There are many myths about children prenatally exposed to crack or cocaine. Even teachers and principals often presume that all children who have been exposed to drugs will be out of control in classrooms as well as doomed to failure. The following are some of the myths—and current research—that surround this special group of children.
Myth 1: Prenatal crack or cocaine exposure is more harmful to children than exposure to other drugs. While prenatal crack or cocaine exposure and its potential effects on infants have received extensive coverage by the media, alcohol and cigarettes in particular have been determined to have an equal or greater detrimental impact on the newborn (Brodkin and Zuckerman 1992, Richardson et al. 1993). The effects of an expectant mother's use of drugs on her child may range from none to moderate or severe; lower birth weight and smaller head circumference seem to be the most common effects (Azuma and Chasnoff 1993, Bateman et al. 1993, Chiriboga 1993).
In addition, because pregnant, drug-abusing women often do not seek medical attention, their children are often born premature. The characteristics of those premature infants are often very similar to those exhibited by children prenatally exposed to crack or cocaine (Gregorchik 1992, Sexson 1993). Finally, over and above the effects of the drugs on the newborn, other variables, including the mother's nutrition, the environment, and the delivery date of the baby, can influence the baby's overall health.
Myth 2: Children prenatally exposed to crack or cocaine live only in inner-city environments. When minority women without prenatal care deliver their babies, doctors or nurses more readily test for drugs both in the mother and the infant (Mayes et al. 1992). Middle-class women often deliver their babies with the support of a private physician who infrequently orders drug tests for patients. Minority, inner-city women are “10 times more likely to be reported to child abuse authorities than white wom[e]n” (Rist 1990). This inconsistency in drug testing leads to misunderstandings about the types of people who use crack or cocaine (Villarreal et al. 1991). All kinds of people, living in cities, rural areas, and suburban areas—including pregnant women—use drugs (Chasnoff et al. 1990, Singer et al. 1993, Tyler 1992).
Myth 3: All children who are prenatally exposed to crack or cocaine are affected in similar ways and require intensive school intervention. Although educators have tried to develop a stereotypic profile of these children (Waller 1993), the research literature (Schutter and Brinker 1992, Sexson 1993) shares a much more complex view of the effects of prenatal exposure. The severity of the effects on the newborn are influenced by such factors as the frequency of the mother's drug use, the amount of the average dose of crack or cocaine, the route of administration, the stage of fetal development, and the genetic susceptibility of the fetus (Lewis 1991). Cohen and Taharally (1992) state that the majority of these children “do not appear to have severe disabilities.” Additionally, these children usually perform in the normal range on individual intelligence tests (Cohen and Taharally 1992, Viadera 1992).
Combined with the belief that all of these children should be treated the same is the idea that all medical, behavioral, or learning problems are caused directly by drug exposure (Griffith 1992). Children who are prenatally exposed to drugs are also vulnerable to environmental factors that contribute to or detract from their cognitive, emotional, and social growth. The complexity of the effects of environmental risk factors complicates accurate predictions of the developmental outcome for these children (Chasnoff et al. 1992, Richardson et al. 1993).
Myth 4: Children who have been prenatally exposed to crack or cocaine require classrooms that have limited physical and social stimulation. The idea that these children require classrooms that are devoid of any stimulating artifacts developed from stereotypical descriptions. Erroneously believing that these children are “out of control,” experts have recommended classrooms similar to those recommended for children with attention deficit disorder (Odom-Winn and Dunagan 1991, Waller 1993).
The need for such austere classrooms just doesn't make sense when we consider the diversity among this group of children. Some children who have been exposed to crack or cocaine may require such classrooms, but the majority certainly should not. In a longitudinal study focused on the literacy development of children passively exposed to crack or cocaine, I discovered that the 26 children in my study successfully adjusted to a variety of classroom environments (Barone 1993, in press). In another study in which programs were established to integrate children exposed to crack or cocaine with non-exposed children, children were involved in active learning that included learning at centers, decision making, and holistic reading and writing experiences. After two years, the children were successful in these active classrooms (Sautter 1992).
Suggestions for Educators
Educators may be confused about what they should do to successfully teach their students who were prenatally exposed to crack or cocaine. The first step should be to forego the idea that these children exhibit similar behaviors. Second, educators should use their common sense and consider the variables that can affect behavior and learning just as they would for children who have not been exposed to drugs. The outlook for children who have been prenatally exposed to crack or cocaine is more positive than the media would have us believe. Educators need to set aside the myths about these children and focus on teaching the child.
