of cultural, racial, and economic bias in research
will dramatically increase.
In working with the Early Childhood Research Institute (ECRI),
I have found that convincing individuals, agencies, or
communities to be part of our study has been a monumental task.
People have problems with the idea of being research subjects.
Also, they are concerned about not having a voice in how the
information is collected, what instruments are used, and what is
said once the results are ready to disseminate.
Many of these concerns are valid. For example, some
instruments used to collect data are outdated and don't take
cultural differences into consideration. It is inappropriate to
study the behavior of people without taking into account such
things as how each culture influences and teaches their children,
the language used in the home, the family patterns that are part
of the cultural heritage, etc. However, what often happens is
that instruments have been designed and normed by the majority
culture and are then used to measure various minority groups. If
we are to have good data from which sound conclusions can be
drawn, we must devise innovative instruments that are culturally
sensitive.
It is also important to be sure that social and economic
status is considered as subjects are recruited and included in a
study. For instance, in studying the effects of prenatal exposure
to cocaine on children, ECRI is making a special effort to
include women who have some economic advantages and can afford
private hospitals, private physicians, and private treatment.
Without these women, our research would not be complete.
At ECRI, we try to involve our subjects in the bigger picture
of our research. We ask their opinions on each phase of the
projects. To be aware of what is pertinent to our research, we
must hear what is important to our subjects.
Joyce Hayden is the Community Liaison for ECRI.
About Fathers
by Charles L. Smith, Jr.
The Prenatal Exposure to Drugs (PED) Program recently made a
commitment to expand its primary focus on young children and
mothers to include consideration of the role of fathers in the
family. Because none of the fathers of the children in the
program serves as the primary parent, our goal was to discover
the factors keeping these fathers from their significant others.
We wanted to explore such factors as drugs, unemployment, lack of
education, the system, or a lack of motivation and
responsibility.
To learn about the fathers in the PED Program, I interviewed
seven men, asking questions about their perspectives of their
role as "father." All seven were chemically dependent;
each had come to a point when he had to go through drug
treatment. They were from dysfunctional families, some did drugs
with family members, and most of the men had been incarcerated
for one reason or another. Many never had their fathers in the
home-their mothers had total responsibility.
The interview questions were very difficult for these young
men to answer. Having no role models and few parenting skills,
many were in situations where the child's mother had total
responsibility. The men wanted to change that, but they had no
idea how to do it.
- When asked what they know about young children,
participants felt they didn't know much about parenting,
but felt children needed love. They all said that
children learn from what they see. They were concerned
about their children's environment, but when drugs were
their primary concern, their children's safety,
well-being, and environment lost importance.
- Regarding who should be responsible for protecting and
nurturing their children, each said both parents have
responsibility.
- They saw the major role of parents as nurturing,
protecting, and making things better. One father
responded, "Being there." When I asked why they
weren't there, they said drugs made them do it. Many are
currently going to parenting classes.
- They all want to accept the responsibility of being a
father and be the provider, protector, and teacher. At
the time of the mothers pregnancies, many used drug
dealing as a means to provide a lifestyle without
considering consequences. They claimed they gave love,
but none of them accepted the responsibility of building
a solid foundation by changing his lifestyle. None of
these fathers are currently married.
- When asked who assumes responsibility for nurturing,
protecting, and guiding, those still with the mother said
both did. Those not with the mothers said they both
should be but agreed the mother actually has total
responsibility. For most, these responses have been
learned recently in parenting classes, during which joint
responsibility is discussed.
- When comparing the family structure when they were
children to that of their children's present family
structure, many said it was the same--no father present
in the home. One participant who has children in multiple
relationships said, "It's not nearly the same. I'm
there for her (the baby), and me and her mother are
raising her. My two sons situation is the same as mine
when I was a kid. I'm giving time, but not as much as I
want."
- With respect to how the service delivery system is
helping them to become better parents, the men felt the
system stifles them with rigid rules and regulations.
Many felt they received no assistance in developing or
maintaining relationships to keep their families together
in a self-sustaining fashion.
- According to the fathers, drugs, greed, machismo, and the
system prevented them from establishing a family with the
children's mothers. Some had specific issues with women
and were mad at their mothers and sisters. Some had
unstable relationships with the children's mothers.
- As a final question, the fathers were asked what they
could do at this time to bring them together with the
mothers. The answers varied widely. Some said parenting
groups and family counseling could help. One said he no
longer had a relationship with the mother, and any
attempt would be a waste of time. One participant
attempting to make a relationship work responded by
stating, "Understanding that everyday will not be a
good day. Being patient and not expecting things to
always go my way." and "Marriage."
