COSTS INCREASE AS CRACK BABIES MATURE

Crack cocaine burst into the national consciousness in 1985 amid cries that
babies born with cocaine in their systems would be a lost generation
weighing heavy on every taxpayer's pocketbook.

Fifteen years later, with tens of thousands of those babies in school, how
much of that is true?

The number of crack cocaine babies peaked in Illinois in 1994 with 3,553
such births, but is nowhere near over: There were 1,535 cocaine-exposed
babies reported in the state last year, 1,331 in Cook County. How many of
the births were in suburbs is unknown.

Whether being a cocaine baby leads to life-threatening disorders later in
life is unclear.

A former cocaine baby, 13-year-old Leanna Dorsett, collapsed and died last
week in her Chicago school. A Cook County medical examiner's autopsy was
inconclusive.

"A general feeling among neonatologists and pediatricians who continue to
follow these babies beyond 3 or 4 or 5 years of age is that these babies do
have neurobehavioral abnormalities," said Dr. Dharmapuri Vidyasagar of the
University of Illinois at Chicago Hospital.

Dr. Ira Chasnoff of Evanston, a nationally known expert on perinatal
development, said these problems often are subtle, hard to diagnose, and
require costly, long-term efforts to help the children learn and achieve.

A study done for the National Institute on Drug Abuse, an arm of the
National Institutes of Health, estimated that based on maternal
self-reporting, 45,000 cocaine-exposed children are born each year.

But many hospitals in prosperous areas refuse to test mothers and babies for
the presence of abusive substances, and the U.S. General Accounting Office
puts the figure at 375,000, based on reviews of hospital records.

Brown University researchers in a 1998 study--the latest available--estimate
that 80,000 cocaine babies born each year will have subtle brain damage
resulting in lower IQs and greater problems with language abilities.

The study said they need special education services costing $352 million a
year.

"If you look at the figures nationally, 80 percent of the children in foster
care are there because of substance abuse problems in the family, most often
during pregnancy," Chasnoff said.

No one can say what those costs are in Illinois because no one knows how
many cocaine-addiction births go unreported, and because DCFS often does not
tell a foster or adoptive parent that a child was a cocaine baby.

Studies done when cocaine-exposed babies were 3 years old showed their
intellectual development was normal, if you allowed for the environment in
which they were raised, Chasnoff said.

But when children reached the age of 6 and could take more sophisticated
tests, many problems were found in their social, emotional and behavioral
development.

"We saw children who had short attention span, difficulty staying on task,
more impulsive behavior, more aggressive behavior, more distractability,"
Chasnoff said.

He said these behaviors "can be traced back to the neurochemical changes in
the brain that have been demonstrated in animal studies and translate
directly into our findings on children." These studies have shown that
cocaine cuts down on the number of dopamine receptors in the brain. These
receptors are at the heart of the body's ability to ignore outside
distractions.

Chasnoff and a team of 25 people at the Child Study Center in the Loop work
with nearly a thousand children a year, seeking ways to help them change
their behavior so that they can learn and get along with others.

With one little boy who couldn't sit still but always jumped up and ran
around, "we worked with the school to create a space for this child that was
marked off with masking tape.

Any time during the school day, he could go back to that area of the room
and pace--he couldn't yell and scream--until he could calm himself." The
area was steadily decreased, and by the end of the year the child was able
to sit on a chair and calm himself.

The idea, Chasnoff said, is that when the body has lost the automatic
ability to shut out distraction, the child must be taught how to shut it out
intellectually instead.

Little Leanna's shaky start made life quite a challenge

Delores Dorsett smoked herself into labor on a crack cocaine binge. Doctors
tried to stop it, but two days later, on Mother's Day, 1986, her daughter
Leanna was born.

Like many cocaine babies, Leanna was born with problems, the greatest being
she was three months premature, and weighed 1 pound, 13 ounces. She lost
several fingers from the umbilical cord wrapping tightly around them and
cutting off the blood. She had a club foot. She was so damaged that doctors
had to test her blood to determine she was a girl.

I met Leanna and her mother that autumn. On Fridays, we would go together to
Northwestern University's Perinatal Dependency Clinic. Delores Dorsett had
an addict's openness. She would answer any question, and slowly it dawned on
me that she had spent her life talking to officials, and I was now one of
them.

