At least 10,000 Illinois children born with cocaine in their systems are now reaching grade-school age.
If the experience of other cities, notably New York, provides any indication, the children will pose tremendous problems for teachers and force school systems to spend millions more to educate them.
The cost in medical care, foster care and special education for these children could reach $50 million to $100 million a year, experts say.
Prenatal exposure to drugs, especially cocaine, is new enough that educators and pediatricians are still debating whether such children are doomed to crippling learning and behavior problems or whether early, intense help can reverse a significant amount of the damage.
One thing is clear from the thousands of children in New York, Los Angeles and Miami who have made it to kindergarten without help: Doing nothing for a drug-exposed baby for the first five years of life is a guarantee of serious, perhaps unsolvable trouble in elementary school and possibly for life.
Taking the optimistic path, educators in Chicago and the suburbs are trying to catch the earliest members of Illinois` group of drug-affected children when most are younger than kindergarten age, in hopes that the damage can at least be ameliorated through early learning activities and help provided to parents.
”We have at least 30 drug-affected children under 5 in our parent-infant and preschool programs,” said Robert Van Dyke, head of the South Metropolitan Association, a consortium of 57 school districts in the south suburbs.
”They run the gamut from mild to severe handicaps,” Van Dyke said. ”We expect to be hit very hard over the next several years.”
A special education cooperative that serves 25 school districts in Du Page County has set up a committee to develop programs for an expected influx of drug-affected children there.
On Chicago`s Southwest Side, in a ritual performed each day, speech pathologist Cathy Lawton holds hands with Matthew, a 3-year-old boy with wide brown eyes and thick lashes, as the two run in little steps across the classroom, as if to sneak up on teacher Mae Piszczor.
”Boo,” Lawton says.
”Buh,” Matthew says.
”That`s a big step forward,” Piszczor said. ”When we got him, he couldn`t even do that.”
Matthew`s name, like those of all the children in this article, has been changed to protect his privacy.
Lawton and Piszczor are almost certain that Matthew was exposed to cocaine before he was born. His inability to speak, his desire to spend hours pouring rice or water from one container to another, his clumsiness with his hands, in addition to what the teachers know about his family, point to that conclusion.
But like many teachers who are being confronted each day with children who have telltale gaps in their abilities, the teachers at Stevenson Elementary School, 8010 S. Kostner Ave., may never know.
”We are seeing more and more children with the kind of short attention spans and other problems that indicate drug use before birth,” Piszczor said. ”Some we know for sure were prenatally exposed because it is in the court record. Others we just suspect.”
This inability to determine which troubled youngster has, in fact, been exposed to drugs raises serious concern among some educators, who fear that
”drug exposure” could become a catch-all diagnosis for poor minority youngsters with learning or behavioral problems.
These educators warn that too many school systems have traditionally assumed the worst where poor or minority youngsters are concerned, so the new attention being paid to cocaine-related problems strikes them as something of a mixed blessing.
Dr. Edith Fifer, director of early childhood special education for the Chicago Public Schools, is one who fears that many minority youngsters run the risk of being misdiagnosed as drug exposed.
And she sees another danger as well, that children who, in fact, were exposed to drugs while in the womb may be regarded as a new biological underclass, incapable of learning or living normal lives.
These children will certainly face problems in school, Fifer said, but many of them can succeed with help and reasonable expectations on the part of their teachers.
Dan Griffith, developmental psychologist for the Chicago-based National Association for Perinatal Addiction Research and Education, agrees.
”Cocaine creates a biological vulnerability in a baby,” Griffith said. But it does not preclude the possibility of progressing adequately in school. ”In the best environment, such a baby may do fine,” Griffith said. ”In a chaotic, abusive household, it will be overwhelmed and unable to develop. Some of these babies are born to the second or third generation of drug addicts.”
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Regardless of the kinds of families they belong to, most drug-exposed children will need special education, experts agree.
And this will add an extra cost of $5,000 to $10,000 a year per student because one person teaches only five to 10 such children, depending on the severity of their handicaps. Regular classes hold 25 to 35 children.
Add to the school costs at least $3.8 million a year for foster and institutional care, the amount spent in fiscal 1991 for such children by the Illinois Department of Children and Family Services. No estimates are available on medical costs.
