In 1994, Case Western Reserve researchers launched an intriguing long-term project to follow hundreds of infants exposed to cocaine while in the womb. Today—as the researchers mark 20 years since the study was first conceived and funded—the same babies born during the initial years of "Project Newborn" are reaching adulthood and still providing university researchers with clues about the ongoing effects of their exposure.

Important findings over the years—the most recent of which were published earlier this year in The Journal of Adolescence, Drug and Alcohol Dependence and elsewhere—have included an increase in drug use in teenage years and negative effects on attention, organizational skills, language development, behavior and the ability to process visual information. These problems can thwart both academic and social success in school. But the impairments should be kept in perspective, said study founder Lynn T. Singer, PhD.

"One of the most important things we have learned is that cocaine-exposed children are not doomed as many of the media reports of the '80s and '90s predicted," said Singer, who is now the university's deputy provost, vice president for academic affairs and a professor of pediatrics and psychiatry.

The project, funded by a series of National Institutes of Health grants, started out following 415 infants—about half of them exposed to cocaine prenatally and the rest not—along with their mothers or other caretakers. Remarkably, almost 90 percent of the original participants still are engaged in the study.

Now, as most of the study participants are 19 years old (and have been assessed 12 times), researchers are looking at connections between their prenatal exposure and social behaviors as teenagers. For example, are cocaine-exposed kids at higher risk than their non-exposed counterparts for substance abuse, legal entanglements and risky sexual activity? The project team is still analyzing the newest data, but the evidence so far suggests that these types of problems are amplified in the young adults, said longtime principal investigator Sonia Minnes, PhD, an associate professor of social work at the Jack, Joseph and Morton Mandel School of Applied Social Sciences.

Minnes hopes to continue the research until the participants reach at least age 20, to clarify whether deficits persist. Research insights could shed light on how to support youngsters believed to be at risk.

"If we can target kids with early interventions," Minnes said, "we could greatly increase the possibility of them staying in school and not being taken down by difficulties such as unemployment and legal problems."

—TAMAR NORDENBERG