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This review has been accessed times since September 30, 2005

Thomas, Janet. (2004). Educating Drug-exposed Children: The Aftermath of the Crack-Baby Crisis. NY: RoutledgeFalmer.

Pp. xviii + 151
ISBN 0-415-94893-2

Reviewed by Harriet R. MacLean
West Contra Costa Unified School District, CA

September 30, 2005

In Educating Drug-Exposed Children: The Aftermath of the Crack-Baby Crisis, Janet Thomas presents a well-structured argument against the stigmatization of drug-affected children and families and in favor of diagnosing and serving their needs through the development of integrated programs organized by the public school system. This book puts the dilemma of drug-affected children in an historical perspective and provides a thorough review of the research and literature in the field, after which the author describes the methodology of her study, summarizes her findings, and concludes with a section that outlines a number of implications and recommendations for educational policy and practice. What sets this book apart in the field is that it is the first to delve into teacher opinions about the drug-affected students they have taught and what teachers say they need to adequately serve drug-affected students and their families. Unfortunately, there are numerous typographical and grammatical errors throughout the text, however, due to the strength of the content and well-founded arguments Thomas presents, these present only a minimal distraction to the reader.

Educating Drug-Exposed Children is divided into two parts. Part I is entitled Poor Urban Drug-Abusing Women and Crack Babies: The Making of an Epidemic and describes the evolution of the “crack baby crisis”. It begins with an explication of the social construction of this term, which emerged in the mid 1980’s and triggered a government funded law enforcement campaign targeting the inner city women who were beginning to produce “crack babies”. As a result, pregnant drug-abusing women have been a major public health issue since the mid 1980’s, and public policy has never managed to adjust its priorities so as to adequately address this problem. Part II contains a description of the methodology of the study Thomas conducted and provides the perspectives and insights of sixteen teachers regarding their experience with drug-exposed students. One key point of this book is that, although drug-affected children frequently demonstrate developmental delays early on, most are quite capable of overcoming these early childhood challenges in the regular education classroom if they are provided appropriate support and interventions. Another key point is that the teachers interviewed for this book, regardless of how long they had been teaching or how many years they had dealt with drug-exposed children in their classrooms, clearly stated their need for information and instruction in appropriate interventions and strategies to better serve these children. These teachers all believe that a lack of information about services and programs designed to help drug-exposed children is the missing piece that dooms a vast majority of these children to years of frustration and eventual failure in school.

The first chapter, entitled The Policy Paradox, sets the reader on the path to an understanding of the phenomenon referred to as the “crack era” and the counterproductive ways in which the federal government has attempted to combat this crisis through punishment and increased law enforcement. Although this strategy of punishing the addict clearly proved to be ineffective early on in the fight against prenatal drug abuse, policy makers persisted in refusing to shift their focus to providing better-integrated support systems to these families. The author argues that the integration of services, including job training, educational opportunities, effective early intervention, mental health services, affordable housing, and child care, would serve as a more efficacious strategy for combating the crack baby crisis. Thomas further asserts that a shift in the policy paradigm from punishment to support would result in the frontloading of less expensive, short-term interventions such as prenatal medical attention for drug abusing pregnant women and eliminate much of the need for more expensive interventions later on, such as extensive post-natal medical care, numerous foster care placements, and costly special education services.

In chapter two, Thomas traces the history of research into the effects of the crack cocaine crisis among childbearing women, beginning in the mid 1980’s and continuing through the late 1990’s. During the course of nearly two decades, the research can be divided into three categories representing three chronological stages. First, starting in the mid 1980’s and continuing until the early 1990’s, a number of early studies suggested that drug-exposed children were a biological underclass that would be a lifelong drain on society. The second stage, which lasted from the mid to late 1990’s, presented new findings that countered these earlier assumptions and brought other factors to light. During this stage, studies suggested that exposure to drugs had not destroyed the cognitive abilities of drug-affected children and that researchers needed to take into consideration confounding factors such as the use of multiple substances and the lack of prenatal care. The third and final group of research studies took place in the late 1990’s; and although they linked drug exposure to some specific impairments and especially to behavior-related problems, these studies continued to suggest that the developmental delays experienced by drug-exposed children could be mitigated. Thus, research overall suggests that, while these children are not doomed to a lifetime of low cognitive functioning, they do need specialized interventions to remediate their developmental delays, and the earlier these occur, the more effective they can be.

Chapter three, The Politics of At-Risk: Drug-Affected Children and Educational Policy, begins, “One of the biggest challenges in addressing the developmental issues of drug-exposed children has been finding their place in the educational policy arena”. With this statement, Thomas embarks on a lengthy description of the ways in which educational and public policy have been the biggest obstacles confronting drug-exposed children at risk for developmental delay. This chapter specifically addresses how difficult it has been for these children to qualify for services under the Individuals with Disabilities Education Act (IDEA) and its 1997 amendments regarding infants, toddlers, and preschoolers. Thomas traces the development of policy based on the IDEA, how that policy then developed into intervention services, and numerous reasons why drug-exposed children have rarely been afforded these services. In fact, no uniform criteria exist for determining which children can be served under the developmental delay category of the IDEA, and the drug-exposed population is mostly overlooked because many have delays that are difficult to detect using traditional assessments. Thus, the first part of this book concludes with the statement, “drug-exposed…children were the motivation behind infant and toddler programs and special education preschool programs, yet this population has the most difficulty being served under this policy”.

