We have demonstrated an association between race/ethnicity and Cognitive and Language scores on the BSID-III. Even though the differences in Cognitive scores were explained by a combination of medical and psychosocial factors, these factors did not account for the differences identified in Language scores. The identification of specific medical and psychosocial factors associated with increased risk for cognitive impairment may allow more precisely targeted early intervention. Our finding of sustained language differences in minority groups regardless of other risk factors provides a compelling argument for focusing early intervention programs on language attainment in these groups. In addition, given that BSID-III scores were below expected in all 3 racial/ethnic groups studied, our findings highlight the continued need for monitoring and provision of early intervention in all at-risk groups.