{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:47:58Z","timestamp":1792176478981,"version":"4.4.0"},"reference-count":40,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome that can occur after intrauterine opioid exposure. Adverse neurobehavioral outcomes have been documented in infants with NAS; however, educational outcomes have not been thoroughly examined. We analyzed Tennessee data to understand the need for special educational services among infants who are born with NAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>By using Tennessee Medicaid and birth certificate data, infants who were born in Tennessee between 2008 and 2011 with a history of NAS were matched (1:3) to infants who were born during the same period without a history of NAS. Groups were matched on the basis of sex, race and\/or ethnicity, age, birth region of residence, and Medicaid enrollment status. Data were linked to Tennessee Department of Education special education data during early childhood (3\u20138 years of age). Conditional multivariable logistic regression was used to assess associations between NAS and selected special education outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>A total of 1815 children with a history of NAS and 5441 children without NAS were assessed. Children with NAS were significantly more likely to be referred for a disability evaluation (351 of 1815 [19.3%] vs 745 of 5441 [13.7%]; P &amp;lt; .0001), to meet criteria for a disability (284 of 1815 [15.6%] vs 634 of 5441 [11.7%]; P &amp;lt; .0001), and to require classroom therapies or services (278 of 1815 [15.3%] vs 620 of 5441 [11.4%]; P &amp;lt; .0001). These findings were sustained in a multivariable analysis, with multiple models controlling for maternal tobacco use, maternal education status, birth weight, gestational age, and\/or NICU admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Results of this novel analysis linking health and education data revealed that children with a history of NAS were significantly more likely to have a subsequent educational disability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2018-0562","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T03:24:29Z","timestamp":1535599469000},"source":"Crossref","is-referenced-by-count":104,"title":["Educational Disabilities Among Children Born With Neonatal Abstinence Syndrome"],"prefix":"10.1542","volume":"142","author":[{"given":"Mary-Margaret A.","family":"Fill","sequence":"first","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia;"},{"name":"Tennessee Department of Health, Nashville, Tennessee;"},{"name":"Department of Health Policy, School of Medicine, Vanderbilt University, Nashville, Tennessee; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela M.","family":"Miller","sequence":"additional","affiliation":[{"name":"Tennessee Department of Health, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel H.","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Tennessee Department of Education, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Warren","sequence":"additional","affiliation":[{"name":"Tennessee Department of Health, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Tennessee Department of Health, Nashville, Tennessee;"},{"name":"Department of Health Policy, School of Medicine, Vanderbilt University, Nashville, Tennessee; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Schaffner","sequence":"additional","affiliation":[{"name":"Department of Health Policy, School of Medicine, Vanderbilt University, Nashville, Tennessee; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy F.","family":"Jones","sequence":"additional","affiliation":[{"name":"Tennessee Department of Health, Nashville, Tennessee;"},{"name":"Department of Health Policy, School of Medicine, Vanderbilt University, Nashville, Tennessee; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2018,9,1]]},"reference":[{"issue":"2","key":"2021121100375695000_B1","article-title":"Neonatal drug withdrawal [published correction appears in Pediatrics. 2014;133(5):937].","volume":"129","author":"Hudak","year":"2012","journal-title":"Pediatrics"},{"issue":"1","key":"2021121100375695000_B2","doi-asserted-by":"crossref","first-page":"F2","DOI":"10.1136\/archdischild-2015-309566","article-title":"Neonatal withdrawal syndrome: reaching epidemic proportions across the globe.","volume":"101","author":"Allegaert","year":"2016","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"18","key":"2021121100375695000_B3","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1001\/jama.2012.3951","article-title":"Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009.","volume":"307","author":"Patrick","year":"2012","journal-title":"JAMA"},{"issue":"8","key":"2021121100375695000_B4","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1038\/jp.2015.36","article-title":"Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012 [published correction appears in J Perinatol. 2015;35(8):667].","volume":"35","author":"Patrick","year":"2015","journal-title":"J Perinatol"},{"issue":"1","key":"2021121100375695000_B5","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/AOG.0000000000002054","article-title":"Opioid use in pregnancy, neonatal abstinence syndrome, and childhood outcomes: executive summary of a joint workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, Society for Maternal-Fetal Medicine, Centers for Disease Control and Prevention, and the March of Dimes Foundation.","volume":"130","author":"Reddy","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"1","key":"2021121100375695000_B6","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.earlhumdev.2007.01.013","article-title":"Adverse neurodevelopmental outcome of infants exposed to opiate in-utero.","volume":"84","author":"Hunt","year":"2008","journal-title":"Early Hum Dev"},{"key":"2021121100375695000_B7","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s12888-015-0438-5","article-title":"Erratum: neurobehavioral consequences of chronic intrauterine opioid exposure in infants and preschool children: a systematic review and meta-analysis.","volume":"15","author":"Baldacchino","year":"2015","journal-title":"BMC Psychiatry"},{"key":"2021121100375695000_B8","unstructured":"Tennessee Department of Health\n          . 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