Topley J, Windsor D, Williams R
Department of Community Child Health, United Bristol Healthcare Trust, Bristol, UK.
Child Care Health Dev. 2008 Jan;34(1):71-6. doi: 10.1111/j.1365-2214.2007.00768.x.
The long-term consequences of intrauterine exposure to Class A drugs are still relatively undocumented, and much of the literature relates to the North American experience, where cocaine use predominates. In Britain, heroin and amphetamine use is more common and, within Britain, patterns of drug use vary. Clearly the long-term educational and welfare needs of these children will be enhanced if the behavioural, developmental and child-care outcomes are known. This study attempts to explore some of these issues.
The developmental, behavioural and child protection outcomes in a group of 62 children exposed to Class A drugs in utero were investigated when the children were in full-time schooling.
Seventy-four per cent (46/62) of the children at the time of the study had no educational or behavioural problems, and 11 (17.7%) were receiving extra support in school. No child had a statement of special educational need. Twelve (19.3%) were reported to have behaviour and concentration problems, and in four cases, this was attributed to poor-quality parenting at the time of the study. Three of the 12 children had fetal alcohol syndrome. Twenty-six (42%) children were placed on the Child Protection Register, and care orders or residence orders were granted for 22 (35.5%) of those who were placed on the register. All of the 22 children went into substitute care at some stage. Of these children, nine were adopted and 10 were placed permanently with other family members. Ten of the 62 (16.1%) children at the time of the study were of concern to professionals for child protection reasons, and four of them were on the Child Protection Register.
This study suggests we can be reasonably optimistic about the developmental and behavioural outcomes for children exposed to Class A drugs in utero. Over 50% required an intervention by social services, and 31% were in substitute care at the time of the study. There were continuing child protection concerns in 16% at school entry.
子宫内接触 A 类药物的长期后果仍相对缺乏文献记载，且大部分文献涉及以可卡因使用为主的北美经验。在英国，海洛因和苯丙胺的使用更为普遍，而且在英国国内，吸毒模式也各不相同。显然，如果了解这些儿童的行为、发育和儿童保育结果，他们长期的教育和福利需求将会增加。本研究试图探讨其中的一些问题。
对一组 62 名在子宫内接触 A 类药物的儿童在全日制上学时的发育、行为和儿童保护结果进行了调查。
在研究时，74%（46/62）的儿童没有教育或行为问题，11 名（17.7%）儿童在学校接受额外支持。没有儿童有特殊教育需求声明。据报告，12 名（19.3%）儿童有行为和注意力问题，其中 4 例归因于研究时的不良养育方式。12 名儿童中有 3 名患有胎儿酒精综合征。26 名（42%）儿童被列入儿童保护登记册，登记册上的 22 名（35.5%）儿童获得了照管令或居住令。所有 22 名儿童在某个阶段都进入了替代照料机构。在这些儿童中，9 名被收养，10 名被永久安置在其他家庭成员处。在研究时，62 名儿童中有 10 名（16.1%）因儿童保护原因受到专业人员关注，其中 4 名在儿童保护登记册上。
本研究表明，我们可以对子宫内接触 A 类药物的儿童的发育和行为结果持合理乐观态度。超过 50%的儿童需要社会服务机构进行干预，研究时 31%的儿童处于替代照料机构。入学时仍有 16%的儿童存在儿童保护问题。
