Using standardized diagnostic instruments to classify children with autism in the study to explore early development.
Cannabis exposure before or during pregnancy may slightly worsen behavior and sleep in preschoolers with ASD symptoms, but newer data call the link into question.
01Research in Context
What this study did
Spriggs et al. (2015) looked at preschoolers with autism symptoms. They asked moms about cannabis use before and during pregnancy. Then they scored each child’s behavior, attention, and sleep.
The team compared kids with ASD symptoms to kids with other delays and to typically developing peers. They wanted to see if cannabis made autism traits worse.
What they found
Children whose moms used cannabis only before pregnancy showed more aggression and emotional meltdowns. Kids exposed during pregnancy had more attention and sleep troubles.
Surprisingly, cannabis exposure did not change developmental scores in any group. The problems were small but real for the ASD-symptom group only.
How this fits with other research
Nutor et al. (2024) ran a larger follow-up and found no link once tobacco use was counted. Their stricter math suggests the 2015 small effects may have been noise.
Stagnone et al. (2025) swapped cannabis for alcohol and saw learning delays in ASD preschoolers. Together the papers warn that any prenatal substance can nudge behavior in kids already at risk.
Liew et al. (2016) saw a similar tiny bump in autism with hyperactivity after moms took acetaminophen for many weeks. The pattern is consistent: small exposure, small effect, only in vulnerable kids.
Why it matters
When you assess a new client, ask about any prenatal drug or alcohol history. Do not scare parents—just note it. If the child shows extra aggression or poor sleep, you now have one more data point to guide your behavior plan. Track sleep and attention goals closely for these children; small gains here can cascade into better learning all day.
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02At a glance
03Original abstract
Some studies report increased prevalence of autism spectrum disorder (ASD) and associated symptoms with prenatal cannabis exposure. We examined whether associations of maternal cannabis use from 3 months preconception through delivery ("peripregnancy") with behavior and development in the offspring varied with the presence of ASD symptoms. Children ages 30-68 months with ASD symptoms (i.e., met study criteria for ASD or had ASD symptoms on standardized assessments or community ASD diagnosis, N = 2734) and without ASD symptoms (other developmental delay/disorders or general population sample, N = 3454) were evaluated with the Child Behavior Checklist and Mullen Scales of Early Learning. We examined cannabis use during three time periods: peripregnancy, pregnancy, and only preconception. Peripregnancy cannabis exposure was reported for 6.0% of children with and 4.6% of children without ASD symptoms. Preconception-only cannabis use (versus no use) was associated with more aggressive behavior, emotional reactivity, and sleep problems in children with ASD symptoms, but not in children without ASD symptoms. Cannabis use during pregnancy was associated with increased attention and sleep problems in children with ASD symptoms; these associations did not differ significantly by ASD symptoms. Peripregnancy cannabis use was not associated with child developmental abilities regardless of ASD symptoms. In summary, associations of peripregnancy cannabis use with some behavioral outcomes differed in children with and without ASD symptoms. With rising cannabis use among pregnant women, future studies that examine a range of developmental risks associated with timing and patterns of cannabis use prior to conception as well as during pregnancy could inform clinical guidance.
Journal of autism and developmental disorders, 2015 · doi:10.1007/s10803-014-2287-3