(4 of 6)
An increasing number of medical experts, however, vehemently challenge the notion that most crack kids are doomed. In fact, they detest the term crack kids, charging that it unfairly brands the children and puts them all into a single dismal category. From this point of view, crack has become a convenient explanation for problems that are mainly caused by a bad environment. When a kindergartner from a broken home in an impoverished neighborhood misbehaves or seems slow, teachers may wrongly assume that crack is the chief reason, when other factors, like poor nutrition, are far more important.
Even when crack is responsible, the situation is rarely hopeless. "This is not a lost generation," says pediatrician Evelyn Davis of Harlem Hospital in New York City. "These children are not monsters. They are salvageable, capable of loving, of making good attachments. Yes, they present problems that we have not dealt with before, but they can be taught."
THE COST OF COMPASSION
Help is possible if society will pay the price -- a very big "if" in these days of tight budgets. Will taxpayers foot the bill to provide the best treatment and schooling to all the crack kids? In Boston a year of special education for a drug-exposed child can cost $13,000, compared with $5,000 spent per youngster at a regular school.
Experts agree that the most vital first step in helping crack kids is to get their mothers off the drug, preferably before birth. Yet only 11% of pregnant addicts get into treatment. Many detox programs do not accept the women because they are not equipped to deal with prenatal medical needs. And very few programs are designed to help drug-dependent women who already have children.
The failure to spend more money for early rehabilitation of crack addicts , and their babies may be a social and financial disaster in the long run. Contends T. Berry Brazelton, the noted Harvard pediatrician: "If we worked with these infants from the first, it would cost us one-tenth or one-hundredth as much as it will cost us later. To educate them, to keep them off the streets, to keep them in prisons will cost us billions."
WHAT THE DRUG DOES
Cocaine causes blood vessels to constrict, thus reducing the vital flow of oxygen and other nutrients. Because fetal cells multiply swiftly in the first months, an embryo deprived of a proper blood supply by a mother's early and continuous use of cocaine is "dealt a small deck," says Zuckerman of Boston City Hospital.
Such babies look quite normal but are undersized, and the circumference of their heads tends to be unusually small, a trait associated with lower IQ scores. "Only the most intensive care after birth will give these babies a chance, but many won't receive it," Zuckerman points out.
Occasionally, heavy maternal cocaine use during the later months of pregnancy can lead to an embolism, or clot, that lodges in a fetal vessel and completely disrupts the blood supply to an organ or limb. The result: a shriveled arm or leg, a missing section of intestine or kidney, or other deformities. Such glaring defects, however, are extremely rare.