Assessment of the caregiving environment and infant functioning in polydrug families: Use of a Structured Clinical Interview

A Structured Clinical Interview (SCI) was used to assess both proximal char acteristics of the rearing environments of prenatally polydrug exposed infa nts in a low SES sample and infant behavioral characteristics (e.g., feedin g, sleeping, self-regulation). The 95-item questionnaire systematized colle ction of developmental history and caregiving environment for 132 infant-ca regiver dyads who were seen for follow-up at 6, 12, and 24 months. Outcome data were indexed in five theoretically based areas: Care-giving Instabilit y, Problems with Social Routine, Dysregulation, Infant Feeding Problems and Infant Sleeping Problems. Main effects were found in the Caregiving Instab ility and Sleeping Problems Index scores for drug exposure but not gestatio nal age. Chronological age and drug interactions were found for Feeding Pro blems and Sleeping Problems Index scores, with those in the drug group havi ng persistent difficulties in these areas. Additionally, there was a term a nd drug interaction effect in the Problems with Social Routine Index. In al l of these areas, prenatal drug exposure was associated with less optimal s cores. The SCI proved to be a useful tool in studying this high-risk popula tion and may be useful in research and clinical settings. Future instrument development is planned.