The relative importance of selected developmental, medical, and social factors in assessing a child's early academic potential was evaluated prospectively in a rural southern school district. Two hundred and ten (210) preschoolers were given the Sprigle School Readiness Screening Test (SSRST) and the Beery Test of Visual Motor Integration (VMI) while physicians rated the children's attention span. A parental questionnaire assessed medical, behavioral, social, and family variables. Follow-up school data were available on 176 children (84%). Using regression techniques, reading and math achievement scores were directly correlated with maternal education, SSRST and VMI results, and lack of family history of learning problems, whereas grade failure was associated with low VMI scores, decreased maternal education, boys with late birthdays, and family history of learning problems. Medical problems and parental preschool behavior concerns were unrelated to school achievement, but physician rating of preschool attention span showed a significant correlation with reading and math scores. A 0-11 Risk Index of School Capability (RISC) scale based on data analyses was developed to rate a preschooler's early academic potential. A score of 7 or above had a 98% positive predictive value of successful grade completion, whereas a score of 3 or below had a 70% predictive value for grade failure. The value of assessing the scores of the VMI and SSRST alone was also considered, but was found less useful. This study demonstrates the importance of evaluating a number of risk factors in assessing a preschooler's early academic potential. Such data can be used to focus school resources for children at increased risk for grade failure.