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Children of opioid-dependent mothers have complex needs

Increased opioid and other drug use in Aotearoa New Zealand and around the world is affecting children’s readiness for learning when they start school, according to a new five-year study by a leading child development expert at the University of Canterbury (UC).

Head of UC’s School of Health Sciences, Professor Lianne Woodward led a study of 100 babies whose mothers took methadone to treat opioid dependence, and 110 babies whose mothers didn’t, following them from birth to four-and-a-half years old. With UC PhD graduate Dr Samantha Lee, researchers assessed children’s physical/motor development, social-emotional skills, approaches to learning, language, and cognitive functioning.

“Opioid use in New Zealand is on the rise, so the hope is that this study can contribute to health and education services planning to help support the needs of these children and their families,” Professor Woodward says.

“We wanted to understand not only the effects of maternal substance use during pregnancy on children’s development, but also how social disadvantage and other medical and family factors might contribute to difficulties.”

Professor Woodward is an international expert in child developmental psychology whose work takes a multidisciplinary approach to understanding the effects of biological and social challenges on children’s development including preterm birth, brain injury, prenatal drug exposures, parenting and psychosocial adversity.

The recent study, titled ‘Health and Neurodevelopment of Children Born to Opioid Dependent Mothers at School Entry’, looked at the extent and the mix of mothers’ substance use as well other social and biological factors, such as the quality of the home environment, mother’s mental health as well as the sex and early health experiences of the baby both during pregnancy and shortly after birth.

The results, published in the Journal of Developmental & Behavioral Pediatrics, found that over 70% of children born to opioid-dependent mothers had at least one health or developmental difficulty that would likely impact their schooling, compared to 29% of comparison children drawn from the general population.

Multiple problems were also common, affecting 48% of methadone-exposed children compared with 15% of control-group children. This is of serious concern says Professor Woodward, whose previous work has shown that children showing multiple developmental problems at school entry are at an extremely high risk (>70%) of later educational delay.

A certain combination of factors contributed to the most adverse risk profile. Male children born to mothers from high-risk social backgrounds who took substances during pregnancy and then provided poorer quality home and caregiving environments for their children were at greatest risk of having high rates of health and neurodevelopmental problems, which meant they were ill-prepared for the learning and behavioural demands of school.

“These children tended to have poorer language skills, were less effective at processing information and had greater difficulty regulating their behaviour, which will pose difficulties for them when they are placed in a large and busy classroom,” Professor Woodward says.

The more substance used during pregnancy, the worse the outcomes for children.

However, with early targeted help for these children and their families, children’s outcomes can be improved.

“It is clear from our results that when there is good support for the family and the family is coping with the challenges of parenting, their children do well,” she says.

“We can mitigate the long term risks associated with opioids and other forms of maternal drug use during pregnancy, but we need early developmental surveillance and intervention to identify those who will benefit from support.”

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