The school readiness of children born to mothers maintained on methadone during pregnancy.
Degree GrantorUniversity of Canterbury
Degree NameMaster of Arts
ABSTRACT Introduction. Research from the early 1980s indicates that there are different neurodevelopmental differences between methadone-exposed and non-exposed infants. However, the extent to which these difficulties translate to later problems in the domain areas of physical health, social-emotional adjustment, approaches to learning, language, and cognition for children born to mothers maintained on methadone during pregnancy, is largely unknown. Accordingly, this research aimed to compare school readiness outcomes between children prenatally exposed to methadone and comparison children at age 4.5 years across five key developmental domains. A secondary aim was to assess the impact of known neonatal, and socio-familial risk factors associated with this population on school readiness outcomes of methadone-exposed children at age 4.5 years. Research Methods. Sixty seven children born to mothers maintained on methadone and 81 comparison children were followed prospectively from birth to age 4.5 years. At age 4.5 years, all children underwent a comprehensive school readiness assessment of health and physical development; social-emotional skills; approaches to learning; language; and cognition. A score < 1SD below the comparison group mean was used to classify children as unready in any one domain. Measures of socio-familial risk were collated from aspects of the maternal interview at the term assessments, based on risk indices used in the research of other at-risk populations. Results. Methadone-exposed children performed worse than comparison children across all school readiness domains. They also had higher odds of being classed as “unready” in each school readiness domain, relative to the control group. They were also iii more likely to have multiple readiness problems (p =<.0001). The most common pattern of comorbidity identified, was among children classified as unready in terms of cognition and general knowledge. However, after controlling for confounding and selection factors, methadone-exposure was not significantly associated with school readiness at age 4.5 years. Maternal smoking during pregnancy, maternal benzodiazepine use during pregnancy, and socio-familial risk were significant covariates of low school readiness at age 4.5 years, independent of group. Discussion. By age 4.5 years, a larger proportion of methadone-exposed than control children were experiencing school readiness difficulties across five key developmental domains. Prenatal methadone exposure alone was not a sufficient explanation for these problems. Findings suggest that readiness outcomes were largely explained by a range of confounding and selection factors, including the extent of socio-familial risk, and poly-drug use during pregnancy. The results raise concerns for the later school performance of methadone-exposed children and emphasise the importance of early and targeted intervention services prior to school entry for this population.