This group of men feels ill-equipped to fulfill the role of
father, having had poor role models growing up. The pressures of
day-to-day life, including exposure to the drug culture,
interfere with establishing a strong family base. The
interactions the fathers have with their children do not
encompass all of the responsibilities of parents. The fathers
role is often unreal and becomes self-serving. They visit, bring
gifts, and play. Mothers are responsible for discipline and
establishing regulations.
This, in turn, leads to disagreements between the mothers and
fathers and disintegration of the family structure. Finally,
these fathers felt the service delivery system was rigid and
controlling and lacked adequate focus on long-term maintenance of
family relationships.
Designing Services: A
Request from Mothers
by Frances Faison-Smith
and Susan Hupp
In the Prenatal Exposure to Drugs (PED) Program, one goals is
to determine supports needed by women to interface with the
community. This project, named by the participants, has a
community liaison who also assists the women in with their
interactions with the University research community. Extensive
collaboration over more than a year has led to the development of
trusting relationships between many of the women and the liaison
and to a clear definition of the liaison's role within the
project.
The liaison has worked with several of the women from the time
of the baby's birth through aftercare and into independent
functioning of their families for successful transition into the
community. The relationships are informal, and the liaison is
guided by needs of the mothers. She responds to a myriad of
requests from assistance in locating housing to discussions about
child rearing practices.
The project is guided by Urie Bronfenbrenner's concept about
the nature of development. For development to occur, he believes
there must be a shift in the balance of power toward the
developing person. This shift may be considered as a hallmark of
transition across the lifespan. Keeping this relative shift in
balance of power in mind, we asked mothers what supports they
needed, what services have been most helpful, and what future
transition services should look like. Many of the mothers have
been strong advocates for their needs and wishes. Their reactions
to services provided for them and their children are critical in
developing a conceptual framework that can shape future services.
The mothers say they would benefit greatly from more support than
is typically provided by the system. They want elective, private,
non-judgmental, nonintrusive mentoring by someone outside of the
system...someone to serve in the role of big sister...someone to
serve as a role model and guide. They would like to receive this
support for an extended period, at least two or three years, to
give them the time needed to learn a new way of living. This
message is clear! The women are asking that the balance of power
be shifted toward them. They are not asking for instant, complete
independence, but for continuous support while they develop
skills to change to a lifestyle unfamiliar to them. They want to
be able to let down their guard without fear of retaliation from
the system and without feeling ashamed and embarrassed by skills
and abilities they have not yet mastered. The PED project staff
is proud that this is their request.
Mentoring models have proven successful. The Afrocentric
Academy in Minneapolis and the Youth Mentoring Institute of the
University of Minnesota attest to the validity of this approach.
Both support young adults in making informed and responsible
choices as they meet the demands of living and working in a
complex world.
Is the request of the mothers merely a wish to avoid the
oversight that the formal system has imposed? We think not.
During their lifetimes, each of the women has met with failure,
as evidenced by such things as being incarcerated of having
parental rights suspended. These women understand that they need
the external support and monitoring.
To some extent, the support they request is provided within
the formal system. Confidential psychological counseling is
available to some, depending on decisions of their health care
providers. While they are somewhat helpful, the mothers report
that these contacts are not frequent enough. Counseling is often
limited to a clinic setting...divorced from their new homes and
neighborhoods. A bit more helpful are support groups that some
women elect to join because they are confidential and not tied to
the formal service delivery system.
PED project mothers talk frequently about their self-esteem
and the need to feel empowered. They request respect, privacy
with respect to their personal and family boundaries, and
support. This sounds like a formula for a successful life, for us
all.
Myths and Stereotypes
About Long-Term Effects
of Prenatal Alcohol and Other Drug Exposure (PADE)
by Phoebe Rinkel, M.S.
In 1990, the early childhood research group of the Juniper
Gardens Children's Project at the University of Kansas began
following the literature related to Prenatal Alcohol and other
Drug Exposure (PADE), anticipating that this was an issue soon to
confront the inner-city community with whom we have been involved
for the past 27 years. We could not have predicted, however, the
extent of the concern which would be expressed for these children
in our community and across the country. We have been inundated
by requests for information from anxious educators and other
professionals. We have discovered there are many myths about
"drug-addicted babies" and drug-affected children.
