Disruptive behavior patterns are particularly challenging for parents, teachers, and peers as these behaviors often interfere with classroom instruction, frequently lead to academic underachievement, and are associated with social skills acquisition and performance deficits. Children who exhibit a combination of hyperactivity-impulsivity-inattention and conduct problems (HIA + CP) have been shown to be at greater risk for negative social, behavioral, and legal outcomes than children with HIA-only or CP-only behavior patterns. This investigation explored the degree to which academic, social, and behavioral characteristics in Grade 4 could differentiate sixth-grade students with HIA + CP (n = 61), HIA-only (n = 29), and CP-only (n = 14). Results showed that the HIA-only group had higher academic achievement in Grade 4 as measured by teacher judgments and standardized tests than the HIA + CP and CP-only groups. By Grade 6, the HIA-only and HIA + CP groups showed lower academic competence than the CP-only group suggesting that by sixth grade, children having HIA alone or in combination with conduct problems are at greater risk for academic failure. Additionally, HIA + CP and CP-only groups had poorer social skills than the HIA-only group. Consistent with past research, students in the three risk groups showed no difficulties in either academic or social self-concept. Early screening and identification methods using a multiple-gating model were recommended as a means of proactive approaches to intervention design and prevention. (Contains 3 tables.)