Project CARE(Cocaine Abuse in the Rural Environment)

这项竞争性更新的目的是确定产前可卡因暴露对暴露的 从小学过渡到中学的后代。本研究将评估 产前可卡因暴露量、其他药物暴露量、照顾者 心理社会功能和环境质量对孩子的影响。我们团队的优势 是：当妇女进入产前保健系统时登记的受试者，提供一系列产前保健 和药物使用; 2）收集的关于使用量和时间的广泛数据; 3）目标和对照组 使用最小化用户错误分类的策略建立; 4）来自众多 在产前收集到7岁的兴趣领域，平均随访率为93%， 存活队列; 5）在所有时间点对儿童进行盲法评估; 6） 可卡因的选择是快克，他唯一的其他非法药物接触是大麻。混合方面 可卡因毒性的致畸模型与儿童发育的交易模型导致 我们假设10-13岁的产前接触可卡因的儿童 表现出特定的神经心理，行为和心理社会缺陷，其程度被修改 暴露量和持续的环境影响。我们建议继续收集数据 在这一周期中，儿童、照顾者和环境都受到更大的重视。每个孩子 将在10岁和12岁时使用以下领域的测量进行盲测：认知/智力; 记忆/学习;语言;注意力和其他执行功能;行为;学业成绩和 功能;心理功能。将在家中评估护理人员/家庭环境 在每次儿童评估之前进行的访问。最后，孩子们会被反复采访 在整个研究中，以确定他们的心理社会功能和发展，他们的看法， 压力生活事件和支持性活动和关系。这项研究将提供重要的 关于产前接触可卡因对发育中儿童的影响的资料，包括查明 受可卡因影响的具体结果，并澄清产前接触量的影响， 持续被动暴露它还将提供一个描述的交易影响可卡因接触， 其他风险因素（以及可能的保护因素）有助于儿童从 从幼儿期到青春期前。

The goal ofthis competitive renewal is to identify the effect ofprenatal cocaine exposure on exposed offspring making the transition from elementary school to the middle school years. This study will evaluate the possible combined effects of amount ofprenatal cocaine exposure, other drug exposure, caregiver psychosocial functioning and the quality ofthe environment on the child's outcome. Strengths ofour cohort are: Ijsubjects enrolled when women entered the prenatal care system, providing a range ofprenatal care and drug use; 2) extensive data collected on amount and timing ofuse; 3)target and control groups established using a strategy that minimized misclassification ofusers; 4) extensive data from numerous domains ofinterest collected prenatally through age 7, with an average follow-up rate of 93% of the surviving cohort; 5) blinded assessments of child at all timepoints; 6) the uniqueness of a sample whose cocaine ofchoice was crack and whose only other illegal drug exposure was marijuana. Blending aspectsof the teratogenic model for the toxicity ofcocaine with the transactional model for child development leads to a refinement ofour hypotheses that prenatally cocaine-exposed children between the ages of 10-13 will manifest specific neuropsychological, behavioral, and psychosocial deficits, the extent to which are modified by the amount of exposure and on-going environmental influences. Wepropose to continue to collect data on the child, caregiver, and environment with a heavier emphasis on the child during this cycle. Each child will be blindly assessed at ages 10 and 12 using measures ofthe following domains: cognition/intelligence; memory/learning; language; attention and other executive functions; behavior; school achievement and functioning; and psychosocial functioning. The caregiver/familyenvironment will be evaluated during home visits which take place prior to each child assessment. Finally, the children will be repeatedly interviewed throughout the study to determine their psychosocial functioning and development, their perception of stressful life events and supportive activities and relationships. The proposed study will provide vital information regarding effects ofprenatal cocaine exposure on the developing child, including identification of specific outcomes affected by cocaine and clarification of the effect of amount of prenatal exposure and ongoing passive exposure. It will also provide a description ofthe transactional effects cocaine exposure and other risk factors (as well as possible protective factors) contribute to outcomes as the child transitions from early childhood to pre-adolescence.