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产前可卡因暴露儿童的精神病理学和特殊教育入学。

Psychopathology and special education enrollment in children with prenatal cocaine exposure.

机构信息

Department of Psychiatry, Alpert Brown Medical School and Women and Infants Hospital, Providence, RI 02905, USA.

出版信息

J Dev Behav Pediatr. 2012 Jun;33(5):377-86. doi: 10.1097/DBP.0b013e3182560cd9.

Abstract

OBJECTIVE

This study evaluated how enrollment in special education services in 11-year-old children relates to prenatal cocaine exposure (PCE), psychopathology, and other risk factors.

METHODS

Participants were 498 children enrolled in The Maternal Lifestyle Study, a prospective, longitudinal, multisite study examining outcomes of children with PCE. Logistic regression was used to examine the effect of PCE and psychopathology on enrollment in an individualized education plan (IEP; a designation specific to children with special education needs), with environmental, maternal, and infant medical variables as covariates.

RESULTS

PCE, an interaction of PCE and oppositional defiant disorder, child attention-deficit hyperactivity disorder, parent-reported internalizing behaviors, and teacher-reported externalizing behaviors, predicted enrollment in an IEP. Other statistically significant variables in the model were male gender, low birth weight, being small for gestational age, white race, caregiver change, low socioeconomic status, low child intelligence quotient, caregiver depression, and prenatal marijuana exposure.

CONCLUSIONS

PCE increased the likelihood of receiving an IEP with adjustment for covariates. Psychopathology also predicted this special education outcome, in combination with and independent of prenatal cocaine exposure.

摘要

目的

本研究评估了 11 岁儿童特殊教育服务的入学率与产前可卡因暴露(PCE)、精神病理学和其他风险因素之间的关系。

方法

参与者为 498 名参加母婴生活方式研究的儿童,该研究是一项前瞻性、纵向、多地点研究,旨在研究 PCE 儿童的结局。使用逻辑回归来检验 PCE 和精神病理学对个别化教育计划(IEP;专门针对有特殊教育需求的儿童的指定)入学的影响,将环境、产妇和婴儿医疗变量作为协变量。

结果

PCE、PCE 和对立违抗性障碍的相互作用、儿童注意力缺陷多动障碍、父母报告的内化行为以及教师报告的外化行为预测了 IEP 的入学率。模型中其他具有统计学意义的变量包括男性、低出生体重、小于胎龄、白种人、照顾者变化、低社会经济地位、低儿童智商、照顾者抑郁和产前大麻暴露。

结论

在调整协变量后,PCE 增加了接受 IEP 的可能性。精神病理学也预测了这一特殊教育结果,与产前可卡因暴露相结合且独立于其存在。

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