Myths have traditionally been used to explain our beliefs about
things we do not quite comprehend, but eventually myths are
replaced by facts gleaned from real life experiences. Research
then translates these experiences into hypotheses, to be
empirically described, and experimentally validated.
Unfortunately, to date, data-based research on the long-term
effects of PADE is sparse, incomplete, and inconclusive, with
many methodological shortcomings. Contrary to reports in the
popular press, it is too soon to tell what the ramifications of
prenatal substance abuse may be for preschool and school age
children. While the growing body of empirical literature suggests
widely varying consequences, media coverage has typically focused
on worst-case scenarios. Although these reports have heightened
public awareness of the problem, they have also contributed to
general misconceptions through damaging descriptions and
pessimistic predictions for the children's' futures: "born
hooked," "the nation's unwanted infants,"
"asocial and incapable of bonding," "missing the
core of what it takes to be human," "oblivious to any
affection," "likely to become sociopaths." These
are terms used in mass media publications. We cannot wait for
experimentally validated conclusions before acting to counter the
emerging stereotypes about the long-term effects of prenatal
alcohol and drug exposure. The most common misconceptions seem to
be embedded in four general myths:
Myth #1: The abuse of
crack/cocaine by pregnant women poses the greatest threat to
infants and young children today. The major misconceptions
implied in this statement are that crack/cocaine is the primary
drug of abuse by pregnant women and is the drug that has the most
harmful effect on the unborn. In fact, estimates based on a
recent national survey suggest that women were 16 times more
likely to have used alcohol as cocaine during the pregnancy
(NIDA, 1991), and alcohol, unlike cocaine, has a proven
teratogenic (causing fetal malformations) effect. Nicotine, which
has a strong relationship to infant mortality, was the second
most frequently reported drug. Marijuana was third. According to
the survey, vastly more pregnant women smoke tobacco and
marijuana than smoke crack.
Myth #2: Prenatal
substance abuse is primarily confined to women of color living in
the inner cities. This myth is based on biases in testing and
reporting that inaccurately suggest that more minority than white
women abuse drugs during pregnancy and that prenatal substance
abuse is largely restricted to lower socioeconomic urban
populations. This stereotype has been challenged by data from
studies showing similar rates of illegal drug abuse during
pregnancy among white and nonwhites (Chasnoff, et al., 1990), and
among urban, suburban, and rural women (Chasnoff, et al. 1989;
Associated Press, 1990; Schutzman, et al., 1991). A recent forum
of national researchers concluded "although the stereotype
of the user is a low-income black woman from the inner city,
there is ample evidence that women in rural areas and middle
class white women also use drugs" (Brown, 1991, p. 5).
Myth #3: The
identification of prenatal alcohol and drug exposure is
predictive of a unique set of aberrant behaviors in early
childhood. This belief is based on several misconceptions: That
all exposed children show detrimental effects in the preschool
years; that children affected by exposure constitute a
homogeneous group; and that abnormal behaviors in a child known
to have been prenatally drug-exposed can be attributed
exclusively to the effect of the drug or drugs. Most of the
children exposed to prenatal substance abuse are not adversely
affected. The most extensive follow-up studies of fetal exposure
to legal and illegal drugs report identifiable effects in about
30-40% of the children (Streissguth & La Due, 1987; Griffith,
1991). Unfortunately, that rate may increase in later years,
since problems associated with early neurological insults, such
as the central nervous system damage seen in some infants (Dixon
& Bejar, 1989), may not be manifested until preschool or
school age (Gottlieb & Zinkus, 1980). No typical profile of
the affected preschoolers has yet emerged. Descriptions are full
of contradictions, such as: showing "indiscriminate
attachment to all adults" versus "showing no preference
for a particular adult" (L.A. U.S.D., 1989, p. 12), or
"apathy" and "agitation," which are
"unlikely to be present in the same child at the same time,
nor are both likely to be the primary characteristics of any one
child" (Kronstadt, 1991, p. 41). Researchers are beginning
to question classifying preschool children as drug exposed
because it neither describes a consistent developmental profile
nor is it predictive of future behaviors (Schutter & Brinker,
1992). As damaging as it can be, fetal drug exposure alone cannot
account for the wide range of outcomes being reported for
children born to substance abusing women (Streissguth & La
Due, 1987; L.A. U.S.D., 1989; Griffith, 1991). Rather, it is
likely that the prognosis involves "an interaction between
the extent of the damage and the stability and structure of the
environment" (Streissguth & La Due, 1987, p. 29).
