Objective: To determine whether preterm children born at ≤32 weeks’ gestation who did not cooperate for developmental testing at 3½ to 4½ years old were more likely to have school problems at 7 to 10 years old than preterm children who completed developmental testing. Study design: The McCarthy Scales of Children’s Abilities were administered to a cohort of 118 preterm children at 3½ to 4½ years old when they were seen in the neonatal follow-up clinic. When these children were 7 to 10 years old, their parents completed the Child Behavior Checklist, and the child’s teacher completed the Teacher’s Report Form. Results: Parents returned questionnaires on 105 (89%) children. On the Teacher’s Report Form, children who were untestable had more somatic complications and more attention problems and scored higher on the Total Problems Scale and the Internalizing Scale than children who had completed testing. Children who were untestable were twice as likely to receive help in school than were children who completed developmental testing. Conclusions: Preterm children born at ≤32 weeks’ gestation who do not cooperate for developmental testing at 3½ to 4½ years old should be examined at school age for evidence of school and behavior problems. (J Pediatr 1999;135:756-60)