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Within-Group Differences

Dena Hofkosh, MD; Janice L. Pringle, PhD; Holly P. Wald, PhD; JoAnn Switala, MPA; Stacey A. Hinderliter, MD; Sara C. Hamel, MD

Arch Pediatr Adolesc Med. 1995;149(6):665-672.

Abstract
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.

(Arch Pediatr Adolesc Med. 1995;149:665-672)

Author Affiliations
From the Departments of Pediatrics (Drs Hofkosh and Hamel) and Psychiatry (Ms Switala), the University of Pittsburgh (Pa) School of Medicine, and the Center for Chemical Dependency and Treatment, St Francis Medical Center, Pittsburgh (Drs Pringle, Wald, and Hinderliter).

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