The author discusses the question of whether problems during infancy associated with organic impairment are substantially different from those related to social-emotional deprivation. Five factors which have a significant impact for both organically impaired and environmentally deprivated infants are addressed: prenatal intensive care, very early diagnosis, objective prognostic criteria, and infant-parent enrichment programs. Tables are provided on early signs of spastic cerebral palsy, feeding difficulty, and behavior disturbance. Four case reports of babies provided with guidance through a home enrichment program illustrate key issues in the management of high risk infants. (SBH)