Date of Award


Document Type


Degree Name

Doctor of Psychology (PsyD)


Graduate Department of Clinical Psychology

First Advisor

Kathleen Gathercoal, Ph.D.

Second Advisor

Elizabeth B. Hamilton, Ph.D.

Third Advisor

Glena L. Andrews, Ph.D.


Previous research reveals pervasive polysubstance use during pregnancy, with widespread neurological, cognitive, and behavioral deficits that have lasting implications for both adults and children with prenatal polysubstance exposure (PPE; Behnke et al., 2013; Forray, 2016). Early PPE identification leads to improved long-term outcomes. However, identifying PPE is difficult due to underreported use, absent dysmorphic features, and behaviorally similar profiles to other psychiatric conditions, with ADHD identified as the most common referral and most prevalent diagnosis assigned for children with PPE (Chasnoff et al., 2010). Despite similar behavioral symptoms, emerging data reveal a specific neurological profile for PPE distinct from ADHD, illustrating the need for targeted interventions. Consequently, it becomes imperative to build a more extensive neurobehavioral profile to identify children with PPE and better distinguish them from other diagnoses. The current study sought diagnostic clarity by exploring behavioral differences between children with PPE and non-exposed ADHD using clinical scales and composites from the BASC-3 parent and teacher rating forms. Participants were derived from an archived database from rural school districts. Results found parents yielded higher predictability than teachers, with parents accurately differentiating PPE from ADHD individuals 100% of the time. However, no independent scales predicted PPE group. Significant differences were observed by parents for Externalizing Problems, Adaptive Skills, Depression, and Withdrawal scales, with higher clinical scores detected for the PPE group. Findings underline the BASC-3 as a potential and effective tool in differentiating PPE from ADHD groups and continue to aid in constructing a comprehensive behavioral profile for those prenatally exposed.

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Psychology Commons