Head Start Children at Risk: Relationship of Prenatal Drug Exposure to Identification of Special Needs and Subsequent Special Education Kindergarten Placement.

* At both national and local levels, prenatal drug abuse and the problems associated with it are increasing, and they have serious implications for the future educational needs of the children who are affected (Bingol, Fuchs, Diaz, Stone, & Gromisch, 1987; Cole et al., 1991; Vincent, Brown, & Getz-Sheflel, 1981). The behaviors seen in preschool children who were exposed to drugs prenatally appear to be the result of a constellation of risk factors resulting from possible organic damage and ongoing environmental instability (Howard, Beckwith, Rodning, & Kropenske, 1989). An estimated 11% to 15% of the babies born in the United States today were exposed in utero to alcohol and illicit drugs (Poulsen,1991). Generalizations about children who were prenatally drug exposed are troublesome (Chasnoff, 1993; Chasnoff, Griffith, Freier, & Murray, 1992; Dixon, 1992; Hoegerman, Wilson, Thurmond, & Schnoll, 1990). There is no typical profile of a drug-exposed child; each child must be assessed and educated with particular attention to his or her individual strengths and vulnerabilities. Accurately grouping children according to the drug to which they were exposed or to the frequency and timing of exposure during fetal development has been difficult (Wilens, Biederman, Kiely, Bredin, & Spencer, 1995). Determining the prevalence of prenatal drug exposure is difficult. There is disagreement on what constitutes prenatal drug exposure in terms of the specific drug and frequency of exposure. Medical records or verification of drug exposure usually are not obtained from parents at the time of Head Start registration. Consequently, there is little data on how many children with a history of prenatal drug exposure are served in Head Start programs (U.S. Department of Education, 1991). There is even less information regarding the status of these preschoolers at the time of transition into kindergarten (Silver et al., 1992). This difficulty, however, does not preclude the profound implications of prenatal drug exposure for later educational needs (Vincent, Poulsen, Cole, Woodruff, & Griffith, 1991). Existing research on the early development of children who were exposed to drugs prenatally can be divided into three general classifications: infant studies, toddler studies, and preschool studies. Because of problems inherent in long-term follow-up studies, such as cost and subject availability, there is a paucity of research that prospectively follows drug-exposed infants into the preschool years and beyond (Bauer, 1991). Long-term effects of prenatal drug exposure on the social and emotional development of children remains unclear (Ciocchetti, 1987, 1990). Because the effects of prenatal drug use are varied, the continuum of impairment can range from minimal to severe across all domains (Poulsen, 1991). Studies also have demonstrated that risk factors such as continued parental substance abuse, poor prenatal care, adverse perinatal events, community violence, crime, child abuse and neglect, and poverty confound the estimation of long-term effects of prenatal drug exposure (Bays, 1990; Osofsky & Fenichel, 1996). While organic deficits caused by prenatal exposure to drugs cannot always be remediated, and immunity against adverse child-rearing conditions cannot always be created, high-quality educational intervention services appear to be able to improve a child's self-esteem, self-control, and developmental progress significantly (Del'Homme, Kasari, Forness, & Bagley, 1996; Epstein, Cullinan, Quinn, & Cumblad, 1994; Sinclair,1993). The literature on prenatal drug exposure and children's behavior in preschool has tended to focus on children with multiple and/or severe disabilities (Ellison, Prasse, Siewert, & Browning, 1983; McKey et al., 1985; Peters & Deiner, 1987). However, there is a large group of preschoolers who were exposed to illicit drugs prenatally that the literature has ignored (MacKnight & Waterman, 1992). …