Myth #4: Extraordinary
new interventions will have to be devised to accommodate the
distinct needs of PADE children when they enter the classroom.
This prediction presumes that effective early intervention
practices used for other high-risk preschoolers will not be
adequate for alcohol/drug-exposed children and that all
school-age children affected by drug/alcohol exposure will have
to be served in special education programs. Model projects for
preschoolers exposed to cocaine or polydrug use are anticipating,
and even beginning to report, favorable outcomes for these
children in programs that are relying on accepted practices in
early intervention and early childhood special education (L.A.
U.S.D., 1989; Florida Department of Education, 1991; Delapenha,
1991; Powell, 1991). Many of the children in these programs do
not demonstrate deficits or disabilities that would make them
eligible for special education services in school; yet, one
concern is that traditional means of testing may not be effective
in picking up subtle but pervasive problems (Griffith, 1989). A
recent report of the long-term consequences of Fetal Alcohol
Syndrome (FAS) described a full continuum of educational
placements among its school-age subjects, ranging from regular
education, through increasing levels of support services, to
self-contained special education. However, few of the children in
this follow-up study were identified in infancy, and most did not
receive early childhood intervention. Would early intervention
have made a difference in the intensity or duration of special
education services needed? The authors concluded that their
follow-up was primarily testimony to what happens to FAS children
in the absence of special services. "We do not yet know the
levels achievable if proper planning and programming are
available" (Streissguth, La Due, & Randels, 1988). It
remains to be seen what the impact would be if recommendations
from researchers and practitioners studying prenatal substance
abuse were implemented. These recommendations include providing
universal prenatal and postnatal health care for women and
infants; removing barriers that prevent women from getting
treatment for substance abuse; providing full funding for the
early intervention and special education programs mandated by
P.L. 94-142 and P.L. 99-457, along with other programs that have
proven to be effective for high-risk children and their families
(WIC, Head Start, Parents as Teachers, etc.); and putting case
management back into the social service system. As we continue to
look for what may be unique about children who seem affected by
prenatal drug and alcohol exposure, we likewise will be looking
for similarities among children with relevant features and
similar backgrounds. We must learn to identify factors that seem
to protect some children from deleterious outcomes and those that
make them more vulnerable. Descriptions of these children must be
more complex, evaluating their interactions with various care
givers across multiple settings over time. Only then will we be
able to verify whether a profile exists that would be useful in
identifying and treating this high-risk population. We have to
treat as individuals children with a history of prenatal drug and
alcohol exposure. If we continue to categorize them we may be
setting up another obstacle for them to overcome: prejudice.
Phoebe Rinkel is an early childhood special educator and
researcher with The Juniper Gardens Children's Project of the
University of Kansas, located in the inner-city area of Kansas
City, Kansas. The project is the primary site for the Early
Childhood Research Institute on Substance Abuse, funded by the
U.S. Office of Special Education Programs. ECRI, a five-year
project, is a research consortium that includes the Institute on
Community Integration at the University of Minnesota and the
University of South Dakota University Affiliated Program.
Principal investigators are Drs. Judith Carta (KS), Scott
McConnell and Mary McEvoy (MN), and Cecilia Rokusek (SD).
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Associated Press (1990). Drugs factor in 14% of Fairbanks
births. Anchorage Daily News, November 13.
Brown, S. (Ed.) (1990). Children and prenatal illicit drug
use: Research, clinical, and policy issues. National Forum on the
Future of Children and Families/National Research
Council/Institute of Medicine, Washington, Dc: National Academy
Press.
Chasnoff, I.J., Landress, H., Barrett, M. (1990). The
prevalence of illicit drug or alcohol use during pregnancy ad
discrepancies in mandatory reporting in Pinellas County, Florida.
The New England Journal of Medicine, 322, 1202-1206.
Delapenha, L. (1991). Strategies for teaching young children
prenatally exposed to drugs. Perinatal Addiction Research and
Education Update, March, p. 5-6.
Dixon, S. and Bejar, R. (1989). Echoencephalographic findings
in neonates associated with maternal cocaine and methamphetamine
use: Incidence and clinical correlates. The Journal of
Pediatrics, 115(5), part I, 770-778.
Florida Department of Education (1991), Cocaine babies:
Florida's substance-exposed youth, Tallahassee, FL.
Gottlieb, M. and Zinkus, P. (1980) Educational health and
development: The learning-disabled child. In Hughes, J.G.,
Pediatrics. St. Louis: Mosby.
