The purpose of this longitudinal study was to evaluate changes in neurologic abnormalities in 212 preterm and 128 full-term children. Preterm infants with severe medical complications were considered at high risk, while those with milder complications were considered at low risk for neurodevelopmental abnormality. The patterns of change in neurologic status for the high- and low-risk preterm and term groups across 6, 12, 24, 40, and 54 months of age were compared using growth modeling analysis. As expected, the term group showed minimal change, while the two preterm groups demonstrated complex, nonlinear patterns of change in neurologic abnormalities. While the results demonstrate improvement over time in both groups of preterm infants, 35% of the children in the high-risk group had neurologic scores in the borderline or abnormal range at 54 months. These findings demonstrate that neurologic deficits are still evident at preschool age in some preterm children and that these deficits are related to the severity of neonatal complications.