Objectives-In this study, the authors aimed to examine the association of a range of blood lead l... more Objectives-In this study, the authors aimed to examine the association of a range of blood lead levels on language skills assessed at 4, 6, 10 and 12 years of age using a prospective longitudinal design controlling for potential confounding variables including maternal vocabulary, caregiver's psychological distress and symptomatology, child's race and prenatal drug exposure. Methods-The participants (N=278) were a subsample of a large longitudinal study that examined the association of prenatal drug exposure on children who were followed prospectively from birth and assessed for receptive and expressive language skills at 4, 6, 10 and 12 years of age. Blood lead levels were determined at 4-years of age by atomic absorption spectrometry. A mixed model approach with restricted maximum likelihood procedures was used to assess the association of lead on language outcomes. Results-Longitudinal mixed model analyses suggested a negative effect of lead exposure on both receptive and expressive language, with the adverse outcomes of lead exposure appearing to become more prominent at 10 and 12 years. Higher caregiver vocabulary was positively associated with child's language scores whereas caregiver psychological distress appeared to negatively affect language scores. Prenatal drug exposure was not related to the effects of lead on language skills. Conclusions-These findings suggest that elevated blood lead levels occurring early in life may be associated with poorer language skills at older ages. A language rich environment may minimize the negative influence of early lead exposure on language skills, with psychological distress seemingly exacerbating the negative outcome.
Deficits in sustained attention and impulsivity have previously been demonstrated in preschoolers... more Deficits in sustained attention and impulsivity have previously been demonstrated in preschoolers prenatally exposed to cocaine. We assessed an additional component of attention, selective attention, in a large, poly-substance cocaine-exposed cohort of 4 year olds and their at-risk comparison group. Employing postpartum maternal report and biological assay, we assigned children to overlapping exposed and complementary control groups for maternal use of cocaine, alcohol, marijuana, and cigarettes. Maternal pregnancy use of cocaine and use of cigarettes were both associated with increased commission errors, indicative of inferior selective attention. Severity of maternal use of marijuana during pregnancy was positively correlated with omission errors, suggesting impaired sustained attention. Substance exposure effects were independent of maternal postpartum psychological distress, birth mother cognitive functioning, current caregiver functioning, other substance exposures and child concurrent verbal IQ.
OCAINE READILY CROSSES THE placental and fetal brain barriers 1-3 and has a direct effect on the ... more OCAINE READILY CROSSES THE placental and fetal brain barriers 1-3 and has a direct effect on the developing fetal brain through alterations in the central monoamine systems and an indirect effect through maternal vascular disruptions. 4 Brain glucose metabolism is decreased in animal studies of cocaineexposed offspring, also potentially affecting neurodevelopment 5 and raising concerns about long-term cognitive outcomes. 6 A number of methodologically sound studies have found a relationship between fetal cocaine exposure and negative child developmental outcomes in the first years of life, 7-15 although others have not. 16,17 A few studies have documented outcomes in the later preschool or early school years. 17-20 Longterm studies are important because cocaine may have "sleeper" effects that are not detectable until complex functional abilities are measurable. 21,22 Compensatory mechanisms may ameliorate negative effects, 23 while environmental circumstances may exacerbate or minimize the sequelae of early brain insults. 18,24 Findings in studies with
Alcoholism: Clinical and Experimental Research, Apr 1, 2003
Background: Reports from clinical and experimental (animal) research converge on the suggestion t... more Background: Reports from clinical and experimental (animal) research converge on the suggestion that prenatal exposure to alcohol, cocaine, or marijuana undermines executive functioning (EF) and its neurological underpinnings. However, large, adequately controlled, prospective studies of alcohol and marijuana effects on EF have reported conflicting findings, and there have been no such studies of cocaine exposure. Methods: EF was investigated in a cohort (n ϭ 316) of 4-year-old children the majority of whose mothers had used varying combinations of cocaine, alcohol, and marijuana during pregnancy. With use of postpartum maternal report and biological assay, children were assigned to overlapping prenatal cocaine-exposed, alcohol-exposed, and marijuana-exposed groups and to complementary control groups. The postnatal environmental assessment included measures of maternal intellectual and psychosocial functioning, current drug or alcohol use, and home environment. Results: The children in the alcohol-exposed group had worse tapping-inhibition performance than children in the non-alcohol-exposed group, and this effect persisted when potential confounding environmental variables, other drug variables, and concurrent verbal intelligence were controlled for. Conclusions: Prenatal alcohol is predictive of decreased EF in early childhood that could not be attributed to environmental factors. The results are discussed in terms of the age and overall high-risk status of the children.
