Importance of stability of early living arrangements on behavior outcomes of children with and without prenatal drug exposure.
OBJECTIVE
We evaluated whether living arrangements of children with or without prenatal drug exposure would be associated with their behavior outcomes and adaptive functioning.


METHODS
A total of 1388 children with or without prenatal cocaine or opiate exposure were enrolled in a longitudinal cohort study at 1 month of age, were seen at intervals, tracked over time for their living situation, and evaluated for behavior problems and adaptive functioning at 3 years of age. The Child Behavior Checklist and Vineland Adaptive Behavior Scales were administered. Using multiple regression models, we determined the factors that would predict behavior problems and adaptive functioning.


RESULTS
Of the children enrolled, 1092 children were evaluated. Total and externalizing behavior problems T scores of children in relative care were lower (better) than those in parental care; externalizing behavior scores were lower than those in nonrelative care (p < .05). Total behavior problem scores increased 2.3 and 1.3 points, respectively, with each move per year and each year of Child Protective Services involvement. Compared to children in nonrelative care, those in parental or relative care had higher (better) scores in the Vineland Adaptive Behavior Scales total composite (p < .023), communication (p < .045), and daily living (p < .001). Each caretaker change was associated with a decrease of 2.65 and 2.19 points, respectively, in communication and daily living scores.


CONCLUSIONS
Children's living arrangements were significantly associated with childhood behavior problems and adaptive functioning. The instability of living situation was also a significant predictor of these outcomes. While family preservation continues to be the goal of the child welfare system, expediting decision toward permanency remains paramount once children are placed in foster care.
Bada
Henrietta S
HS
Department of Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky 40536, USA. hbada2@uky.edu
Langer
John
J
Twomey
Jean
J
Bursi
Charlotte
C
Lagasse
Linda
L
Bauer
Charles R
CR
Shankaran
Seetha
S
Lester
Barry M
BM
Higgins
Rosemary
R
Maza
Penelope L
PL
D002653:Child Behavior Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002655:Child Custody; D002669:Child Welfare; D002675:Child, Preschool; D003042:Cocaine / Q000633:toxicity*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology; D005191:Family Characteristics; D005260:Female; D005581:Foster Home Care / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007389:Internal-External Control; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009294:Narcotics / Q000633:toxicity*; D016487:Parenting / Q000523:psychology; D010552:Personality Assessment; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D012917:Social Adjustment; D012931:Social Environment; D014481:United States
D009294:Narcotics; D003042:Cocaine