 Data was studied from the BSID-II tests of 344 ELBW infants admitted to the neonatal intensive care unit at the Rainbow Infants and Children’s Hospital in Cleveland, OH from 1992-1995.It was found that the predictive validity of a subnormal MDI for cognitive function at school age is poor but better for ELBW children who have neurosensory impairments.This brought on concern that decisions to provide intensive care for ELBW infants in the delivery room might be biased because of reported high rates of cognitive impairments.