Although elementary schools provide an opportunity for early identification and treatment of academic and psychological problems, relatively little is known about the types of symptoms being addressed in schools. Latent profile analysis on data from 678 urban first graders yielded 3 classes of children: nonsymptomatic (NS), internalizers and average performers (IAP), and externalizers and low performers (ELP), with different combinations of symptoms. Survival analyses conducted on the children's use of services (in Grades 1-9) indicated that students in the ELP class received mental health and special education services faster than those in the NS class, whereas IAP children were no more likely than NS children to receive services. Findings suggest that staff may be more sensitive to early educational and externalizing problems. (Contains 4 tables and 3 figures.)