Urban areas across the nation face similar problems. New York expects to spend $2 billion in the next 15 years to care for and educate a projected 72,000 children who will have been born to crack-addicted mothers there by the turn of the century, the state comptroller recently announced.
Researchers and educators from across the country will meet Dec. 13-17 in Chicago to share knowledge and develop plans to deal with the thousands of drug-affected children being born each year.
Children born exposed to cocaine are not the sole province of the lower classes, experts say. Many drug-exposed children are born into middle-class and wealthy families.
”Parents of a higher income may be able to hide it a little better,”
said Kelly Baggett, a special education teacher who teaches drug-exposed children at Woodland Elementary School outside Atlanta.
Cocaine is especially dangerous to the fetus if it is used during the first three months of pregnancy, when the brain and other organs are developing.
By reducing the supply of blood to the developing infant, cocaine can cause subtle neurological abnormalities that may result in lifelong learning and behavior problems.
Many cocaine-exposed infants are born into severely troubled families where neglect and abuse are common, making it difficult to determine how much of the child`s often bizarre behavior is the result of the biological effects of cocaine and how much is due to a splintered home life.
Griffith said the most important finding about cocaine-exposed children is their ”low frustration threshold and an inability to organize
themselves.”
As infants, they must expend so much energy to control their muscles and breathing and to move themselves from slumber to wakefulness that they have none left over to respond to a human voice or their mother`s face, Griffith said.
Extra stimulation either throws them into paroxysms of crying or back into the escape of constant sleep.
But if their reactions are controlled by swaddling, dim lights and quiet- in other words, if they are kept below their frustration threshold-they can begin to respond like normal infants, Griffith said.
As toddlers, they again need their environment controlled so they can focus their attention enough to achieve the next level of tasks, becoming potty-trained, learning colors and numbers, handling puzzle pieces.
David, 6, was exposed to cocaine and probably a variety of other drugs and alcohol before he was born, according to DCFS records given to teachers Lawton and Piszczor.
David received no special help for his problems until his mother enrolled him in kindergarten in Park Forest. The teacher there realized he could not be taught in a regular classroom, and she called her local special education department for help.
”I can`t imagine what that teacher must have thought when he walked in,” Piszczor said.
David now attends Stevenson because DCFS officials removed him from his mother`s custody and placed him with his grandmother, who lives in Chicago.
On this day, David pushes a doll buggy around the room. He is several inches taller than most of the other children in the room, but his abilities lag several years behind his age. Outbursts of temper interfere with his learning, his teachers say.
”He is very emotional. He wants to do things a certain way,” Piszczor said. ”He throws tantrums a lot. He screams and falls to the floor. One day last month, he screamed until he did not have a voice.”
When David first came to Stevenson, he had test scores that suggested he was mentally retarded. Since then, David`s attitude has improved and his understanding of language has expanded.
”He can talk, but it`s disconnected,” Lawton said. ”You`ll say to him, `What did you do last night?` And he`ll say, `My friend has a new pair of shoes.` ”
David has no memories of his younger sisters, having lived with them only six months ago.
”We can`t let him around some of the younger kids. He`ll throw them to the ground,” Piszczor said. ”One minute he could be fine, and the next minute he could throw a brick through the window.”
Griffith has studied nearly 400 cocaine-exposed children for two to four years and found that even in stable, adoptive homes, about one-third have trouble speaking, paying attention and controlling impulses.
Linda Villafuerte of Calumet City has six foster children, ages 1 to 11, who were exposed prenatally to drugs.
Villafuerte fought to keep the oldest child out of special education classes, even though she appeared to be retarded when she entered 1st grade. The girl is now in a regular 4th grade, wins spelling bees and has been on the honor roll, her mother said.
”The children are very smart, but they`re so distracted they can`t concentrate,” Villafuerte said. ”They just have to learn how to adjust their bodies to their disorders.”
Villafuerte said the children`s motor skills are ”out of whack.” One toddler had to be taught how to chew when she first arrived at the Villafuerte home. Another baby holds his arms at a rigid angle so that his arms and shoulders resemble the letter ”W.”
Daily exercises and weekly trips to a physical therapist combat some of the problems.
”We can create environments in which these children can learn,”
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Griffith said. ”But once they need to make decisions for themselves, they fall apart. No one knows how long in their lives they will need to have these artificially structured environments.”