Expressive and receptive language functioning in preschool children with prenatal cocaine exposure.
OBJECTIVE
To estimate the relationship between severity of prenatal cocaine exposure and expressive and receptive language skills in full-term, African American children at age 3 years.


METHODS
Language was assessed at age 3 using the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P). The sample included 424 children (226 cocaine exposed, 198 non-cocaine exposed) who received preschool language assessments at age 3, drawn from a cohort of 476 children enrolled prospectively at birth.


RESULTS
Structural equation modeling was used to regress expressive and receptive language as intercorrelated response variables on level of prenatal cocaine exposure, measured by a latent construct including maternal self-report of cocaine use and maternal/infant urine toxicology assays and infant meconium. Results indicated a.168 SD decrease in expressive language functioning for every unit increase in exposure level (95% CI = -.320, -.015; p =.031) after consideration for fetal growth and gestational age as correlated response variables. Receptive language was more modestly related to prenatal cocaine exposure and was not statistically significant. Results for expressive language remained stable with inclusion of the McCarthy general cognitive index as a response variable (expressive language beta = -.173, 95% CI = -.330, -.016; p =.031), and with adjustment for maternal age and prenatal exposures to alcohol, tobacco, and marijuana (expressive language beta = -.175, 95% CI = -.347, -.003; p =.046). Additional child and caregiver environmental variables assessed at age 3 were also evaluated in varying statistical models with similar results.


CONCLUSIONS
The evidence from this study supports a gradient relationship between increased level of prenatal cocaine exposure and decreased expressive language functioning in preschool-aged cocaine-exposed children.
Morrow
Connie E
CE
Department of Pediatrics, University of Miami School of Medicine, Miami, Florida 33101, USA. cmorrow@med.miami.edu.
Vogel
April L
AL
Anthony
James C
JC
Ofir
Audrey Y
AY
Dausa
Ana T
AT
Bandstra
Emmalee S
ES
D002648:Child; D002663:Child Language; D016241:Child of Impaired Parents; D002675:Child, Preschool; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007807:Language Tests; D008297:Male; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D014705:Verbal Behavior