Levine Todd P, Liu Jing, Das Abhik, Lester Barry, Lagasse Linda, Shankaran Seetha, Bada Henrietta S, Bauer Charles R, Higgins Rosemary
Department of Pediatrics, Warren Alpert Medical School, Brown University, Providence, Rhode Island 02905, USA.
Pediatrics. 2008 Jul;122(1):e83-91. doi: 10.1542/peds.2007-2826. Epub 2008 Jun 9.
The objective of this study was to evaluate the effects of prenatal cocaine exposure on special education at age 7 with adjustment for covariates.
As part of the prospective, longitudinal, multisite study of children with prenatal cocaine exposure (Maternal Lifestyle Study), school records were reviewed for 943 children at 7 years to determine involvement in special education outcomes: (1) individualized education plan; (2) special education conditions; (3) support services; (4) special education classes; and (5) speech and language services. Logistic regression was used to examine the effect of prenatal cocaine exposure on these outcomes with environmental, maternal, and infant medical variables as covariates, as well as with and without low child IQ.
Complete data for each analysis model were available for 737 to 916 children. When controlling for covariates including low child IQ, prenatal cocaine exposure had a significant effect on individualized education plan. When low child IQ was not included in the model, prenatal cocaine exposure had a significant effect on support services. Male gender, low birth weight, white race, and low child IQ also predicted individualized education plan. Low birth weight and low child IQ were significant in all models. White race was also significant in speech and language services. Other covariate effects were model specific. When included in the models, low child IQ accounted for more of the variance and changed the significance of other covariates.
Prenatal cocaine exposure increased the likelihood of receiving an individualized education plan and support services, with adjustment for covariates. Low birth weight and low child IQ increased the likelihood of all outcomes. The finding that white children were more likely to get an individualized education plan and speech and language services could indicate a greater advantage in getting educational resources for this population.
本研究的目的是评估产前可卡因暴露对7岁儿童特殊教育的影响,并对协变量进行调整。
作为产前可卡因暴露儿童前瞻性、纵向、多地点研究(母亲生活方式研究)的一部分,对943名7岁儿童的学校记录进行了审查,以确定其特殊教育结果的参与情况:(1)个性化教育计划;(2)特殊教育条件;(3)支持服务;(4)特殊教育课程;(5)言语和语言服务。使用逻辑回归分析产前可卡因暴露对这些结果的影响,将环境、母亲和婴儿医学变量作为协变量,同时考虑有无低儿童智商的情况。
每个分析模型的完整数据适用于737至916名儿童。在控制包括低儿童智商在内的协变量时,产前可卡因暴露对个性化教育计划有显著影响。当模型中不包括低儿童智商时,产前可卡因暴露对支持服务有显著影响。男性、低出生体重、白人种族和低儿童智商也可预测个性化教育计划。低出生体重和低儿童智商在所有模型中均具有显著性。白人种族在言语和语言服务中也具有显著性。其他协变量效应因模型而异。当纳入模型时,低儿童智商占方差的比例更大,并改变了其他协变量的显著性。
在对协变量进行调整后,产前可卡因暴露增加了接受个性化教育计划和支持服务的可能性。低出生体重和低儿童智商增加了所有结果的可能性。白人儿童更有可能获得个性化教育计划和言语及语言服务这一发现可能表明该人群在获取教育资源方面具有更大优势。