The relationship of selected demographic, socioeconomic status (SES), and psychological characteristics was examined in interviews with 176 Northern Plains American Indian mothers whose children were referred to diagnostic clinics for evaluation of developmental disabilities, including fetal alcohol spectrum disorders (FASD). Thirty-nine mothers had children diagnosed with an FASD (Group 1), 107 had children who were not diagnosed with an FASD or other major disability (Group 2), and 30 additional mothers with normally performing children, matched by age, sex, and reservation with those diagnosed with an FASD, were recruited as a comparison group (Group 3). Analysis revealed statistically significant differences (p [less than or equal] 0.001) in alcohol consumption among all three groups, and a statistically significant difference in the mean Total Distress score among the three groups of mothers, F(2, 176) = 9.60, p less than 0.001, with Group 3 having a lower mean score than Groups 1 and 2. Sequential regression analysis revealed that the quantity of alcohol consumed prior to knowledge of pregnancy, when combined with SES and Total Distress, was more highly associated with having a child diagnosed with an FASD (R[superscript 2] = 0.206) than was quantity of alcohol consumed alone. (Contains 5 tables.)