Читать книгу Lifespan Development - Tara L. Kuther - Страница 169

1 In your view, is substance use during pregnancy a form of abuse? Why or why not?

2 What do you think could be done to reduce the prevalence of substance use by pregnant women?

Although it was once believed that cocaine- and heroin-exposed infants would suffer lifelong cognitive deficits, research suggests more subtle effects (Behnke & Smith, 2013; Lambert & Bauer, 2012). Prenatal cocaine or heroin exposure has a small but lasting effect on attention and behavioral control, as well as language skills through late childhood (Singer, Minnes, Min, Lewis, & Short, 2015; Viteri et al., 2015). In adolescence, prenatal exposure to cocaine is associated with behavior problems and substance use (Min, Minnes, Yoon, Short, & Singer, 2014; Richardson, Goldschmidt, Larkby, & Day, 2015).

The challenge of determining the effects of prenatal exposure to cocaine and heroin is that most cocaine- and heroin-exposed infants were also exposed to other substances, including tobacco, alcohol, and marijuana, making it difficult to isolate the effect of each drug on prenatal development. We must be cautious in interpreting findings about illicit drug use and the effects on prenatal development because many other contextual factors often co-occur with parental substance use and also pose risks for development. These risks include poverty, malnutrition, inconsistent parenting, stress, and diminished parental responsiveness (Smith et al., 2016). For example, parents who abuse drugs tend to provide poorer quality care, a home environment less conducive to cognitive development, and parent–child interaction that is less sensitive and positive than the environments provided by other parents (Hatzis, Dawe, Harnett, & Barlow, 2017). Children raised by substance-abusing parents are at risk for being subjected to overly harsh discipline and lack of supervision as well as disruptions in care due to factors such as parental incarceration, inability to care for a child, and even death (e.g., from a drug overdose or violence).

At the same time, quality care can lessen the long-term impact of prenatal exposure to substances (Calhoun, Conner, Miller, & Messina, 2015). Some evidence suggests, for example, that developmental differences in exposed infants are reduced and often disappear when medical and environmental factors are considered (Behnke & Smith, 2013). Disentangling the long-term effects of prenatal exposure to substances, subsequent parenting, and contextual factors is challenging. Researchers and health care providers who construct interventions must address the contextual and parenting-related risk factors to improve the developmental outlook for children exposed to drugs prenatally. The accompanying Applying Developmental Science feature examines the difficulties of addressing maternal drug use in the legal system.