Early interactions between drug-involved mothers and infants. Within-group differences
D. Hofkosh, J. L. Pringle, H. P. Wald, J. Switala, S. A. Hinderliter and S. C. Hamel
Department of Pediatrics, University of Pittsburgh, School of Medicine, Pa, USA.
OBJECTIVE: To explore differences in maternal characteristics,
mother-infant interaction, and infant development within a group of women
who used cocaine, alcohol, and tobacco during pregnancy and their infants.
DESIGN: Prospective survey. SETTING: Countywide, voluntary, home-based
clinical intervention program. PARTICIPANTS: Thirty-two mother-infant pairs
identified through a risk-assessment screen who participated in the program
for 1 year. VARIABLES: Maternal characteristics, neonatal characteristics,
interactional measures (Nursing Child Assessment Feeding Scale and Home
Observation for Measurement of the Environment scale), and developmental
assessment (Bayley Scales of Infant Development at 1 year). RESULTS: The
majority of women were black, single, and unemployed. Fifteen (47%) of the
infants were born prematurely; four (13%) were small for gestational age.
Mean Bayley Scales of Infant Development scores were as follows: the mental
development index was 99.8, and the psychomotor development index was
102.4. Older mothers (r = .41, P = .04), mothers of higher parity (r = .42,
P = .02), and mothers who were more actively involved in the program (r =
.41, P = .04) had higher scores on the Nursing Child Assessment Satellite
Training Feeding Scale. Mothers who were better educated (r = .49, P =
.009) and mothers who were more active in the program (r = .44, P = .02)
had higher scores on the Home Observation for Measurement of the
Environment scale. Several of the subscales of the Home Observation for
Measurement of the Environment scale were significantly associated with
scores on the Bayley Scales of Infant Development. CONCLUSIONS: For this
group of substance-exposed infants whose mothers were receiving support
services, developmental skills at 1 year were age appropriate. Despite drug
abuse and poverty, there was some variability in the ability of mothers to
provide a developmentally supportive environment for their infants. Those
who were better organized to support infant development had infants who
performed better on global developmental assessments.