Structural equation modeling was used to simultaneously examine maternal psychological distress a... more Structural equation modeling was used to simultaneously examine maternal psychological distress and social support as mediators linking maternal childhood trauma (MCT) to both maternal and child-reported behavior at 9 years of age in 231 birth mother-child dyads, who were primarily poor, urban, and African American. One half of the mothers (n = 116) reported a history of childhood abuse and neglect. Although MCT was associated with both increased maternal psychological distress and limited social support at 6 years, the pathway to child behavior ratings at 9 years was informant dependent. MCT influenced maternal ratings of her child's behavior, with some effects mediated through psychological distress. MCT indirectly influenced children's self-perception of behavior through maternal experience of social support. Maternal ratings and child self-ratings of child behavior problems were moderately correlated. No significant gender interaction was found. Findings suggest a need for understanding trauma histories in the lives of mothers who seek assistance for parenting and child behavior problems, especially in urban low income communities. Interventions targeting both increasing maternal social support and reducing psychological distress may promote competency and resiliency among children for whom MCT poses a risk to optimal development. Keywords Maternal childhood abuse & neglect; child behavioral problems; maternal psychological distress; maternal social support; cross-informant Childhood abuse and neglect continue to be prevalent. The Fourth National Incidence Study of Child Abuse and Neglect (Sedlak et al., 2010) estimated that more than 1.25 million children experienced maltreatment in 2005-2006. A recent community survey reported that about 30% of women had experienced at least one form of childhood maltreatment, with
Methylenedioxymethamphetamine (MDMA, ectasy) is a widely used recreational drug affecting the ser... more Methylenedioxymethamphetamine (MDMA, ectasy) is a widely used recreational drug affecting the serotonergic system. Preclinical studies indicate learning/memory problems with fetal exposure. Human infant prenatal exposure was related to alterations in gender ratio and poorer motor development at 4 months.
Prenatal exposure to cocaine (PCE) may alter areas of the brain dense with monoamine receptors su... more Prenatal exposure to cocaine (PCE) may alter areas of the brain dense with monoamine receptors such as the prefrontal cortex and negatively affect cognitive processes implicated in executive function (EF). This study investigated the effects of PCE on EF at 12 and 15years. EF was examined in 189 PCE and 183 non-cocaine exposed (NCE) children who were primarily African American and of low socioeconomic status. Caregivers rated their child on the Behavior Rating Inventory of Executive Function (BRIEF) at ages 12 and 15. The BRIEF includes two summary scales and eight subscales: Behavioral Regulation Index (BRI) (Inhibit, Shift, and Emotion) and Metacognition Index (MI) (Monitor, Working Memory, Plan/Organize, Organization of Materials and Task Completion). Two additional measures were included at age 15 (BRIEF Self-Report and the CANTAB Stockings of Cambridge (SOC)). Girls with PCE were perceived by caregivers to have more behavioral regulation problems at age 12 (p<0.005) and more metacognitive problems at age 12 (p<0.003) than NCE females, but there was no association for males. PCE girls improved in behavioral regulation (p<0.05) and metacognition (p<0.04) from 12 to 15years compared to NCE girls based on caregiver report. By self-report PCE was associated with problems of inhibition (p<0.006). Girls with PCE performed more poorly on number of moves to complete the SOC, requiring planning and problem solving, than NCE girls. Prenatally cocaine exposed girls were perceived by caregivers as having problems of behavioral regulation, and by self-report, inhibitory control problems. Girls with PCE also performed more poorly on a task of planning and problem solving at age 15 which corresponded to caregiver report at age 12. Early assessment and remediation of these weaknesses in girls may improve school performance and behavior associated with poor EF.
