POVERTY HAS GREATER IMPACT THAN COCAINE ON YOUNG BRAIN

NEW YORK, Dec 06 (Reuters Health) -- Poverty has a greater negative
impact on the ability of a young child`s brain to focus, organize, and
problem-solve than exposure to cocaine before birth, according to US
researchers.

``The findings are overwhelming and persistent -- there may be a drug
effect, but it`s totally overshadowed by poverty,`` said study lead
author Dr. Hallam Hurt, the chairman of the division of neonatology at
the Albert Einstein Medical Center in Philadelphia, Pennsylvania. The
report is published in the December issue of The Journal of
Developmental and Behavioral Pediatrics.

Hurt`s team studied the mental development of over 200 children from
birth to 4.5 years, with regular general evaluations and the
administration at ages 3.5 and 4.5 of a task-oriented, nonverbal
organizational test utilizing the ``Goodman Lock Box`` -- a colorful,
large, toy-filled box with compartments, rows, and lockable doors. All
of the children were born full-term to families of low-income
backgrounds who were receiving state medical assistance, but only half
had been repeatedly and frequently exposed to cocaine before birth.

The researchers found that poor children exposed to cocaine prenatally
performed similarly to poor children not exposed to cocaine, and both
low-income groups were well below the test standard for normal
behavior as based on a prior study of mixed-income children.

``A decade ago, the cocaine-exposed child was stereotyped as being
neurologically crippled -- trembling in a corner and irreparably
damaged,`` recalled Hurt in an interview with Reuters Health. ``But
this is unequivocally not the case. And furthermore, the inner-city
child who has had no drug exposure at all is doing no better than the
child labeled a `crack-baby,``` he added.

`The problem is in the inner-city home, but it`s not a questions of
bricks and mortar,`` Hurt said. ``These children simply haven`t been
exposed to a whole variety of experiences,`` pointing out that certain
things and activities one might find in a higher income family
environment -- such as books, newspapers, communal family meals, and
travel -- are often absent or uncommon in lower income households.

Hurt explained that in terms of poverty`s effects, the focus needs to
be on the parenting skills of low-income caregivers in the present,
rather than on cocaine abuse in the past. ``No one thinks cocaine is a
good idea, but one must also remember that babies are resilient,``
Hurt said. ``And if you label a child and they carry that picture of
severe neurological damage, then people do not give them the attention
they need. That child deserves the same attention as any other child
- -- and the inner-city child in particular desperately needs attention,
and early!``

Hurt remains hopeful that whether or not a child has been exposed to
cocaine before birth, intervention after birth in the parent-child
relationship can have a positive effect. ``So we encourage young
physicians not just to look at the growth and development of
low-income children but of the parents as well. Parents should
encourage children to talk, and then listen to them and praise them
and put their pictures up on the fridge because it shows they
appreciate the child. It`s a complex problem, but simple things like
this are important."