Griffith, D. (1991). Developmental and educational
implications for drug-exposed children, intervention for
drug-using parents: Working together in a multidisciplinary
community approach. Presented at the drug-exposed babies and
addicted parents conference, Overland Park, KS, October 10, 1992.
Griffith, D. (1989), as cited in Adler, T. Cocaine babies face
behavior deficits. Science Monitor, July 14.
Kronstadt, D. (1991) Complex developmental issues of prenatal
drug exposure. In Center for the Future of Children, The David
and Lucille Packard Foundation, The Future of Children: Drug
Exposed Infants. Volume 1, Number 1, Los Altos, CA.
L.A. U.S.D. (1989). Today's challenge: Teaching strategies for
working with young children prenatally exposed to drugs/alcohol.
p.12
L.A. U.S.D. Division of Special Education PED Program, Los
Angeles, CA. NIDA/National Institute on Drug Abuse (1991).
National household survey on drug abuse: Population estimates
1990. Washington, DC: U.S. Government Printing Office.
Powell, D. (1991). Project D.A.I.S.Y.: Family-based
intervention with pre-kindergarten children prenatally exposed to
drugs. The Prevention Report, National Resource Center on Family
Based Service, University of Iowa School of Social Work, Oakdale,
IA.
Schutter, Linda S. and Brinker, Richard P. (1992). Conjuring a
new category of disability from prenatal cocaine exposure: Are
infants unique biological or caretaking casualties? Topics in
Early Childhood Special Education, 11 (4), 84-111.
Schutzman, D., Frankenfield-Chernicoff, M., Clatterbaugh, H.,
& Singer, J. (1991). Incidence of intrauterine cocaine
exposure in a suburban setting, Pediatrics, Vol. 88, No. 4,
October, 825-827.
Streissguth, A.P., and La Due, R.A., (1987). Fetal alcohol:
Teratogenic causes of developmental disabilities. In S.R.
Schroeder (Ed.), Toxic substances and mental retardation, (1-32).
Washington, DC: American Association on Mental Deficiency.
Streissguth, A.P., La Due, R.A., & Randels, S.P. (1986,
1988). A manual on adolescents and adults with FAS with special
reference to American Indians. Washington, DC: Indian Health
Service. Copyright NAPARE, 1992, reprinted with permission.
Research Highlights
by Erna Fishhaut
The myths mentioned in Rinkel's article (Early Report, Fall
1992) help to remind us how little we really know about how
children are affected by prenatal exposure to alcohol and/or
other drugs. In the January 15, 1992, issue of the Journal of the
American Medical Association, an article,
"The Problem of Prenatal Cocaine Exposure-A Rush to
Judgment," warns "...premature conclusions about the
severity and universality of cocaine effects are in themselves
potentially dangerous to children." The authors (Drs. Linda
Mayes, Richard Granger, Marc Bornstein, and Barry Zuckerman)
report that a review of current literature indicates evidence is
far too slim and fragmented to allow any clear predictions about
the effects of intrauterine exposure to cocaine on the course and
outcome of child growth and development.
It follows that if we don't know about the effects of the
substances, it is extremely difficult to decide what the
appropriate treatment should be. Universities, hospitals, human
service agencies, and educational institutions are trying to
determine what interventions should be tried, when and how they
should be used, and what resources are necessary to service
children who have been exposed to chemicals prior to birth.
Careful study, using a variety of approaches in preschools,
public schools, and home settings, is essential.
At the University of Minnesota there are many research
projects underway which we hope will provide some answers to
questions that plague practitioners who provide health,
educational, social, and psychological services to children and
families troubled as a result of prenatal chemical abuse. This
article briefly describes a few of the studies presently being
conducted. These projects are supported by state and federal
agencies as well as foundation funds.
- BEHAVIOR EFFECTS OF PRENATAL COCAINE USE ON
CHILDREN AGES 2-5 was one of the first applied
research projects to compare the behavior of children
with prenatal cocaine exposure to their non-exposed
peers. Directed by Dr. David Rotholz, the study was a
collaborative effort of the Institute for Disabilities
Studies (IDS), Turning Point, Inc., and the St. Anthony
Developmental Learning Center. Recently, the Minneapolis
Public Schools Early Childhood Special Education Program
was added to the collaboration.
The program studies the interactions between the child and the
teachers, the other children, and his/her preschool environment.
Children were observed during the regular preschool activities to
determine similarities and differences in behavior exhibited.
