This study examined whether infant joint attention (JA) skills predicted social behaviors in a sample of at-risk preschool children (n = 30) with a history of prenatal exposure to cocaine. JA behaviors were assessed with the Early Social and Communication Scales at 12, 15, and 18 months of age. Three classes of JA were measured: Initiating JA (IJA), Responding to JA (RJA), and Requests. Behavioral outcomes were measured at 36 months and included ratings of disruptive and withdrawn behaviors and social competence. JA behaviors were related to behavioral outcomes after controlling for language and cognitive ability. The functionally distinct uses of JA were differentially related to behavioral outcome. IJA negatively predicted disruptive behaviors, whereas Requests positively predicted disruptive behaviors. Infant RJA negatively predicted withdrawn behaviors and positively predicted social competence. These results are interpreted in the context of competing theories that attempt to explain variability in the expression of JA skills in the second year of life.This research was partially supported by the Florida Department of Education and by a National Research Service Award from the National Institute on Drug Abuse (1 F32 DA05971-01). Portions of this paper, which was based on a dissertation submitted by the first author at the University of Miami, were presented at the biennial meeting of the Society for Research in Child Development in Albuquerque, NM, April 1999. The authors acknowledge the efforts of Joycelyn Lee for videotape coding and the teachers and staff at the Linda Ray Intervention Center, without whose commitment and efforts this research would not have been possible.

This study investigated the potential long-term effects of cocaine exposure on brain functioning using fMRI in school-aged children. The sample included 12 children with prenatal cocaine exposure and 12 non-exposed children (8–9 years old). Groups did not differ on IQ, socioeconomic status, or perinatal risk factors. A response inhibition task was administered during an fMRI scan using a 1.5-T MRI system. Task performance did not differentiate groups, but groups were differentiated by patterns of task-related brain activity. Cocaine-exposed children showed greater activation in the right inferior frontal cortex and caudate during response inhibition, whereas non-exposed children showed greater activations in temporal and occipital regions. These preliminary findings suggest that prenatal cocaine may affect the development of brain systems involved in the regulation of attention and response inhibition.

Background Prenatal cocaine exposure is a marker of developmental risk. Social environmental risk factors may include maternal stress and maternal perceptions of difficult infant temperament. Objectives To examine factors that may predict or moderate maternal ratings of parenting stress and difficult temperament in cocaine-exposed (CE) infants. Method Neonatal behavior, infant temperament, parenting stress, and maternal psychopathology were measured in a large sample of infant–mother dyads with prenatal CE and a nonexposed comparison sample. Participants were drawn from an existing longitudinal data set (Maternal Lifestyle Study). Result Relations between neonatal behavior and infant temperament ratings were moderated by mothers’ ratings of parenting stress. Relations between neonatal cry and parenting stress were moderated by maternal psychopathology ratings. Results were unrelated to drug exposure history. Conclusions For mothers of at risk infants (with or without prenatal CE), psychological distress affects the degree to which infant behavioral characteristics are experienced as stressful or difficult. Implications for treatment and outcome are discussed.