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The effect of cyanotic congenital heart disease on intellectual development was evaluated in a 5-year study of 98 children with cyanotic and 100 with cyanotic congenital heart disease. 81 normal siblings of patients and 40 well babies were also tested. Gesell, Cattell, and Stanford-Binet Scales were administered at specified time intervals, and clinical, physiological, demographic, and behavioral variables were recorded. Cyanotic children scored significantly below acyanotic and well children. When IQ was adjusted for physical incapacity, however, the difference between cardiac group was reduced. A manor finding was that incapacity is significantly related to intellectual functioning in the early years but the correlation between S-B IQ and incapacity beyond 3 years is slight. Explanation were sought in (1) the nature of intellectual functions tapped by tests at different age levels and in (2) the role of incapacity in affecting the nature of the cardiac child's experience and functioning in the early years. [ABSTRACT FROM AUTHOR]