Enhancing Developmentally Oriented Primary Care (EDOPC) is a formal didactic curriculum based on Healthy Steps materials that is designed to improve practicing pediatricians' knowledge and confidence in developmental screening within the medical home. We modified the EDOPC program to provide a formal curriculum to pediatric residents serving children in distressed neighborhoods. Using a pre/post design, we evaluated whether the modified EDOPC program improved their knowledge and confidence regarding developmental screening and referrals to community supports. In particular, we assessed resident knowledge and confidence pertaining to 4 early child disorders: autism, social-emotional risk factors, postpartum depression, and developmental delays. Overall knowledge of development significantly increased, while self-rated confidence in the ability to refer and manage was not affected. Chart audits 1 year after the intervention demonstrated increased use of screening tools and more referrals to community services. This article will discuss lessons about facilitators and barriers to teaching residents about vulnerable preschool children. (Contains 10 tables.)