Academic journal article Communication Disorders Quarterly

Strategies for Addressing the Executive Function Impairments of Students Prenatally Exposed to Alcohol and Other Drugs

Academic journal article Communication Disorders Quarterly

Strategies for Addressing the Executive Function Impairments of Students Prenatally Exposed to Alcohol and Other Drugs

Article excerpt

Students who have been exposed prenatally to alcohol or other drugs are susceptible to a range of developmental problems-from mild to severe. In this article, the authors review critical learning and behavioral problems of children exposed prenatally to alcohol and other drugs, with a specific focus on executive function deficits. They discuss various risk factors associated with prenatal drug exposure so that educators may better understand the nature of the problem and choose more effective classroom interventions that address the executive function deficits of these students. Many of the suggested interventions are also appropriate for developing executive functioning in students with attention-deficit disorders, traumatic brain injury, autism, and other disorders associated with deficits in executive functions.

Currently, there is nation-wide concern that the use of illicit drugs has reached epidemic proportions. The growing number of children affected by exposure to alcohol and other drugs is especially troubling. According to the U.S. Department of Health and Human Services (1996), approximately 5.5% of all pregnant women use an illicit drug during their pregnancy.

Despite the magnitude of the problem, our knowledge regarding the effects of maternal drug use remains limited. Research has described numerous negative effects on infants and young children of maternal alcohol and other drug use (Bateman & Chiriboga, 2000; Chiriboga, Brust, Bateman, & Hauser, 1999; Gottwald & Thurman, 1994; Sinclair, 1998; Vathy, 1995). Many problems are not apparent during infancy but surface when a child is older (Hans, 1996). For example, neurobehavioral problems may go undetected until the child is required to perform more cognitively demanding tasks, which often does not occur until he or she enters school (Watson & Westby, 2003). Children exposed to alcohol and other drugs are susceptible to a range of developmental problems that can negatively influence the learning process.

Few researchers have explored the long-term effects of prenatal drug exposure on school-age children and adults. In one recent study, learning difficulties identified in first-grade children who had been exposed prenatally to alcohol were still observed at 11 and 14 years of age (Carmichael-Olson et al., 1997). Other investigators have suggested that IQ scores may not truly reflect potential deficits in attention, memory, executive function, motor development, and auditory information-processing skills that individuals who were exposed prenatally may have (Arendt, Agelopoulos, Salvator, & Singer, 1999; Connor, Sampson, Bookstein, Barr, & Streissguth, 2000; Kerns, Don, Mateer, & Streissguth, 1997; Potter, Zelazo, Stack, & Papageorgious, 2000; Watson & Westby, 2003). These studies have supported the idea that not all students who have been exposed prenatally have low intellectual ability. They also suggest that the effects of prenatal drug exposure (e.g., executive function deficits) are subtler than might be expected, indicating that these individuals cannot be evaluated adequately on the basis of IQ measures or facial features alone (Connor et al., 2000; Faden & Gruabard, 2000).

A variety of coexisting factors places students who have been prenatally exposed to alcohol and other drugs at risk for developmental delays (Johnson, Seikel, Madison, Foose, & Rinard, 1997; Kodituwakku, Kalberg, & May, 2001; Mayes, 1996; Mentis & Lundgren, 1995). In addition to the biological changes related to the direct effects of alcohol and other drugs on the developing nervous system, environmental factors--such as deficient parenting skills, maltreatment, poor nutrition, poverty, an unpredictable and unstable home environment, and low educational achievement levels of parents--place these students at an even greater risk for having physical, cognitive, academic, social, and emotional problems (Azuma & Chasnoff, 1993; Griffith, 1992; Hans, 1996; Leventhal et al. …

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