title: The effects of prenatal cocaine on language development at 10 years of age.
abstract: OBJECTIVE
  To examine the long term effects of prenatal cocaine exposure (PCE) on the language development of 10-year-old children utilizing a prospective design, controlling for confounding drug and environmental factors.
  
  
  METHODS
  Children exposed to cocaine in utero (PCE; n=175) and non-exposed children (NCE; n=175) were followed prospectively to 10years of age and were compared on language subscales of the Test of Language Development-Intermediate 3rd Edition (TOLD-I:3) and phonological processing as measured by the Comprehensive Test of Phonological Processing (CTOPP).
  
  
  METHODS
  Multivariate analysis of covariance (MANCOVA), linear regression, and logistic regressions were used to evaluate the relationship of prenatal cocaine exposure to language development, while controlling for confounders.
  
  
  RESULTS
  After controlling for confounding variables, prenatal cocaine effects were observed for specific aspects of language including syntax (Sentence Combining subtest of the TOLD-I:3, p=0.001), semantics (Malopropism subtest of the TOLD-I:3, p=0.05) and phonological processing (Phonological Awareness subscale, p=0.01). The caregiver factors of vocabulary, HOME, and psychological symptoms also had consistent effects on language subtests and phonological processing scores. Children with PCE who experienced foster or adoptive care had enhanced language development compared to those living with birth mothers or in relative care. Cocaine exposed girls had lower scores on the phonological awareness subscale of the CTOPP than non-exposed girls.
  
  
  CONCLUSIONS
  PCE has subtle effects on specific aspects of language development and phonological processing at age 10, even after controlling for confounding variables. Environmental factors (i.e., postnatal lead exposure, home environment, and caregiver vocabulary and psychological symptoms) also impact language skills at 10years. Adoptive or foster care appears to enrich PCE children's linguistic environment and protects children against language delay in the PCE sample.
authors.affiliation: Department of Communication Sciences, Case Western Reserve University, Cleveland, OH 44106, USA. bxl@case.edu
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Lewis
authors.forename: Sonia
authors.initials: S
authors.lastname: Minnes
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Short
authors.forename: Paul
authors.initials: P
authors.lastname: Weishampel
authors.forename: Sudtida
authors.initials: S
authors.lastname: Satayathum
authors.forename: Meeyoung O
authors.initials: MO
authors.lastname: Min
authors.forename: Suchitra
authors.initials: S
authors.lastname: Nelson
authors.forename: Lynn T
authors.initials: LT
authors.lastname: Singer
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003042:Cocaine / Q000633:toxicity*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007804:Language Development; D007805:Language Development Disorders / Q000139:chemically induced* / Q000523:psychology; D007807:Language Tests; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000523:psychology*; D011446:Prospective Studies; D012737:Sex Factors; D012931:Social Environment
chemical_list: D003042:Cocaine