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Children entering foster care are often described as having multiple problems, although there are surprisingly few comprehensive baseline descriptions of children as they enter care. Further, few studies have examined the interactions among baseline characteristics, physical and mental health problems, and their joint influence on the likelihood that a child will remain in care. The purpose of this study was to investigate the relationship of physical and developmental problems identified shortly after the children entered substitute care to the likelihood of their remaining in care. Data for these analyses came from 272 children (ages 1 month to 7 years) seen at the Foster Care Clinic in Waterbury, Connecticut, between November 1985 and December 1989. All children received a complete physical health assessment and developmental screening upon entry into care. The outcome variable, children's placement status as of September 1990, was confirmed through the Social Services Agency's records. Results indicate that children in foster care commonly showed developmental delays (53%). Further, those who were older at entry into care and nonwhite and who had developmental problems identified were 1.93 times more likely to remain in foster care. Given these findings, early comprehensive assessment for children entering foster care is strongly recommended. J Dev Behav Pediatr 15:105–110, 1994. Index terms: developmental problems, foster care.