Intelligence and achievement test scores for 89 children with myelomeningocele (MM), ages 4 to 14 years, were obtained from medical records. These children scored below the population average but within the normal range on most tests. The greatest deficits occurred on Performance IQ, arithmetic achievement, and visual-motor integration (copying geometric designs). With increasing age, these children fell further behind age-peers on tests of arithmetic and visual-motor performance while keeping pace on reading and spelling tests. We speculate that these findings may reflect a developmental difference between MM children and nonhandicapped children in a visual-perceptual-organizational cognitive function such as Rourke (1987) has proposed.