Children with gestational cocaine exposure do not differ from non-exposed controls on most traditional measures of cognition and behavior. Yet, animal data demonstrating significant cocaine effects on the developing nervous system of the fetus suggest that children with gestational cocaine exposure will differ from controls when cognition is analyzed in terms its distinct neurocognitive systems. The proposed 5-year study will investigate the effect of gestational cocaine exposure on neurocognitive function, examine neural bases of neurocognitive function (fMRI), and explore early substance use in children. The specific aims of this research are: (1) to identify the neurocognitive system(s) most impacted by in utero cocaine exposure; (2) to correlate fMRI findings of both cocaine-exposed and non-exposed children with their neurocognitive assays; (3) to monitor the acquisition of substance use and other risk-taking behaviors; (4) to identify neurocognitive profiles associated with early drug use; and (5) to explore the neural bases of early drug use. Background information regarding growth, development, social and emotional functioning, family dynamics, and acquisition of substance use and risk-taking behaviors will be obtained from standardized medical and psychological assessments. Neuropsychological tasks adapted for use with children will provide behavioral assays of neurocognitive systems. fMRI will provide information about the neural bases of gestational cocaine exposure and early substance use. A cohort of 120 inner city children, followed, since birth, ages 9-11 years, half with gestational cocaine exposure will be administered the battery of medical, psychological, and neurocognitive measures. Fifty of the 120 children will also have fMRI, which will be obtained twice during the study: once early on, as baseline, and once during adolescence. Three teams of investigators will be involved: The PI and team from Albert Einstein Medical Center will maintain longitudinal follow-up of subjects and assess subjects for acquisition of early drug use and other risk behaviors; the Co-PI and team from the Center for Cognitive Neuroscience at the University of Pennsylvania are collaborating to carry out neurocognitive assessments; and the Children's Hospital of Philadelphia team are collaborating to obtain fMRI data. This investigation has both the potential to gain a detailed understanding of the neurocognitive and neural effects of gestational cocaine exposure, as well as to direct investigations and interventions for young children seemingly destined for early drug use and, possibly, addiction.