Not all drug dependent babies in Tennessee are using the speech and behavioral therapy they're eligible for. That's a key takeaway from a study published this month that confirms a long-held concern about infants who spend their first few weeks of life withdrawing from opioids.
This study, led by epidemiologist Mary-Marget Fill of the Tennessee Health Department, is the first sizeable research showing babies diagnosed with neonatal abstinence syndrome are more likely to need special education services in school. The findings were published in the journal Pediatrics this month.
Using data from TennCare on 7,000 babies with NAS and pairing that with their education records, researchers found roughly one in seven affected children required special classroom services for developmental delays and language difficulties, compared to one in 10 children not exposed to drugs.
With a diagnosis of NAS, they automatically qualify for early intervention services, which have proven to be very effective. Even though places like Vanderbilt University Medical Center refer new mothers to government services, Fill says many children are not getting help in the critical early years.
"That's why we're sort of trying to shout this from the rooftops," she says. "Because there is a whole host of people involved in a child's life that should be aware of this information."
Right now, kindergarten teachers are often the ones who first recognize a need for intervention. In fact, that's how Fill's research launched in the first place. Educators from East Tennessee alerted the state Health Department that they were concerned about several children they suspected were born drug-dependent.
More than 1,000 babies in Tennessee are being diagnosed with NAS each year, though there are some recent signs of improvement. The trickiest problem now is that many of the mothers are taking legally prescribed opioids meant to help them step down off stronger painkillers or street drugs. So far this year, two-thirds of mothers were on medication-assisted treatment.
Fill, who is a pediatrician and has treated babies with NAS herself, notes that with a little help, these infants should have no more trouble than most kids in school.
"Far and away, many of the children with NAS are not going to have any problems," she says. "But right now, the pendulum is very far on the side of these children falling through the cracks."