Executive function in children with prenatal cocaine exposure (12-15 years)

- This study compared prenatally cocaine exposed to non-exposed teens on executive function at 12 and 15 years.
- Girls with prenatal cocaine exposure had more executive function problems at 12 years than non-cocaine exposed girls.
- There were no cocaine effects for self-reported executive function summary scores.
- Girls with prenatal cocaine exposure took more moves on the Stockings of Cambridge (SOC) than non-cocaine-exposed girls.
- Prenatally cocaine-exposed girls showed the greatest caregiver reported executive function improvements from 12 to 15 years.

PurposePrenatal exposure to cocaine (PCE) may alter areas of the brain dense with monoamine receptors such as the prefrontal cortex and negatively affect cognitive processes implicated in executive function (EF). This study investigated the effects of PCE on EF at 12 and 15 years.MethodsEF was examined in 189 PCE and 183 non-cocaine exposed (NCE) children who were primarily African American and of low socioeconomic status. Caregivers rated their child on the Behavior Rating Inventory of Executive Function (BRIEF) at ages 12 and 15. The BRIEF includes two summary scales and eight subscales: Behavioral Regulation Index (BRI) (Inhibit, Shift, and Emotion) and Metacognition Index (MI) (Monitor, Working Memory, Plan/Organize, Organization of Materials and Task Completion). Two additional measures were included at age 15 (BRIEF Self-Report and the CANTAB Stockings of Cambridge (SOC)).ResultsGirls with PCE were perceived by caregivers to have more behavioral regulation problems at age 12 (p < 0.005) and more metacognitive problems at age 12 (p < 0.003) than NCE females, but there was no association for males. PCE girls improved in behavioral regulation (p < 0.05) and metacognition (p < 0.04) from 12 to 15 years compared to NCE girls based on caregiver report. By self-report PCE was associated with problems of inhibition (p < 0.006). Girls with PCE performed more poorly on number of moves to complete the SOC, requiring planning and problem solving, than NCE girls.ConclusionPrenatally cocaine exposed girls were perceived by caregivers as having problems of behavioral regulation, and by self-report, inhibitory control problems. Girls with PCE also performed more poorly on a task of planning and problem solving at age 15 which corresponded to caregiver report at age 12. Early assessment and remediation of these weaknesses in girls may improve school performance and behavior associated with poor EF.