Preliminary results (based on about 180 hours of direct
observation) showed a surprising lack of difference between the
behavior of children who had been prenatally exposed to cocaine
and the non-exposed groups. Comparing all of the behaviors, the
levels of active participation, gross motor behavior, and pretend
play were virtually identical, as was teacher behavior across the
two groups of children.
In analyzing data about specific activities, however,
differences were found. In fine motor activities-which represents
a large portion of the preschool curriculum-the children with
prenatal cocaine exposure were actively engaged less often than
their non-exposed peers. This was also true when children played
with large motor equipment-exposed children were passively
engaged more than the non-exposed children. The study continues
to look at additional children in multiple settings, trying to
find more answers to difficult questions.
- EARLY CHILDHOOD RESEARCH INSTITUTE ON SUBSTANCE
ABUSE (ECRI), directed by Drs. Mary McEvoy and
Scott McConnell, develops and evaluates interventions
addressing developmental needs of young children exposed
prenatally to alcohol or other drugs. It disseminates
information to practitioners, administrators, policy
makers, and researchers throughout the nation. The
Institute operates in collaboration with Juniper Gardens
Children's Project at the University of Kansas and the
University Affiliated Program at the University of South
Dakota.
Two of the projects under the auspices of ECRI are:
PRENATAL COCAINE EXPOSURE AND MOTHER-INFANT
INTERACTIONS. McEvoy and McConnell are developing and
implementing a systematic and reliable observation system for
describing interactions between a group of prenatally
cocaine-exposed infants and their mothers. Many observers note
problematic early interactions between such infants and their
mothers. However, there is need for empirical documentation of
interactions of this high-risk group. This project will observe
and do other developmental assessments when the children are six
and 12 months of age. The results will be useful in developing
appropriate interventions for infants prenatally exposed to
cocaine and for their families.
PRENATAL COCAINE EXPOSURE AND SOCIAL DEVELOPMENT OF
YOUNG CHILDREN.
This program, directed by McConnell and McEvoy, is conducting
descriptive and intervention-based research to increase knowledge
of social outcomes for children exposed prenatally to cocaine.
Its goal is to improve resources and early intervention
strategies for use with such children and their families.
PRENATAL EXPOSURE TO DRUGS (PED) PROGRAM. The
PED Program is a collaboration between researchers at the
University of Minnesota and Turning Point, Inc. designed to
investigate the early learning potential of infants exposed
prenatally to cocaine. The goal is to describe young children's
abilities in two areas that underlie the development of cognitive
abilities.
- Dr. Charles Nelson, Institute of Child Development, is
analyzing how well the children process information that
is presented visually. He hopes to be able to track the
various stages of memory formation and retrieval, as well
as to identify where in the brain these operations are
performed.
- Dr. Susan Hupp, Institute for Disabilities Studies and
Department of Educational Psychology, is working with the
same children to learn how they structure their own
learning during play-what behavior can be observed as
they explore the environment, interact with toys, etc.
The investigators want to be able to portray the range of
child functioning rather than focus on the development of child
profiles.
The results of the studies will enable them to make
recommendations about the likelihood that early intervention will
improve learning opportunities and learning potential of these
children during the infant and preschool years.
STEEP AT CUHCC. STEEP (Steps Toward
Effective, Enjoyable Parenting) is a prevention-intervention
program developed by Drs. Byron Egeland and Martha Farrell
Erickson to promote healthy parent-infant interaction and prevent
social and emotional problems. The current STEEP program at CUHCC
(Community-University Health Care Center) directed by Drs. Amos
Deinard, Egeland, and Robert ten Bensel is specifically designed
for women who have used chemicals during their pregnancies and/or
up to 12 months after delivery and, as a result, are at risk for
parenting problems.
The program begins with home visits during the second
trimester to help expectant mothers to deal with their feelings
about pregnancy and preparation for parenting. Home visits
continue every other week until the baby is one year old. Groups
of eight moms meet biweekly with a group facilitator who, in an
informal setting, provides information about infant development
and the cues and signals mothers can recognize in their own baby
that will influence interactions between parent and infant.
Outcome assessments will be done when the children are one,
one-and-one-half, two, and three years of age and will measure
the child's developmental status, social/emotional competence,
parent knowledge and attitudes, parent-child interaction, and
other life factors. The evaluation will attempt to identify
factors which may explain why the program works better for some
families than for others.
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Fall 1992, Volume 20, Number 1