s / Drug and Alcohol Dependence 140 (2014) e86–e168 e151 Active vaccination inhibits the acquisit... more s / Drug and Alcohol Dependence 140 (2014) e86–e168 e151 Active vaccination inhibits the acquisition of methamphetamine self-administration in rats Michelle L. Miller1, A.Y. Moreno2, S. Aarde1, K. Creehan1, K. Janda2, Michael A. Taffe1 1 Committee on the Neurobiology of Addictive Disorders, The Scripps Research Institute, La Jolla, CA, United States 2 Chemistry, Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA, United States Aims: d-Methamphetamine (METH) addiction is a serious public health concern for which successful treatment remains elusive. Immunopharmacotherapy has been shown to attenuate locomotor and thermoregulatory effects ofMETH. The aimof the current study was to investigate whether active vaccination against METH could alter intravenous METH self-administration in rats. Methods: Male Sprague-Dawley rats (N=24) were vaccinated with either a candidate anti-METH vaccine (MH6) or a control keyhole-limpet hemocyanin conjugate vaccine (KLH). Effects of vaccination on the acquisition of METH self-administration under 0.1mg/kg/inf and across a range of doses of METH (0, 0.01, 0.05, 0.20mg/kg/inf) during steady-state responding were investigated. Results: Active vaccination inhibited the acquisition of METH self-administration under the 0.1mg/kg/inf dose condition, with 66% of the MH6-vaccinated rats compared to 100% of the controls reaching criteria, and produced transient and dose-dependent effects on self-administration during the maintenance phase. Conclusions: These data demonstrate that active immunopharmacotherapy for METH inhibits the acquisition of METH selfadministration. Financial support: Supported by NIH/NIDA grant #DA024705. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.426 Behavioral adjustment in prenatally cocaine-exposed adolescents Meeyoung O. Min1, S. Minnes1, E.J. Short2, S. Yoon1, L.T. Singer3 1 Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States 2 Psychology, Case Western Reserve University, Cleveland, OH, United States 3 Environmental Health, Case Western Reserve University, Cleveland, OH, United States Aims: To assess differences in self-reported behavioral adjustment in prenatally cocaine exposed (PCE) andnon-cocaine exposed (NCE) adolescents at ages 12 and 15 years. Methods: Adolescents (N=371; 189 PCE, 182 NCE), primarily African-American and low socioeconomic status, were prospectively enrolled in a longitudinal study at birth (92% retention). The Youth Self-Report (YSR) was used to assess behavioral adjustment. A mixed model repeated measures analysis was used, controlling for covariates including other prenatal drug exposures and lead. Results: Adolescents with PCE reported greater externalizing problems (adjusted mean± SE: 49.9±0.78 vs. 47.3±0.76 at 12; 52.6±0.86 vs. 50.2±0.84 at 15) than NCE adolescents (p< .02) after control for covariates. PCE adolescents reported increased inattention at 15 year (59.4±0.68 vs. 57.3±0.67; p< .03) compared to NCE adolescents. No PCE effect on internalizing problems was found. All externalizing, internalizing, and attention problem scores increased from 12 to 15 years. Girls reported a greater increase in externalizing and internalizing problems from 12 to 15 years than boys. Greater maternal psychological distress was related to higher internalizing problems (p= .03). Greater parental monitoring was related to fewer externalizing problems; greater family conflict was related to more externalizing and attention problems;andgreaterviolenceexposurewas related tomoreexternalizing and internalizing problems. Prenatal marijuana exposure was related to inattention (p< .02). Marginal effects of prenatal alcohol on internalizing behavior (p= .07) and blood lead on inattention (p= .051) were found. Conclusions: PCE is related to externalizing problems and inattention in adolescence. Interventions focusing on strengthening parental monitoring and decreasing family conflict and violence exposure may be promising in reducing behavioral problems among high risk adolescents with PCE. Financial support: National Institute onDrug AbuseGrant R0107957. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.427 Executive function in children with prenatal cocaine exposure at 12 and 15 years Sonia Minnes1, Meeyoung O. Min1, E. Short3, M. Wu1, S. Yoon1, Lynn Singer2 1 Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States 2 School of Medicine, Case Western Reserve University, Cleveland, OH, United States 3 Psychology, Case Western Reserve University, Cleveland, OH, United States Aims: To examine between and within group differences in executive function (EF) in prenatally cocaine exposed (PCE) and non-cocaine exposed (NCE) children at 12 and 15 years of age. Methods: Three hundred seventy (188 PCE, 182 NCE), primarily African American, low socioeconomic status children participated in a prospective, longitudinal study. The Behavior Rating Inventory of Executive…
International Review of Research in Mental Retardation, 2004
Publisher Summary This chapter discusses prenatal drug exposure and mental retardation. Prenatal ... more Publisher Summary This chapter discusses prenatal drug exposure and mental retardation. Prenatal exposure to cocaine is a behavioral teratogen. The early “rush to judgement” that occurred with crack cocaine can be replaced by sound research. As is evident from studies of cocaine exposure, even in cases where no birth defects are obvious, long-term follow-up may be needed to detect and ameliorate neurobehavioral effects. At both the individual and the societal levels, even in situations where etiology and pathogenesis are well-known, developmental disorders such as mental retardation do not emerge as a result of a single factor or at a single point in development. Neither a prenatal teratogenic environment nor a postnatal rearing environment model of development following prenatal cocaine exposure has total explanatory power. At each stage in development, the human brain is uniquely susceptible to exposure of teratogenic compounds. It is also readily apparent that prevention and treatment of conditions arising from exposure to teratogenic substances will be largely dictated by the stage or stages in which the exposure occurs. The chapter discusses several drawbacks of the traditional etiological classification of mental retardation—prenatal, perinatal, or postnatal.
