A study involving 83 child care providers conducted two surveys to investigate providers' self-perceived knowledge, skills, and attitudes toward working with children (and their families) who are exposed to substances, and their attitudes towards children with Down syndrome and children who are chronically ill. Results from the surveys indicated: (1) attitudes toward children who had been exposed to substances were poorer than toward children with Down syndrome, but were not significantly different from attitudes toward children with chronic illness; (2) participants who had received prior training in working with children who are chronically ill had better attitudes toward these children than those who had not received training; (3) participants who had received prior training in working with children who had been exposed to substances had poorer attitudes toward these children than those who had not received training; (4) providers' self-perceived level of knowledge or skill regarding working with children exposed to substances had no relationship with attitude scores; and (5) the only significant correlations were between the attitude subscales and between self-perceived level of skill and level of knowledge regarding working with children exposed to substances. (CR)