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Background. Infants with neurodevelopmental abnormality need to start therapy early, and because of this they should be detected as soon as possible. Currently, no widely accepted method of early evaluation exists.Objectives_ To assess and compare, in terms of predicting neurodevelopmental outcome at 1 year of age: (i) a perinatal risk rating (PRR); (ii) the DubQwitz Neurological Assessment. (DNA); and (iii) the Infant Neuromotor Assessment (INA). Design and setting. A prospective neurodevelopmental followup study on graduates from the Groote Schuur Hospital (GSH) neonatal intensive care unit (NICU). Subjects. A cohort of 130 consecutive NICD graduates were selected according to high-risk criteria_Outcome measures. Each infant was examined at term gestational age on the DNAbefore discharge, and a PRR was allocated_ Study infants were seen again at 18 weeks of age when an INA was done, and at 1 year of age a Griffiths Developmental Assessment and full neurological examination was carried out.Results. All of the 130 infants assessed at term were seen at 18 weeks. Thereafter 5 were lost to follow-up and 2 died. The outcome for the remaining 123 is known.Conclusions. Prediction of a normal outcome at 1 year of age was 96% on the DNA and 98% for the PRR, but for an abnormal outcome they predicted only 56% and 42%, respectively. The INA done at 18 weeks predicted a normal outcome at 1 year in 99% of cases if 3 or less abnormal signs were present and an abnormal outcome in 82% of cases with 4 or more abnormal signs. Based on these findings a protocol for follow-up of these high-risk infants is suggested.