The proposed study will follow into early adolescence, a cohort of children affected by prenatal alcohol exposure due to maternal drinking. While the negative consequences of alcohol exposure for the infant and the young child are fairly well established, there is little systematic data about long-term effects. Clinical studies of adolescents and adults with alcohol syndrome (FAS) or alcohol effects (FAE) suggest very negative consequences for these groups, including deficits in neurocognitive functioning, academic performance, social and emotional functioning and a greatly increased probability of alcohol and drug abuse. While such consequences do exist, it is not clear what are the relative contributions of direct neurological damage, familial factors and secondary effects (e.g., mental retardation). This study will examine four kinds of outcomes (neurocognitive functioning, social functioning, alcohol and drug use and physical status) in 14 year old, low income, predominantly African American children (N=270) and social and physical functioning and drug and alcohol use in their caregivers. Four groups will be employed. Three groups will be drawn from a longitudinal cohort first identified in the prenatal period. These are: 1) Exposed/affected (FAS/FAE); 2) Exposed- nondysmorphic; and 3) Nonexposed, social economic status (SES) controls. In addition, a fourth group (""""""""Special Education Contrast"""""""") will be recruited through the Fulton County Board of Education. This group will be matched for race SES and cognitive and educational status with the children in the FAS/FAE group to control for the effects of intellectual limitations on the outcome variables. Outcome variables will include standard cognitive measures, specific neuropsychological tests, measures of social competence and emotional functioning, and measures of alcohol and drug use. In addition, assessment will be made of environmental factors including maternal attitudes and functioning and environmental stress including exposure to familial and community violence. It is anticipated that adolescents with significant alcohol pathology will show deficits relative to contrast groups in cognitive, emotional and social functioning and that negative environmental factors will exacerbate these deficits. It is also hypothesized that adolescent with alcohol effects will show a specific pattern of functioning which is different from that seen in the more heterogeneous Special Education contrast group.
