Systematic review finds highest risk of impairment in the neurosensory domain

Researchers conducted a systematic review of 86 studies examining how prenatal opioid exposure may affect children’s brain development and behavior from infancy through adolescence. The review analyzed developmental outcomes across six areas of brain function, including executive skills, language, motor development, emotional regulation, general development, and the neurosensory domain.

The neurosensory domain includes how the brain processes information from the senses—such as vision, hearing, movement, and body awareness. Across the studies reviewed, neurosensory differences were the most frequently reported developmental concern among children with prenatal opioid exposure, including children who experienced Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS) and those who did not.

Study Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC12695250/pdf/jdbp-46-e621.pdf

The Science in Plain English:

When researchers compared children with prenatal opioid exposure to children without exposure, the neurosensory domain showed the strongest overall pattern of differences across the studies.

Using a statistical method called risk difference, the review found that children with prenatal opioid exposure had the highest risk (76.9%) of impairment in the neurosensory domain. The systematic review found 53.8 additional studies (per 100 studies) reporting neurosensory differences compared with unexposed groups. This was far higher than other developmental areas.

These neurosensory differences often involved systems responsible for:

• sensory processing (how the brain filters sound, touch, movement, and other sensory input)

• visual functioning (how the eyes and brain work together)

• motor coordination and body awareness

Although these findings were consistent across many studies, researchers also emphasize that children’s experiences vary widely, and many factors—including environment, caregiving, and early support—play an important role in development.

Bullet Point Summary

• Prenatal opioid exposure showed the largest risk difference in the neurosensory domain (76.9%).

• Neurosensory differences often involved multiple sensory systems, including:

  • sensory processing (sound, touch, movement, light)

  • visual functioning

  • coordination and body awareness

• These sensory differences may influence daily functioning. They can affect how children regulate their bodies, move through environments, and process information at home or school.

• The studies included children from 1 month to 17 years of age, meaning neurosensory differences can appear in infancy and continue into childhood or adolescence.

• Not every child with prenatal opioid exposure experiences these differences, and the level of support needed varies from child to child.

What this means for you:

If you are raising a child with prenatal opioid exposure, this research may help explain something many caregivers notice: your child may experience the world differently through their senses.

For example, your child might:

• feel overwhelmed by noise or busy environments

• react strongly to touch, clothing, or textures

• seek movement or deep pressure

• struggle with balance or coordination

• have difficulty with visual tasks such as focusing or tracking

These reactions are not behavior problems. They are often signals from your child’s nervous system about how sensory information is being processed.

Research like this helps professionals understand that children with prenatal opioid exposure—including those who had Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS)—may benefit from supports that address sensory processing and regulation.

Helpful supports may include:

• predictable routines and calm environments

• sensory-informed parenting strategies

• occupational therapy or sensory integration supports

• vision or motor evaluations when needed

Most importantly, these findings describe patterns across groups of children—not predictions about your individual child. Many opioid-exposed children show creativity, determination, empathy, and resilience. With understanding and the right supports, they can continue to grow, learn, and thrive.