A day care director of a center sponsored by a metropolitan medical center designed and implemented a practicum study to address the lack of a system for identifying and assessing high-risk children. The practicum was also intended to develop a program which would respond to teachers' concerns for children with special needs and obtain positive endorsements from teachers at the center. Registration forms were revised to include health and developmental information provided by parents. A new screening instrument was reviewed, selected, and implemented in student evaluations. A reference manual was compiled for center staff. The manual provided guidelines for step-by-step responses to students with problems. The manual also included lists of behaviors suggesting special needs status, of behavioral and developmental signs of high risk, and of resources for children; documentation strategies; conference recommendations; and parental release forms. Evaluation data indicated a favorable response to the project on the part of the center staff. There was an increase in the percentage of children's evaluations completed. A committee of parents and hospital personnel determined that the project had yielded a plan that would identify and provide follow-up services to children who might be at-risk. Related materials, such as the manual, registration form, and survey forms, are appended. (RH)