Azuma, S., and I. Chasnoff. (1993). “Outcome of Children Prenatally Exposed to Cocaine and Other Drugs: A Path Analysis of Three-year Data.” Pediatrics 92, 3: 396–402.
Bateman, D., S. Ng, C. Hansen, and Heagarty. (1993). “The Effects of Intrauterine Cocaine Exposure in Newborns.”American Journal of Public Health 83, 2: 190–193.
Barone, D. (1993). “Wednesday's Child: Literacy Development of Children Prenatally Exposed to Crack/Cocaine.”Research in the Teaching of English 27, 1: 7–45.
Barone, D. (In press). “The Importance of Classroom Context: Literacy Development of Children Prenatally Exposed to Crack/Cocaine—Year Two.” Research in Teaching of English.
Brodkin, A., and B. Zuckerman. (1992). “Are Crack Babies Doomed to School Failure?” Instructor 101, 7: 16–17.
Chasnoff, I., D. Griffith, C. Freier, and J. Murray. (1992). “Cocaine/Polydrug Use in Pregnancy: Two-year Follow-up.”Pediatrics 89, 2: 284–289.
Chasnoff, I., H. Landress, and M. Barrett. (1990). “The Prevalence of Illicit-Drug or Alcohol Use During Pregnancy and Discrepancies in Mandatory Reporting in Pinellas County, Florida.” New England Journal of Medicine 322, 17: 1202–1206.
Chiriboga, C. (1993). “Fetal Effects.”Neurologic Clinics 11, 3: 707–720.
Cohen, S., and C. Taharally. (1992). “Getting Ready for Young Children with Prenatal Drug Exposure.” Childhood Education 69, 1: 5–9.
Gregorchik, L. (1992). “The Cocaine-Exposed Children Are Here.” Phi Delta Kappan 73, 9: 709–711.
Griffith, D. (1992). “Prenatal Exposure to Cocaine and Other Drugs: Developmental and Educational Prognoses.” Phi Delta Kappan 74, 1: 30–34.
Lewis, K. (1991). “Pathophysiology of Prenatal Drug-exposure: In Utero, in the Newborn, in Childhood, and in Agencies.”Journal of Pediatric Nursing 6, 3: 185–190.
Mayes, L., R. Granger, M. Bornstein, and B. Zuckerman. (1992). “The Problem of Prenatal Cocaine Exposure.” JAMA 267, 3: 406–408.
Odom-Winn, D., and D. Dunagan. (1991). Crack Kids in School. Freeport, N.Y.: Educational Activities, Inc.
Richardson, G., N. Day, and P. McGauhey. (1993). “The Impact of Perinatal Marijuana and Cocaine Use on the Infant and Child.”Clinical Obstetrics and Gynecology 36, 2: 302–318.
Rist, M. (1990). “The Shadow Children: Preparing for the Arrival of Crack Babies in School.” Phi Delta Kappan: Research Bulletin 9: 1–6.
Sautter, R. (1992). “Crack: Healing the Children: Kappan Special Report.” Phi Delta Kappan 74, 3: K1–K12.
Schutter, L., and R. Brinker. (1992). “Conjuring a New Category of Disability from Prenatal Cocaine Exposure: Are the Infants Unique Biological or Caretaking Casualties.” Topics in Early Childhood Special Education 11, 4: 84–111.
Sexson, R. (1993). “Cocaine: A Neonatal Perspective.” The International Journal of the Addicions 28, 7: 585–598.
Singer, L., R. Arendt, and S. Minnes. (1993). “Neurodevelopmental Effects of Cocaine.” Clinics in Perinatology 20, 1: 245–252.
Tyler, R. (1992). “Prenatal Drug Exposure: An Overview of Associated Problems and Intervention Strategies.” Phi Delta Kappan 73, 9: 705–711.
Viadera, D. (1992). “New Research Finds Little Lasting Harm for `Crack' Children.” Education Week XL, 19: 1,10.
Villarreal, S. F., L. E. McKinney, and M. Quackenbush. (1991). Handle with Care: Helping Children Prenatally Exposed to Drugs and Alcohol. Santa Cruz, Calif.: ETR Associates.
Waller, M. (1993). “Helping Crack-Affected Children Succeed.” Educational Leadership 50, 4: 57–60.
Diane Barone is Director of the Reading Center and Clinic, College of Education, University of Nevada-Reno, Reno, NV 89557.