Part two of Educating Drug-Exposed Children begins with chapter four, entitled, Identifying a Cracked Foundation: Teacher Observations. In this chapter, Janet Thomas states the purpose of her study, “to place value on the experience and insight of teachers…[and] to help set an agenda for educationally oriented policy interventions for drug-impacted children with developmental challenges” and describes her methodology at length. All salient features of the study are covered in this chapter, including the research questions, design, sample, and data analysis, while the actual data collection instruments, demographic information, and survey/questionnaire results are included in the appendices. Thomas used a purposeful sampling technique to identify sixteen teachers in three cities with the highest occurrence of drug-exposed births in the nation, that is, Baltimore Maryland, Cook County (which includes Chicago) Illinois, and Champaign Illinois. She used a constant comparative method of data analysis, through which she reports that the following three themes emerged from the data:

• Behavior problems are common among drug-exposed children and frequently result in learning problems.
• Students affected by drugs have a much higher propensity for psychosocial risk factors.
• Teachers are in dire need of information and training in specialized interventions that are effective with drug-exposed students in general education classrooms.

Some other key points also emerged from the teacher interviews. For example, no assessment tools exist and hence, when teachers do get information that students are drug-affected, it usually comes from the Department of Children and Family Services (DCFS) or during intake interviews with caregivers. Meanwhile, these children change schools often, leaving teachers with inadequate time and resources to understand their needs and serve them. But most important of all, there exists no educational policy designed to help teachers experience success in working with this particular population of students.

Other findings of this study include a fascinating list of distinctive characteristics of drug-affected children, features about which the teachers were “generally consistent”. For example, all sixteen teachers agreed or strongly agreed on the Likert scale survey that drug-exposed students:

• Are delayed in speech and language development
• Have problems processing information
• Lose control easily
• Are easily distracted
• Have difficulty staying on task
• Have trouble transitioning from one task to another.

One very interesting pattern the teachers observed in drug-exposed school-aged children was an inconsistent cognitive level, or, as one teacher stated, “It’s like one day they get it, and the [next] day they don’t.” This developmental pattern, along with a few others, such as aggressive behavior, temper tantrums, and violent emotional outbursts, are what clearly distinguish drug-affected from other developmentally delayed children according to these teachers.

Janet Thomas goes into great detail about the ways in which the responses of the sixteen teachers were alike and different, and how they elaborated on various aspects of the questionnaire. For example, veteran teachers placed more emphasis on psychosocial issues while teachers with fewer years of experience spent more time elaborating on the behavior and learning delays displayed by drug-exposed students. The general sentiment of all the teachers in this study, however, was that researchers and policymakers do not care about drug-affected children. This conclusion was based on their observations that, when researchers do show up in classrooms, they invariably bring statistics but no strategies, while what teachers crave is information about concrete techniques for helping these students experience success in school. Unfortunately, the reality is that individual teachers are forced to construct their own knowledge and create their own best practices for teaching drug-exposed students. Those in Thomas’ study shared what had worked for them with her, such as adapting the classroom learning environment to the behavioral style of the students and providing a lot of structure with “lots of cues to stay on task”. Nonetheless, the collective teacher voice in this study conveys anger and cynicism about the refusal of our society to help these children and frustration at what they perceive as their own limitations in serving their students.

The final chapter, Healing the Crack in Their World: Education and Drug-Affected Children, outlines ways in which public policy makers and educators can partner to provide better educational experiences for drug-affected children and families. Thomas advocates that the fields of education and public health must unite and make maternal health a high priority public policy concern. She enumerates some goals we should set for ourselves in mounting this campaign, including the creation of comprehensive family centered treatment models, the integration of quality early intervention programs with treatment services targeting pregnant women and mothers, and an emphasis on large scale enrollment activities in communities with a high incidence of drug-exposed births. Next, Thomas lists three ways in which public schools can work towards addressing the unique needs of drug-exposed students

• Learn how to identify drug-exposed children with developmental challenges
• Design educational assessments to diagnose specific developmental problems
• Identify and implement effective classroom interventions
• Create integrated school-based support services to meet student needs.

Clearly, the data presented by Janet Thomas in Educating Drug-Exposed Children is compelling and real. While there are numerous policy recommendations in the final pages of this book, the essential message taken away by the reader is that public schools have not provided teachers with the information and resources they need. The reader wonders, however, whether individual public schools have the capacity, in terms of human, financial, and other resources, to take the initiative in creating the types of programs conceived in this book. Thomas further urges, “Public schools should…coordinate the interagency collaborations necessary to adequately support the diversity of needs within drug-impacted families”. Again, while this is a wonderful idea, the reader contemplates, with what funding and personnel? A policy shift of this magnitude, focused on the development of educationally and emotionally responsive learning environments for drug-exposed students, must begin at a higher level, where policy determinations are reached and funding decisions are made. If public schools are to become hubs of interagency collaborations specifically designed to serve drug impacted students and families, then the paradigm shift must begin with legislators and policy makers. In this way such an endeavor would have an increased likelihood of success.

About the Reviewer

Harriet R. MacLean is the principal of Walter T. Helms Middle School in San Pablo, California. Her research interests include student motivation as it is affected by teacher quality, support, and expectations. Dr. MacLean was selected to present her research at the 2005 David L. Clark National Research Seminar in Educational Administration and Policy at AERA in Montreal, and received her Ed.D in Educational Leadership from St. Mary’s College of California in May 2005. Active in a number of professional organizations, Dr. MacLean has served as adjunct staff for the Principals’ Leadership Institute at the University of California Berkeley.

Copyright is retained by the first or sole author, who grants right of first publication to the Education Review.

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