When I first saw Leanna, she was 3 months old and weighed 5 pounds, 6
ounces--underweight for a newborn. She was a shocking baby, with huge,
desperate eyes that bored into you. While the terrible cocaine withdrawal at
birth had passed, she was still jittery when you held her, writhing and
crying and fussing, though her doctor wasn't sure if it was due to the
cocaine or being born prematurely.

Her mother was then 30 years old and had seven children. Leanna wasn't her
only child harmed by cocaine. Nor did Leanna's birth end Delores' addiction.
When Leanna came home from the hospital after nearly three months of
intensive care, Delores prepared for the occasion by smoking crack.

For more than a dozen years, I thought about Leanna Dorsett. Wondered what
became of her. She was such a small spark of life, facing hard odds, right
off the bat. Beaten up in the womb.

My naive optimism told me that everything would be all right. I would wait a
decent interval of years--and those years just snap by--until she was 18, or
maybe even 21. And then I would swoop back into her life and find out.

I truly believed, or hoped anyway, that she would be a college senior
somewhere, bright, vivacious, the missing fingers the only hint that she had
to battle her way into this unhappy world.

Would it be fair of me, I often wondered, to present myself at all? This
unexpected person, the observer, exploding into her life to tell her that
her mother was a drug addict, that she had to be swaddled tightly to give
her the sense of security that most babies have naturally but cocaine babies
have lost, a balm to her shattered nerves?

I pondered the matter from time to time. But really there was no rush. The
years still stretched ahead. Maybe she would appreciate learning the truth.
To have mysteries finally illuminated. Maybe she would resent it. Who could
tell? I always believe that the truth helps. But what if your truth is an
awful truth?

That debate doesn't matter now. Leanna Dorsett collapsed and died last week
in her classroom at Garrett Morgan Elementary School, where she was in the
seventh grade.

"She was a beautiful young lady," said her foster mother of six years,
Claudette Winters. "She liked to dance. She liked music. She liked all her
classes."

She said the Illinois Department of Children and Family Services never told
her that Leanna was a cocaine baby.

"No, they didn't," Winters said.

That's par for the course for DCFS. Sometimes they tell the parents.
Sometimes they don't.

"It would depend on the case," said Audrey Finkel, the deputy chief of
communications for DCFS.

Leanna's foster mother should have been told.

"Absolutely," said Dr. Ira Chasnoff, who treated Leanna as a baby and is now
president of Children's Research Triangle, an independent organization
working with high risk and drug-exposed children. "Any family who is asked
to foster or adopt a child needs to have a complete history. It has
tremendous implications for the child's ongoing health and education. So
even if the child is perfectly healthy, but having behavior problems, you
can understand the behavior in context. So often we see children put on
medication--Ritalin is an easy out--when what they need is a specific type
of therapeutic approach to help manage their behaviors."

The medical examiner's office said Friday that autopsy results are
inconclusive. And while experts don't know that being a cocaine baby could
cause a 13-year-old to die suddenly, it certainly might.

"We know early on that children exposed prenatally to cocaine have an
increased rate of cardiac arrhythmias," Chasnoff said. "We've followed a
bunch of children and found they have cleared up by 6 months of age. We have
not found any of the children having them at an older age. But I think it's
possible."

Leanna Dorsett was buried Thursday. Her classmates and teachers remembered
her not as someone who was dealt an unfair blow, but as a beautiful child
whose inherent goodness managed to shine through adversity.

"There's a lot of broken hearts at the school," said public schools CEO Paul
Vallas. "The principal is a veteran, and she's distraught."

The principal, Dr. Inez G. Walton, wept as she spoke of Leanna.

"She was still a little wide-eyed girl, a very cordial child, well-mannered,
well-dressed," Walton said. "She was a loving child, she tried to please.
Everybody just really cared about her because of that. She had problems in
terms of academics, because she was physically challenged. She had a lot of
operations. But she was a child who would hug. She was just a joy to have in
the school, truly a joy. I've lost children before, and all of it hurts. But
not like this. This just shook everybody. The engineering staff. The people
in the lunchroom. They loved her. This little girl touched everyone in that
school like she was an angel on a mission and her mission was to touch
people, and she did."