Highlights Prenatal cocaine/polydrug exposure (PCE) may lead to substance (SUDs) through associ... more Highlights Prenatal cocaine/polydrug exposure (PCE) may lead to substance (SUDs) through associated cognitive deficits and early substance use. PCE and non-exposed adolescents were compared on cognitive functions and drug use. PCE adolescents had deficits in Perceptual Reasoning IQ and visual attention.
Journal of Speech Language and Hearing Research, Oct 1, 2013
Purpose-In this study, the authors aimed to examine the long-term effects of prenatal cocaine exp... more Purpose-In this study, the authors aimed to examine the long-term effects of prenatal cocaine exposure (PCE) on the language development of 12-year-old children using a prospective design, controlling for confounding prenatal drug exposure and environmental factors. Method-Children who were exposed to cocaine in utero (PCE; n = 183) and children who were not exposed to cocaine (i.e., no cocaine exposure [NCE]; n = 181) were followed prospectively from birth to 12 years of age and were compared on language subtests of the Test of Language Development-Intermediate, Third Edition (Hammill & Newcomer, 1997b), and phonological processing as measured by the Comprehensive Test of Phonological Processing (Wagner & Torgesen, 1999). The authors evaluated the relationship of PCE to language development through a multivariate analysis of covariance and regression analyses while controlling for confounders. Results-Results show that PCE has small effects on specific aspects of language, including syntax and phonological processing. The caregiver variables of lower maternal vocabulary, more psychological symptoms, and a poorer home environment also had consistent effects on language and phonological processing scores. Conclusions-These findings suggest that PCE continues to have small, subtle effects on specific aspects of language at age 12 years. Phonological processing skills were significantly related to the reading outcomes of letter-word identification, reading fluency, and reading comprehension, indicating that PCE also has small but lasting effects on the language skills that are related to later literacy skills. Keywords cocaine; phonological processing; reading outcomes; language outcomes; home environment; teratology; adolescents Researchers have conducted studies examining the effects of prenatal cocaine exposure (PCE) on language skills in children for more than two decades, with some contradictory or at least equivocal results. In the early 1990s, case reports suggested that preschool children
Differences in caregiver reported executive function in 12-year-old children who were prenatally ... more Differences in caregiver reported executive function in 12-year-old children who were prenatally exposed to cocaine (PCE) compared to children who were not prenatally exposed to cocaine (NCE) were assessed. One hundred and sixty-nine PCE and 169 NCE, primarily African-American, low socioeconomic status children participated in a prospective longitudinal study. The Behavior Rating Inventory of Executive Function (BRIEF) Parent Form was administered. Two broadband BRIEF scores (Behavioral Regulation Index (BRI) and Metacognition Index (MI)) and a summary Global Executive Composite (GEC) were computed. Multiple and logistic regression analyses were used to assess the effects of amount of PCE on executive function, controlling for covariates including caregiver (rater) psychological distress, child's gender and other prenatal drug exposure variables. After adjustment for covariates, amount of PCE was associated with the GEC and two MI subscales, Plan/Organize and Monitor, with heavier exposure associated with more problems of executive function. An amount of PCE by gender interaction revealed amount of PCE effects in other remaining subscales of the MI (Initiate, Working Memory, and Organization of Materials) only among girls. Head circumference did not mediate the effects of cocaine on outcomes. Higher current caregiver psychological distress levels were independently associated with poorer ratings on the executive function scales. Assessment and targeted interventions to improve metacognitive processes are recommended for girls who were prenatally exposed to cocaine.
The impact of early postnatal lead exposure measured at age 4 on children's IQ and academic achie... more The impact of early postnatal lead exposure measured at age 4 on children's IQ and academic achievement at 4, 9, and 11 years of age was examined. The sample consisted of 278 inner-city, primarily African American children who were polydrug exposed prenatally. Regression analyses indicated a linear effect of lead exposure on outcomes and no moderating effects of polydrug exposure. An IQ loss of about 4.1-5.4 Full Scale IQ points was estimated for each 10 ug/dl increase in blood lead level at ages 4, 9, and 11 years as a function of blood lead level at age 4. Decrements in scores on tests of non-verbal reasoning were consistently associated with higher lead levels at age 4, while verbal decrements became apparent only at age 11. Lower reading summary scores at 9 and 11 years were consistently associated with higher lead exposure, while decrements in mathematics were not apparent until 11 years. Subgroup analyses on children with blood lead levels < 10 μg/dL showed detrimental lead effects even at the 5 μg/dL level, providing additional evidence of adverse effects occurring at blood lead levels below the current 10 μg/dL public health blood lead action level.
