Abstract 66 Poster Session III, Monday, 5/3 (poster 356)

The developmental consequences of prenatal exposure to cocaine still remain unknown. Most studies of cognitive outcome using standardized mental assessment tests have failed to find consistent effects. Such instruments may not be sufficiently sensitive to the subtle effects that are the most likely consequences. In a well-controlled longitudinal study of effects of prenatal cocaine exposure designed to follow children through school age, we examined the problem solving ability of 214 subjects, 78 exposed to cocaine and 136 unexposed to cocaine from the same inner-city populations. Subjects were presented with 4 problems: retrieving a toy from a large plexiglass box that was only possible by pressing a lever; obtaining a toy from a basket that was only reachable by using a pulley; placing round or square blocks into the appropriate hole when only one hole was visible until a cover was slid over to expose the second hole; and retrieving a small toy lodged in the middle of a plastic tube that was only obtainable if pushed out with a stick. Subjects were given 2 or 3 minutes to solve each of the problems spontaneously, and were then given a cue and another 2 minutes to solve each of the problems. Two summary scores were computed for each subject that were the sum of the problems solved spontaneously, and the sum of the problems solved either spontaneously or with a cue. Analyses of covariance controlling for environmental risk, neonatal medical risk, and prenatal exposure to alcohol, cigarettes, and marijuana, indicated that cocaine-exposed subjects solved significantly fewer problems spontaneously (1.04 vs .91, F(1,210)=5.7, p<.02), or even after a cue (2.01 vs 1.72; F(1,210)=7.5, p<.01). These findings suggest that prenatal exposure to cocaine does affect problem solving at 2 years of age. Of note is that these tasks not only tap cognitive ability, but require control of the frustration generated by difficult problems. Cocaine exposure has been implicated in difficulties of coping with frustration. These findings have implications for later learning difficulties in cocaine-exposed children.