A group of health and education experts is meeting in Miami for a crash course on how this country can stop a potential human plague almost too horrible to imagine. It is the dysfunctional development of cocaine babies, or, as some have called it, the emergence of a "bio-underclass." President Bush was photographed cuddling one such infant at D.C. General Hospital recently, which helped generate an outpouring of sympathy for the plight of the babies. But a few years from now, the experts note, those infants won't look so cute anymore. Already, a few of them are turning up in first- and second-grade classrooms around the country, wreaking havoc on themselves and others. Severe emotional damage and even physical deformities not so readily apparent today may mushroom in the near future. The children's irritability and anger -- along with their need for love and understanding -- will surely grow. Will the thousands of children of cocaine-addicted mothers receive the special attention they need? "The frightening thing about the question is that we have no idea what the needs are," said physician J. Harold Nickens, chairman of the D.C. Chapter of the American Society of Addiction Medicine. "Given the intensity of cocaine's effect on the developing fetal brain, it may be necessary for the medical community to define a new organic brain syndrome based on the physical and chemical damage done to the fetus by intrauterine cocaine exposure." In Miami at the National Training Forum on Drugs, Alcohol, Pregnancy and Parenting, which is being co-sponsored by the U.S. Department of Health and Human Services, physicians who specialize in perinatal addiction, along with scores of special education teachers, nutritionists and social workers, are racking their brains just to get a grip on what we are up against. The old term "post-drug impairment syndrome" was disturbing enough, encompassing such symptoms as poor abstract reasoning, poor judgment, poor memory, tantrums, inability to concentrate and inability to deal with stress. But the effects of cocaine on the fetus are proving to be far worse than any other drug -- with irreparable physical damage done during the first 12 weeks of pregnancy. By the time many cocaine users realize they are pregnant, it is often too late, Nickens said. "The fetus becomes an unwilling intravenous cocaine user and remains exposed to the drug four to five days after a single drug use by the mother," he said. "The concentrations of cocaine to which the fetus is exposed are many times greater than the concentrations experienced by the mother. At these levels, the newborn runs the risk of strokes, seizures, small heads, missing bowels, malformed genitals as well as other, yet to be determined defects." Moreover, Nickens said, a time bomb exists even in those children who may appear "normal" and are deemed medically ready for discharge from hospitals. They are, in effect, addicts unaware of the lifelong challenge of recovery ahead of them. "While they know nothing of their addiction at an intellectual level, at a neurochemical level, their brains will never forget cocaine," Nickens said. "They are likely to experience the same dysphoria, thought and mood disorders experienced by any recovering addict -- but without the knowledge or support that is necessary for them to stay sober." Thus, the child of cocaine becomes a prime candidate for drug abuse -- which would constitute a unique and devastating "relapse." "Exposure to any psychoactive, mood-altering substance later in life is certain to have negative effects," Nickens said. "Should that substance be cocaine, the stage is set for a terrifying emotional and neurobiological disaster as the brain is reacquainted with its 'old friend.' " Within the first few hours of the training forum, teachers were expressing fear and frustration over the emergence of these children in their classrooms. Protective services workers had only horror stories to tell about the brutality that such children experience. "We are desperately searching for answers," Nickens said. "We feel like we have a tiger by the tail." One idea being discussed at the forum involves identifying these children at birth -- if not before -- and giving them intensive training and medical treatment while they are young. The cost would be high, but not nearly as expensive as allowing them to grow up to be human tigers.