Objectives-In this study, the authors aimed to examine the association of a range of blood lead l... more Objectives-In this study, the authors aimed to examine the association of a range of blood lead levels on language skills assessed at 4, 6, 10 and 12 years of age using a prospective longitudinal design controlling for potential confounding variables including maternal vocabulary, caregiver's psychological distress and symptomatology, child's race and prenatal drug exposure. Methods-The participants (N=278) were a subsample of a large longitudinal study that examined the association of prenatal drug exposure on children who were followed prospectively from birth and assessed for receptive and expressive language skills at 4, 6, 10 and 12 years of age. Blood lead levels were determined at 4-years of age by atomic absorption spectrometry. A mixed model approach with restricted maximum likelihood procedures was used to assess the association of lead on language outcomes. Results-Longitudinal mixed model analyses suggested a negative effect of lead exposure on both receptive and expressive language, with the adverse outcomes of lead exposure appearing to become more prominent at 10 and 12 years. Higher caregiver vocabulary was positively associated with child's language scores whereas caregiver psychological distress appeared to negatively affect language scores. Prenatal drug exposure was not related to the effects of lead on language skills. Conclusions-These findings suggest that elevated blood lead levels occurring early in life may be associated with poorer language skills at older ages. A language rich environment may minimize the negative influence of early lead exposure on language skills, with psychological distress seemingly exacerbating the negative outcome.
Deficits in sustained attention and impulsivity have previously been demonstrated in preschoolers... more Deficits in sustained attention and impulsivity have previously been demonstrated in preschoolers prenatally exposed to cocaine. We assessed an additional component of attention, selective attention, in a large, poly-substance cocaine-exposed cohort of 4 year olds and their at-risk comparison group. Employing postpartum maternal report and biological assay, we assigned children to overlapping exposed and complementary control groups for maternal use of cocaine, alcohol, marijuana, and cigarettes. Maternal pregnancy use of cocaine and use of cigarettes were both associated with increased commission errors, indicative of inferior selective attention. Severity of maternal use of marijuana during pregnancy was positively correlated with omission errors, suggesting impaired sustained attention. Substance exposure effects were independent of maternal postpartum psychological distress, birth mother cognitive functioning, current caregiver functioning, other substance exposures and child concurrent verbal IQ.
OCAINE READILY CROSSES THE placental and fetal brain barriers 1-3 and has a direct effect on the ... more OCAINE READILY CROSSES THE placental and fetal brain barriers 1-3 and has a direct effect on the developing fetal brain through alterations in the central monoamine systems and an indirect effect through maternal vascular disruptions. 4 Brain glucose metabolism is decreased in animal studies of cocaineexposed offspring, also potentially affecting neurodevelopment 5 and raising concerns about long-term cognitive outcomes. 6 A number of methodologically sound studies have found a relationship between fetal cocaine exposure and negative child developmental outcomes in the first years of life, 7-15 although others have not. 16,17 A few studies have documented outcomes in the later preschool or early school years. 17-20 Longterm studies are important because cocaine may have "sleeper" effects that are not detectable until complex functional abilities are measurable. 21,22 Compensatory mechanisms may ameliorate negative effects, 23 while environmental circumstances may exacerbate or minimize the sequelae of early brain insults. 18,24 Findings in studies with
Alcoholism: Clinical and Experimental Research, Apr 1, 2003
Background: Reports from clinical and experimental (animal) research converge on the suggestion t... more Background: Reports from clinical and experimental (animal) research converge on the suggestion that prenatal exposure to alcohol, cocaine, or marijuana undermines executive functioning (EF) and its neurological underpinnings. However, large, adequately controlled, prospective studies of alcohol and marijuana effects on EF have reported conflicting findings, and there have been no such studies of cocaine exposure. Methods: EF was investigated in a cohort (n ϭ 316) of 4-year-old children the majority of whose mothers had used varying combinations of cocaine, alcohol, and marijuana during pregnancy. With use of postpartum maternal report and biological assay, children were assigned to overlapping prenatal cocaine-exposed, alcohol-exposed, and marijuana-exposed groups and to complementary control groups. The postnatal environmental assessment included measures of maternal intellectual and psychosocial functioning, current drug or alcohol use, and home environment. Results: The children in the alcohol-exposed group had worse tapping-inhibition performance than children in the non-alcohol-exposed group, and this effect persisted when potential confounding environmental variables, other drug variables, and concurrent verbal intelligence were controlled for. Conclusions: Prenatal alcohol is predictive of decreased EF in early childhood that could not be attributed to environmental factors. The results are discussed in terms of the age and overall high-risk status of the children.
