BACKGROUND AND AIM: Generally, early life exposures to environmental pollutants occur at low levels and their contribution to child’s cognitive abilities, still largely unknown, is a subject of many on-going studies. At low exposures, accounting for multiple neurotoxicants, as well as beneficial elements and genetic variability is important. This study explored prenatal and childhood exposure to trace elements, organophosphate and pyrethroid pesticides and its association with neuropsychological scores. METHODS: Children were recruited in the Ljubljana Maternity Hospital (Slovenia) at birth and were assessed for neuropsychological performance at 7-8 years of age (WISC IV, n=178). Extensive information on life-style was obtained for both periods. Essential and non-essential trace element levels were determined at birth (cord blood), and at follow-up in peripheral whole blood, plasma and urine. Organophosphate and pyrethroid pesticides metabolites were determined in children’s urine at follow-up. RESULTS:Among the potentially neurotoxic substances, 4-nitrophenol, representing parathion exposure, showed negative association with full scale IQ of the children (coeff=-2.09, p=0.022) in a model adjusted for plasma selenium (coeff=16.5, p=0.037) and whole blood copper (coeff=-14.5, p=0.033) (Model R²=0.10, p=0.005). Additional adjustment revealed borderline significant positive effect of breastfeeding in infancy, language classes, and negative effect of watching TV during weekdays, and resulted in a stronger correlation coefficient between 4-nitrophenol and IQ (coeff=-3.03, p=0.004) and stronger overall model (R²=0.27, p0.001). Mercury exposure in prenatal period was positively associated with IQ in the same model (coeff=2.77, p=0.046), most probably indicating beneficial effect of fish consumption during pregnancy. CONCLUSIONS:Although the majority of children had their exposure estimates below the known health-based values, this study demonstrated an importance of evaluating mixed exposures, essential elements as well as child’s cognitive activities along the critical periods of development when estimating their neuropsychological impacts. Continuing this work, paraoxonase genetic polymorphism will be considered and model outcomes will be verified using machine learning approaches. KEYWORDS: trace elements, pesticides, nutrients, neuropsyhological performance