'Crack baby' development issues not side-effect of drug, but poverty
A 25-year study that followed babies born to crack cocaine addicted mothers found that the children were slow to develop. What surprised the researchers was that the determining factor wasn't crack cocaine. It was poverty.
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After nearly 25 years of studying the effects of cocaine and publishing or presenting dozens of findings, it wasn't easy to summarize it in a PowerPoint presentation. The study received nearly $7.9 million in federal funding over the years, as well as $130,000 from the Einstein Society.Skip to next paragraph
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Hurt, who had taken her team from Einstein to Children's in 2003, began her lecture with quotations from the media around the time the study began. A social worker on TV predicted that a crack baby would grow up to "have an IQ of perhaps 50."
A print article quoted a psychologist as saying "crack was interfering with the central core of what it is to be human," and yet another article predicted that crack babies were "doomed to a life of uncertain suffering, of probable deviance, of permanent inferiority."
Hurt, who is also a professor of pediatrics at the University of Pennsylvania, is always quick to point out that cocaine can have devastating effects on pregnancy. The drug can, for instance, cause a problematic rise in a pregnant woman's blood pressure and trigger premature labor.
Babies born prematurely, no matter the cause, are at risk for a host of medical and developmental problems. On top of that, a parent's drug use can create a chaotic home life for a child.
Hurt's study enrolled only full-term babies so the possible effects of prematurity did not skew the results. The babies were then evaluated periodically, beginning at six months and then every six or 12 months on through young adulthood. Their mothers agreed to be tested for drug use throughout the study.
The researchers consistently found no significant differences between the cocaine-exposed children and the controls. At age 4, for instance, the average IQ of the cocaine-exposed children was 79.0 and the average IQ for the non-exposed children was 81.9. Both numbers are well below the average of 90 to 109 for U.S. children in the same age group.
When it came to school readiness at age 6, about 25 percent of children in each group scored in the abnormal range on tests for math and letter and word recognition.
"We went looking for the effects of cocaine," Hurt said. But after a time "we began to ask, 'Was there something else going on?'"
While the cocaine-exposed children and a group of non-exposed controls performed about the same on tests, both groups lagged on developmental and intellectual measures compared to the norm. Hurt and her team began to think the "something else" was poverty.
As the children grew, the researchers did many evaluations to tease out environmental factors that could be affecting their development. On the upside, they found that children being raised in a nurturing home — measured by such factors as caregiver warmth and affection and language stimulation - were doing better than kids in a less nurturing home.
On the downside, they found that 81 percent of the children had seen someone arrested; 74 percent had heard gunshots; 35 percent had seen someone get shot; and 19 percent had seen a dead body outside — and the kids were only 7 years old at the time. Those children who reported a high exposure to violence were likelier to show signs of depression and anxiety and to have lower self-esteem.
More recently, the team did MRI scans on the participants' brains.
The investigators found one brain area linked to attention skills that differed between exposed and non-exposed children, but they could not find any clinically significant effect on behavioral tests of attention skills. Drug use did not differ between the exposed and non-exposed participants as young adults.
About 42 percent used marijuana and three tested positive for cocaine one time each. The team has kept tabs on 110 of the 224 children originally in the study. Of the 110, two are dead — one shot in a bar and another in a drive-by shooting — three are in prison, six graduated from college, and six more are on track to graduate. There have been 60 children born to the 110 participants. The years of tracking kids have led Hurt to a conclusion she didn't see coming.