This article reviews some of the literature on educational approaches for drug-exposed children. Common effects of prenatal and perinatal drug use on the female user, the developing fetus, and the neonate are reviewed. It is noted that female drug users have an increased incidence of medical complications during pregnancy; that the specific effects of drug use during pregnancy depend on several factors, including the type of drug, timing of drug use, and the extent and duration of use; and that outcomes associated with drug use include physical birth defects, mental retardation and developmental delays, and growth delays. The issue of Fetal Alcohol Syndrome is examined. Educational concerns related to alcohol- and other drug-related birth defects are presented. Indicators for early intervention services are outlined in the areas of motor and neurological development; affective and behavioral development; social/attachment development; problems solving, attention and concentration; language development; and play. Recommendations for classroom application of intervention strategies for optimal learning in at-risk children are described. These include lists of 6 protective factors, 9 facilitative factors, and 22 teaching strategies for optimal learning. The article concludes with recommendations for services to be offered to at-risk children. (NB)