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The goals of this study were: (1) to determine if 24-month-old children exposed to opioids show decreased focused attention during free play compared with children of the same age who were not prenatally exposed; (2) to identify medical and social risk factors other than drug exposure that are related to focused attention; and (3) to determine if mothers' teaching ability had an effect on attention. Focused attention was rated during a 3-minute free play session for 30 toddlers who were methadone-exposed and for 44 comparison toddlers. The mother teaching the child to use a toy was also rated separately from the free play session. There was no difference in focused attention of 24 month olds during free play based only on prenatal exposure. Despite group differences in medical and social risk factors, only maternal IQ was significantly related to focused attention. Maternal instruction was strongly related to focused attention and mediated the effects of maternal IQ on attention.