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DECLINE IN MENTAL DEVELOPMENT AND INFANT-MOTHER ATTACHMENT SCORES IN INFANTS OF SUBSTANCE ABUSE MOTHERS

A cohort of 24 physically and neurologically normal infants followed in a special pediatric clinic designed for care of off-spring of substance abusing mothers† was evaluated at ages 1 and 2 years with the Bayley Scales of Infant Development and with a modification of the Ainsworth-Bell Infant-Mother Attachment Scale. The 11 male and 13 female infants were from a low income Hispanic background. Mean Bayley Mental Scores (MDI) declined from 95.5 at 1 year to 87.3 at 2 years. At 1 year of age 80% of children had normal MDI scores (mean=95.5) and 20% had suspect scores (mean=83.0). When re-tested at age 2, 67% were normal (mean=87.3), 29% were suspect (mean=80.8) and 1 female infant was abnormal (67.0). Of the 7 infants with suspect scores, 5 were male and 2 were female. When infant-mother attachment behavior was evaluated at 1 year, 83% were found to be normal, 17% suspect or abnormal. Normal second year attachment behavior was found in 71% of the sample with 29% suspect or abnormal. All 7 children with suspect/abnormal attachment behavior at 2 years showed a decline in mental score from the first year. Four of these had fallen from normal to suspect category. In summary, infants of substance abuse mothers showed a decline in Bayley mental scores and a decline in appropriate attachment behavior over the first 2 years. Test results suggest that male infants may be more vulnerable to this decline. Health providers must recognize that these families need long term support. †Herion, PCP, polydrugs.