Twenty-six of 30 participants (87%) who took part in a medication study for treatment of ADHD were followed up 2.9 to 4.8 years (Mean = 3.9 years) later. Parent ratings on the Aberrant Behavior Checklist Community (ABC-C) indicated continued problems on the acting-out subscales, and parent assessments on the Stony Brook Checklist-3R showed a high rate of difficulty on domains called ADHD. Conduct Disorder, and Separation Anxiety Disorder. A high percentage of children (69%) were taking psychotropic drugs, substantial numbers of their families had sought nonmedical treatments, children's friendships were often rudimentary, and a significant minority of children had disciplinary problems in school or difficulty with the law. Using Pearson correlations, we identified a number of initial variables that predicted follow-up parent ratings on the ABC-C and Stony Brook. The ABC-C Irritability subscale was useful in predicting both internalizing and externalizing problems at follow-up, whereas parent and teacher hyperactivity subscales failed to predict later hyperactivity. Children identified with both low intelligence and ADHD appear to have significant behavioral and emotional problems in their early adolescence, and there may be some important qualitative differences in the outcome of these youngsters as compared with that of children identified with ADHD and normal IQ.