In the North Paddington Primary School Study 350 children were identified at five and studied over a five-year period. The children were given a comprehensive examination on entry to school, the findings from which are briefly described. Here the results of the neurodevelopmental assessment are reviewed. Children with a high (abnormal) neurodevelopmental score (NDS) are shown to be a very vulnerable group with significantly higher rates of learning difficulty by the age of 10. The NDS alone does not give as good a prediction of such difficulty as the school doctor's clinical judgment. It is emphasised that prediction of difficulties is not an objective of the school entrant examination but clearly the clinical tests from which a NDS can be calculated provide a sound basis for clinical practice. Attention is drawn to the need for the school doctor with discretion to pass on to teachers the results of their examination that may increase the teachers' insight into their pupils and help them in their methods of teaching and care.