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Poverty Impairs Problem-Solving Abilities in Children

From the WebMD Archives

Dec. 21, 1999 (Los Angeles) -- Researchers studying the effects of cocaine use during pregnancy on a baby's future learning abilities have found that children from underprivileged, inner-city families fared poorly on a problem-solving test whether or not they were exposed to the drug in the womb.

"Either there's no drug effect, or it's being overpowered by being an inner-city child," senior author Hallam Hurt, MD, tells WebMD.

The study is the latest on two groups of children monitored since birth by Hurt and her colleagues at Albert Einstein Medical Center in Philadelphia. All children were born to mothers living in poverty.

Children in the first group were born to mothers with no history of cocaine abuse and negative results on drug-screening tests. Children in the second group, considered cocaine-exposed, were born to mothers reporting a history of cocaine abuse and testing positive on screening tests.

In all, over 200 children were enrolled at birth. This study, published in the Journal of Developmental and Behavioral Pediatrics, evaluated more than 150 of the children at three-and-a-half years of age. Of those subjects, 129 were evaluated again one year later.

Each child played with the Goodman Lock Box, a large red box with 10 locked compartments, each containing a toy of interest to a toddler. It's designed to help assess problem-solving skills in preschoolers. The children were invited to open the compartments and play with the toys, as examiners watched and rated them on three behavioral components: aimless actions, competence, and mental organization.

Both groups of children achieved similar scores in all three categories. However, their mental organization scores were significantly lower than those of a standardized sample of preschoolers not living in poverty. Mental organization is needed for higher learning later in life. In addition, Hurt says, the children under study had IQs of only 79-80, significantly lower than the average score of 100.

These findings, Hurt says, "are fitting into a pattern that is somewhat repetitive and concerning. I was disheartened when we did this study, but not surprised."

What's more, she says, these deficits seem to persist: she has data showing that by the time they reach first grade, 21% of these children either are held back or placed in special-education classes.

Poverty in and of itself may create a less stable home environment with fewer opportunities for stimulation, says Hurt, who leads the division of neonatology. She cites studies showing that even a seemingly minor feature such as a newspaper in the home implies a more enriched setting that promotes better child development.

A newspaper is "a marker that someone in that home is still trying to learn," says Fonda Davis Eyler, PhD, a professor of pediatrics at the University of Florida in Gainesville. "We can surmise that in a poverty situation, where a parent may be trying to hold down more than one job or caring for a lot of children and there's not enough to make ends meet, they may not have the time or the energy or the resources to provide a more stimulating environment for a child."

Studies like this one "tell me that environment is important," Eyler adds. "Programs like good subsidized day care could make a difference." Health care providers, she says, are in a good position to refer high-risk families for help.

Hurt suggests that school might be the most likely place to intervene. "When we first get ahold of the child, which is usually when they enter the school system, we have to start working on self-esteem issues and resiliency, to give the child tools for social competence."

Vital Information:

  • According to a new study, children from poor, inner-city families performed poorly on a problem-solving test regardless of whether they were exposed to cocaine in the womb.
  • Problem-solving deficits seem to persist into school age, with 21% of these children being held back or being placed in special education classes by first grade.
  • Results may indicate that poverty can create a less stable environment for children with fewer opportunities for stimulation.