Motor development of cocaine-exposed children at age two years

Objective. This article was designed to investigate effects of prenatal coc aine exposure on motor development of young children from a predominately u nderprivileged, urban population. Methodology. A total of 260 infants and young children were initially recru ited from either the newborn nursery or the at-risk pediatric clinic of an urban teaching hospital Prenatal history and birth outcomes were collected from medical records. Demographic characteristics and additional drug histo ries were obtained from the mothers. The 199 subjects (98 cocaine-exposed a nd 101 unexposed) who returned at age 2 years were assessed by examiners bl inded to drug exposure status using the Peabody Developmental Motor Scales. Results. Compared with control subjects, the cocaine-exposed group performe d significantly less well on both the fine and the gross motor development indices. Mean scores for both groups were within the average range on the g ross motor index, but greater than 1 standard deviation below average on th e fine motor index. Differences were significant on the balance and the rec eipt and propulsion subscales of the gross motor scale, and on the hand use and the eye-hand coordination subscales of the fine motor scale. Cocaine s tatus independently predicted poorer hand use and eye-hand coordination sco res. There also was an effect of alcohol exposure on the receipt and propul sion subscale. Conclusions. Findings indicate that deficiencies in motor development remai n detectable at 2 years of age in children exposed to drugs prenatally. Alt hough other environmental variables may influence motor development, childr en exposed to cocaine and to alcohol in utero may encounter developmental c hallenges that impede later achievement.