Structural equation modeling was used to simultaneously examine maternal psychological distress a... more Structural equation modeling was used to simultaneously examine maternal psychological distress and social support as mediators linking maternal childhood trauma (MCT) to both maternal and child-reported behavior at 9 years of age in 231 birth mother-child dyads, who were primarily poor, urban, and African American. One half of the mothers (n = 116) reported a history of childhood abuse and neglect. Although MCT was associated with both increased maternal psychological distress and limited social support at 6 years, the pathway to child behavior ratings at 9 years was informant dependent. MCT influenced maternal ratings of her child's behavior, with some effects mediated through psychological distress. MCT indirectly influenced children's self-perception of behavior through maternal experience of social support. Maternal ratings and child self-ratings of child behavior problems were moderately correlated. No significant gender interaction was found. Findings suggest a need for understanding trauma histories in the lives of mothers who seek assistance for parenting and child behavior problems, especially in urban low income communities. Interventions targeting both increasing maternal social support and reducing psychological distress may promote competency and resiliency among children for whom MCT poses a risk to optimal development. Keywords Maternal childhood abuse & neglect; child behavioral problems; maternal psychological distress; maternal social support; cross-informant Childhood abuse and neglect continue to be prevalent. The Fourth National Incidence Study of Child Abuse and Neglect (Sedlak et al., 2010) estimated that more than 1.25 million children experienced maltreatment in 2005-2006. A recent community survey reported that about 30% of women had experienced at least one form of childhood maltreatment, with
Methylenedioxymethamphetamine (MDMA, ectasy) is a widely used recreational drug affecting the ser... more Methylenedioxymethamphetamine (MDMA, ectasy) is a widely used recreational drug affecting the serotonergic system. Preclinical studies indicate learning/memory problems with fetal exposure. Human infant prenatal exposure was related to alterations in gender ratio and poorer motor development at 4 months.
Prenatal exposure to cocaine (PCE) may alter areas of the brain dense with monoamine receptors su... more Prenatal exposure to cocaine (PCE) may alter areas of the brain dense with monoamine receptors such as the prefrontal cortex and negatively affect cognitive processes implicated in executive function (EF). This study investigated the effects of PCE on EF at 12 and 15years. EF was examined in 189 PCE and 183 non-cocaine exposed (NCE) children who were primarily African American and of low socioeconomic status. Caregivers rated their child on the Behavior Rating Inventory of Executive Function (BRIEF) at ages 12 and 15. The BRIEF includes two summary scales and eight subscales: Behavioral Regulation Index (BRI) (Inhibit, Shift, and Emotion) and Metacognition Index (MI) (Monitor, Working Memory, Plan/Organize, Organization of Materials and Task Completion). Two additional measures were included at age 15 (BRIEF Self-Report and the CANTAB Stockings of Cambridge (SOC)). Girls with PCE were perceived by caregivers to have more behavioral regulation problems at age 12 (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.005) and more metacognitive problems at age 12 (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.003) than NCE females, but there was no association for males. PCE girls improved in behavioral regulation (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) and metacognition (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.04) from 12 to 15years compared to NCE girls based on caregiver report. By self-report PCE was associated with problems of inhibition (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.006). Girls with PCE performed more poorly on number of moves to complete the SOC, requiring planning and problem solving, than NCE girls. Prenatally cocaine exposed girls were perceived by caregivers as having problems of behavioral regulation, and by self-report, inhibitory control problems. Girls with PCE also performed more poorly on a task of planning and problem solving at age 15 which corresponded to caregiver report at age 12. Early assessment and remediation of these weaknesses in girls may improve school performance and behavior associated with poor EF.
