A child's brain begins developing long before birth, establishing the foundation for learning and behavior throughout life. Prenatal substance exposure occurs when a developing fetus encounters alcohol or other drugs used during pregnancy. Because the brain develops significantly before birth, certain substances may interfere with this process, potentially affecting a child’s development long after birth.
Prenatal substance use is also a concern in Sacramento County. According to the California Department of Public Health (CDPH), Sacramento County’s reported prenatal substance use rate for alcohol was approximately 6.4% during the 2020-2022 period. Cannabis use for pregnant mothers during that same period was a reported 9.3%.
Understanding how prenatal substance exposure may affect learning and behavior can help families recognize developmental concerns and seek appropriate support as children grow.
Prenatal Substance Exposure and Brain Development
A 2020 study examined newborns prenatally exposed to substances including cocaine, marijuana, and opioids. Researchers identified differences in brain structure and tissue organization among exposed infants. These findings suggest that prenatal exposure may influence early neurological development before learning or behavioral difficulties become apparent.
Effects vary depending on the substance involved and the circumstances surrounding exposure. Experiences after birth can also influence developmental progress, making it difficult to predict individual outcomes.
Effects on Young Children
During infancy and early childhood, children begin developing communication skills and learning how to respond to their environment. Prenatal substance exposure may affect this progress, although developmental differences are not always immediately noticeable.
Researchers examine developmental difficulties associated with prenatal alcohol exposure across several areas of functioning. Neurocognitive functioning involves learning and memory, while self-regulation refers to managing emotions and behavior. Adaptive functioning describes the practical skills children need for everyday activities. These areas can also help explain developmental concerns associated with other substances, although the evidence varies by substance.
Early developmental concerns may include:
Delayed communication: Difficulty developing language skills or understanding verbal instructions
Emotional regulation difficulties: Strong reactions to frustration or changes in routine
Attention challenges: Trouble maintaining focus or following age-appropriate directions
Delayed adaptive skills: Difficulty learning daily routines or completing basic self-care activities
According to the Centers for Disease Control and Prevention (CDC), children with fetal alcohol spectrum disorders (FASDs) may experience developmental delays that affect learning and behavior. Research has also linked prenatal exposure to certain other substances with developmental concerns. However, the types of difficulties observed and the strength of the evidence vary by substance.
Effects on School-Aged Children
As children enter school, they face more complex academic expectations and social interactions. Difficulties associated with prenatal substance exposure may become more apparent when students take on greater responsibility for their schoolwork and classroom behavior.
Neurocognitive challenges can make it harder for students to remember instructions or organize schoolwork. Some students also struggle with executive functioning, which helps them plan activities and solve problems. Difficulties with self-regulation may affect classroom behavior or peer relationships.
According to the CDC, children with FASDs may experience problems with learning and attention, along with difficulties understanding the consequences of their actions. These challenges can affect educational participation even when students demonstrate strengths in other areas.
Adaptive functioning also plays an important role in school success. For example, a student may understand academic material but struggle to organize supplies or follow a daily schedule independently.
Recognizing how developmental differences affect school performance can help caregivers and educators provide appropriate support rather than interpreting every difficulty as a behavioral choice.
Effects on Adolescents
During adolescence, young people assume greater responsibility for their decisions and daily activities. Adolescents with developmental difficulties associated with prenatal substance exposure may need additional support during this transitional period.
Difficulties with executive functioning can interfere with evaluating consequences or the ability to make decisions independently. Emotional regulation challenges may also affect relationships as adolescents begin to navigate more complex social situations. Some teenagers may need continued help developing the practical skills they need for adulthood.
With continued support and opportunities to practice independent decision-making, adolescents can strengthen their skills and prepare for adulthood at a pace that reflects their developmental needs.
The Importance of Early Intervention and Support
A 2024 study found an increased risk of higher rates of attention-deficit/hyperactivity disorder (ADHD) and intellectual disability in children who were exposed to substances during pregnancy. Similarly, research examining prenatal alcohol exposure indicates that children may experience executive functioning difficulties.
These findings highlight why developmental evaluations should consider a child's individual strengths alongside specific areas of difficulty. Identifying concerns early can help families access services that address learning needs and support daily functioning.
Finding Support in Sacramento County
If you are pregnant or postpartum, or supporting someone who is, compassionate care is available 24/7 for mental health and substance use struggles. In Sacramento, you can contact the Maternal Support Line (916-681-2907) and BHS SAC (Behavioral Health Services, Screening and Coordination) at 916-875-1055, or visit our website. Free or low-cost group and virtual supports are available throughout Sacramento County, including bilingual and culturally relevant options.