Data are presented on 232 children under 18 years of age in the metropolitan area of Vancouver referred in 1960 to psychiatric facilities for evaluation because of academic difficulties. This material formed the basis for a 5-year follow-up study on the utility of the psychiatric consultation to the children's teachers and the children's subsequent progress in school. In only 40% of cases were the findings of psychiatric evaluation available to the school personnel; in less than half of these instances were the findings deemed by the teachers to be of any assistance to them in their work with the children.Data collected on all 1,037 children who received psychiatric care for the first time in the metropolitan area of Vancouver in 1960, (previously described by Nichol and Richman 1964), form the basis for this follow-up study of a random sample of the 232 children who were referred for academic difficulties. In order to determine how psychiatric services are being used for children with learning difficulties, there is a need to survey not only the work of all the psychiatrists providing care from a designated area, but also those associated with indirect and direct school consultation services. This is the only way to provide an adequate basis for the planning and development of further services and to obtain an understanding of how psychiatric evaluations, performed in various clinical settings, are made available and utilized by school personnel. The findings of the initial study and of the follow-up of a random sample of children with academic difficulties are given in this paper.