Project Summary/Abstract The overarching premise of this proposal is that the extant and proposed cohorts (n>4400), infrastructure, and investigative team of PASS-ECHO are uniquely poised to answer questions relating to the impact of prenatal and early childhood environmental exposures on later health outcomes. To accomplish this objective, the study will build upon the successful study infrastructure established through the Prenatal Alcohol in SIDS and Stillbirth (PASS) Network (NICHD U02-HD045935) and will utilize this unique cohort to provide a wealth of prenatal and infant data that can expand the capability of the ECHO study in areas of neurodevelopment, neurophysiology, and asthma, particularly among rural and American Indian youth. The PASS-ECHO investigative team has a proven track record in conducting complex and high quality studies while maintaining longitudinal participant and community engagement in the region. Complementary to the common protocol, the PASS-ECHO cohort will examine in-depth data concurrent to individual-, family-, and social-level factors .While this proposal focuses on neurodevelopmental and asthma outcomes, the PASS-ECHO cohort is capable of including additional measures to provide additional data for the other ECHO focus areas. The PASS-ECHO investigators, infrastructure, and cohort have the capacity to contribute significantly to meet the overarching goal of ECHO.