The need for stronger emphasis on prevention programs throughout the country has been brought to light by a new study of school-age children who were prenatally exposed to cocaine or crack. Researchers at Brown University estimate that subtle deficits in IQ and language development will occur in up to 80,550 cocaine-exposed children. Although the developmental effects are subtle, special education to prevent these children from failing in the school environment will cost up to $352 million per year nationwide. The research, a meta-analysis of eight longitudinal studies of school-age, prenatally exposed children, was funded by the Robert Wood Johnson Foundation. The findings are reported in the October 23 issue of Science.
"Every dollar of prevention saves five times that amount in treatment and other costs to society," said Dr. Alan I. Leshner, Director of the National Institute on Drug Abuse (NIDA), National Institutes of Health. "Children who are exposed prenatally to crack clearly are not doomed to failure, but these findings indicate that a significant percentage does develop problems with learning and language skills that require remedial attention. That fact emphasizes the need for more drug prevention efforts, particularly directed at women of child-bearing age. The findings also argue for early identification and intervention for children most at risk for developing these problems."
The research team found average differences of 3.26 IQ points between cocaine-exposed children and control group children; cocaine-exposed children's tests scores were significantly lower than those of control children on tests of IQ, receptive language, and expressive language. When examined from a societal population perspective, the impact of a difference even as small as 3.26 IQ points is substantial. For example, based on typical criteria used for early intervention and special education services (i.e., IQ scores below 70 or, in some cases, 78), a 3.26 IQ differential results in a 1.5-fold increase in the number of children eligible for such services.
"These figures are underestimates," notes Dr. Barry Lester, NIDA grantee and lead member of the research team. "These are additional costs attributable only to new cases each year, and do not include the accumulating costs and burdens associated with annual additions." Based on the nature of the studies analyzed, the authors suggest that it is unlikely that their findings are attributable to such other factors as cigarette smoking, use of drugs other than cocaine, and poverty. References for the studies analyzed for this paper are available in Science Online (www.sciencemag.org).