I'd like to add a caveat to the "3 IQ" point differential between the
children in the study who were cocaine exposed.  Recent work by Ira Chasnoff
et al. has shown that once one has corrected for socioeconomic status and
comparable groups are studied (children in the same neighborhood, same
ethnicity) there is no significant difference in IQ.

He points out that the problems with drug exposed children is BEHAVIORAL not
COGNITIVE.

Please also keep in mind that none of the studies look at Cocaine use only.
Most women who use substances do polysubstance abuse (Alcohol, Tobacco, other
drugs).  It is Alcohol and Tobacco that appear to cause the most significant
deficits in cognitive ability.

A great reference book for those interested:

Chasnoff, Ira J., Anson, Amy R and Iaukea, K. A. M., Understanding the
Drug-Exposed Child, Approaches to Behavior and Learning, Imprint
Publications, Chicago, 1998.

There is also a wonderful researcher at University of Nevada-Reno who has
done landmark work in the area of Fetal Alcohol Syndrome and Fetal Alcohol
Effects.  Susan Doctor has been collecting large numbers of cases better
characterizing alcohol exposure in utero and long term consequences.  There
are also great work being done out of the University of Washington and
University of Nevada Medical School in Las Vegas.  Much of this work is
looking at the spectrum of cognitive and behavior deficits that many adults
with in utero exposure face.  This is an interesting issue when working with
parents who have both fetal alcohol effects and currently have chemical
dependency issues of their own.

I am very cautious looking at any study looking at IQ differences-perhaps it
is due to the concerns I have about researches that us "IQ differences" and
its use  in Public Policy justifying "racial differences," "class
differences."  It is a very slippery slope IMHO.

Pierrette Mimi Poinsett, MD FAAP
Modesto CA

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