s / Drug and Alcohol Dependence 140 (2014) e86–e168 e151 Active vaccination inhibits the acquisit... more s / Drug and Alcohol Dependence 140 (2014) e86–e168 e151 Active vaccination inhibits the acquisition of methamphetamine self-administration in rats Michelle L. Miller1, A.Y. Moreno2, S. Aarde1, K. Creehan1, K. Janda2, Michael A. Taffe1 1 Committee on the Neurobiology of Addictive Disorders, The Scripps Research Institute, La Jolla, CA, United States 2 Chemistry, Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA, United States Aims: d-Methamphetamine (METH) addiction is a serious public health concern for which successful treatment remains elusive. Immunopharmacotherapy has been shown to attenuate locomotor and thermoregulatory effects ofMETH. The aimof the current study was to investigate whether active vaccination against METH could alter intravenous METH self-administration in rats. Methods: Male Sprague-Dawley rats (N=24) were vaccinated with either a candidate anti-METH vaccine (MH6) or a control keyhole-limpet hemocyanin conjugate vaccine (KLH). Effects of vaccination on the acquisition of METH self-administration under 0.1mg/kg/inf and across a range of doses of METH (0, 0.01, 0.05, 0.20mg/kg/inf) during steady-state responding were investigated. Results: Active vaccination inhibited the acquisition of METH self-administration under the 0.1mg/kg/inf dose condition, with 66% of the MH6-vaccinated rats compared to 100% of the controls reaching criteria, and produced transient and dose-dependent effects on self-administration during the maintenance phase. Conclusions: These data demonstrate that active immunopharmacotherapy for METH inhibits the acquisition of METH selfadministration. Financial support: Supported by NIH/NIDA grant #DA024705. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.426 Behavioral adjustment in prenatally cocaine-exposed adolescents Meeyoung O. Min1, S. Minnes1, E.J. Short2, S. Yoon1, L.T. Singer3 1 Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States 2 Psychology, Case Western Reserve University, Cleveland, OH, United States 3 Environmental Health, Case Western Reserve University, Cleveland, OH, United States Aims: To assess differences in self-reported behavioral adjustment in prenatally cocaine exposed (PCE) andnon-cocaine exposed (NCE) adolescents at ages 12 and 15 years. Methods: Adolescents (N=371; 189 PCE, 182 NCE), primarily African-American and low socioeconomic status, were prospectively enrolled in a longitudinal study at birth (92% retention). The Youth Self-Report (YSR) was used to assess behavioral adjustment. A mixed model repeated measures analysis was used, controlling for covariates including other prenatal drug exposures and lead. Results: Adolescents with PCE reported greater externalizing problems (adjusted mean± SE: 49.9±0.78 vs. 47.3±0.76 at 12; 52.6±0.86 vs. 50.2±0.84 at 15) than NCE adolescents (p< .02) after control for covariates. PCE adolescents reported increased inattention at 15 year (59.4±0.68 vs. 57.3±0.67; p< .03) compared to NCE adolescents. No PCE effect on internalizing problems was found. All externalizing, internalizing, and attention problem scores increased from 12 to 15 years. Girls reported a greater increase in externalizing and internalizing problems from 12 to 15 years than boys. Greater maternal psychological distress was related to higher internalizing problems (p= .03). Greater parental monitoring was related to fewer externalizing problems; greater family conflict was related to more externalizing and attention problems;andgreaterviolenceexposurewas related tomoreexternalizing and internalizing problems. Prenatal marijuana exposure was related to inattention (p< .02). Marginal effects of prenatal alcohol on internalizing behavior (p= .07) and blood lead on inattention (p= .051) were found. Conclusions: PCE is related to externalizing problems and inattention in adolescence. Interventions focusing on strengthening parental monitoring and decreasing family conflict and violence exposure may be promising in reducing behavioral problems among high risk adolescents with PCE. Financial support: National Institute onDrug AbuseGrant R0107957. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.427 Executive function in children with prenatal cocaine exposure at 12 and 15 years Sonia Minnes1, Meeyoung O. Min1, E. Short3, M. Wu1, S. Yoon1, Lynn Singer2 1 Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States 2 School of Medicine, Case Western Reserve University, Cleveland, OH, United States 3 Psychology, Case Western Reserve University, Cleveland, OH, United States Aims: To examine between and within group differences in executive function (EF) in prenatally cocaine exposed (PCE) and non-cocaine exposed (NCE) children at 12 and 15 years of age. Methods: Three hundred seventy (188 PCE, 182 NCE), primarily African American, low socioeconomic status children participated in a prospective, longitudinal study. The Behavior Rating Inventory of Executive…
International Review of Research in Mental Retardation, 2004
Publisher Summary This chapter discusses prenatal drug exposure and mental retardation. Prenatal ... more Publisher Summary This chapter discusses prenatal drug exposure and mental retardation. Prenatal exposure to cocaine is a behavioral teratogen. The early “rush to judgement” that occurred with crack cocaine can be replaced by sound research. As is evident from studies of cocaine exposure, even in cases where no birth defects are obvious, long-term follow-up may be needed to detect and ameliorate neurobehavioral effects. At both the individual and the societal levels, even in situations where etiology and pathogenesis are well-known, developmental disorders such as mental retardation do not emerge as a result of a single factor or at a single point in development. Neither a prenatal teratogenic environment nor a postnatal rearing environment model of development following prenatal cocaine exposure has total explanatory power. At each stage in development, the human brain is uniquely susceptible to exposure of teratogenic compounds. It is also readily apparent that prevention and treatment of conditions arising from exposure to teratogenic substances will be largely dictated by the stage or stages in which the exposure occurs. The chapter discusses several drawbacks of the traditional etiological classification of mental retardation—prenatal, perinatal, or postnatal.
