Perinatal medical status, environmental risk, and infant developmental status in a group of high-risk infants cared for in an NICU immediately after birth were evaluated for their usefulness as possible criteria for entry into preventive early intervention services. Those children whose 4-year IQ scores placed them in the borderline or deficient category were considered to be the “target” group for whom early preventive intervention would have been indicated. Of the individual categories of risk, family environment was most accurate, 18-month developmental assessments were somewhat useful, and perinatal health histories were least effective in identifying the target children. The aggregation of all three categories of risk was the most accurate in identifying low performance at age 4, but would result in a high rate of under-referrals to early intervention services. A 2-tiered system of developmental follow-up, based on environmental risk criteria, is proposed.
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