• We followed a group of high-risk children, both those who passed early developmental screenings and those who did not. Three hundred sixty-two children who had previously passed screenings were evaluated at 5 years of age. Significant differences were found between this group and a comparison group in mean scores on verbal, perceptuomotor, and preacademic tests. Children who had previously failed screenings at or before 30 months of age were followed up through telephone interviews with referral agencies and records review. Ninety percent proved to have significant problems, and 67% were in special education programs at 5 years of age. This study demonstrates the need for long-term follow-up of high-risk children at least to the age of school entry.