Highlights Prenatal cocaine/polydrug exposure (PCE) may lead to substance (SUDs) through associ... more Highlights Prenatal cocaine/polydrug exposure (PCE) may lead to substance (SUDs) through associated cognitive deficits and early substance use. PCE and non-exposed adolescents were compared on cognitive functions and drug use. PCE adolescents had deficits in Perceptual Reasoning IQ and visual attention.
Journal of Speech Language and Hearing Research, Oct 1, 2013
Purpose-In this study, the authors aimed to examine the long-term effects of prenatal cocaine exp... more Purpose-In this study, the authors aimed to examine the long-term effects of prenatal cocaine exposure (PCE) on the language development of 12-year-old children using a prospective design, controlling for confounding prenatal drug exposure and environmental factors. Method-Children who were exposed to cocaine in utero (PCE; n = 183) and children who were not exposed to cocaine (i.e., no cocaine exposure [NCE]; n = 181) were followed prospectively from birth to 12 years of age and were compared on language subtests of the Test of Language Development-Intermediate, Third Edition (Hammill & Newcomer, 1997b), and phonological processing as measured by the Comprehensive Test of Phonological Processing (Wagner & Torgesen, 1999). The authors evaluated the relationship of PCE to language development through a multivariate analysis of covariance and regression analyses while controlling for confounders. Results-Results show that PCE has small effects on specific aspects of language, including syntax and phonological processing. The caregiver variables of lower maternal vocabulary, more psychological symptoms, and a poorer home environment also had consistent effects on language and phonological processing scores. Conclusions-These findings suggest that PCE continues to have small, subtle effects on specific aspects of language at age 12 years. Phonological processing skills were significantly related to the reading outcomes of letter-word identification, reading fluency, and reading comprehension, indicating that PCE also has small but lasting effects on the language skills that are related to later literacy skills. Keywords cocaine; phonological processing; reading outcomes; language outcomes; home environment; teratology; adolescents Researchers have conducted studies examining the effects of prenatal cocaine exposure (PCE) on language skills in children for more than two decades, with some contradictory or at least equivocal results. In the early 1990s, case reports suggested that preschool children
Differences in caregiver reported executive function in 12-year-old children who were prenatally ... more Differences in caregiver reported executive function in 12-year-old children who were prenatally exposed to cocaine (PCE) compared to children who were not prenatally exposed to cocaine (NCE) were assessed. One hundred and sixty-nine PCE and 169 NCE, primarily African-American, low socioeconomic status children participated in a prospective longitudinal study. The Behavior Rating Inventory of Executive Function (BRIEF) Parent Form was administered. Two broadband BRIEF scores (Behavioral Regulation Index (BRI) and Metacognition Index (MI)) and a summary Global Executive Composite (GEC) were computed. Multiple and logistic regression analyses were used to assess the effects of amount of PCE on executive function, controlling for covariates including caregiver (rater) psychological distress, child's gender and other prenatal drug exposure variables. After adjustment for covariates, amount of PCE was associated with the GEC and two MI subscales, Plan/Organize and Monitor, with heavier exposure associated with more problems of executive function. An amount of PCE by gender interaction revealed amount of PCE effects in other remaining subscales of the MI (Initiate, Working Memory, and Organization of Materials) only among girls. Head circumference did not mediate the effects of cocaine on outcomes. Higher current caregiver psychological distress levels were independently associated with poorer ratings on the executive function scales. Assessment and targeted interventions to improve metacognitive processes are recommended for girls who were prenatally exposed to cocaine.
The impact of early postnatal lead exposure measured at age 4 on children's IQ and academic achie... more The impact of early postnatal lead exposure measured at age 4 on children's IQ and academic achievement at 4, 9, and 11 years of age was examined. The sample consisted of 278 inner-city, primarily African American children who were polydrug exposed prenatally. Regression analyses indicated a linear effect of lead exposure on outcomes and no moderating effects of polydrug exposure. An IQ loss of about 4.1-5.4 Full Scale IQ points was estimated for each 10 ug/dl increase in blood lead level at ages 4, 9, and 11 years as a function of blood lead level at age 4. Decrements in scores on tests of non-verbal reasoning were consistently associated with higher lead levels at age 4, while verbal decrements became apparent only at age 11. Lower reading summary scores at 9 and 11 years were consistently associated with higher lead exposure, while decrements in mathematics were not apparent until 11 years. Subgroup analyses on children with blood lead levels < 10 μg/dL showed detrimental lead effects even at the 5 μg/dL level, providing additional evidence of adverse effects occurring at blood lead levels below the current 10 μg/dL public health blood lead action level.
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Papers by Lynn Singer