This study examined whether cry acoustics enhance the prediction of developmental outcome in preterm infants, after accounting for medical and social variables. Selection criteria for 149 preterm subjects included being born at less than 35 weeks gestational age and less than 1,500 grams; for 25 term subjects, selection criteria included being born healthy at term age (38 to 41 weeks gestational age). At 40 weeks gestational age, both during and following a neurobehavioral examination, cries were elicited with a painful heel flick when infants were supine and awake. Cries were recorded for 30 seconds using standardized procedures, and 10 acoustical variables were measured using the Cry Research, Inc. (CRI) computer-aided automated cry analysis system. At 30 months, infants were administered the McCarthy Scales of Children's Abilities or the Bayley Scales of Infant Development. Results suggested that acoustical analysis of the cry at term conceptual age enhances the prediction of developmental outcome even after accounting for medical and demographic variables. The number of short cry utterances was the best predictor in infants with fewer short utterances doing more poorly. Data from this study supported the notion that cry analysis may have some diagnostic utility as a non-invasive technique for the early identification of infants at biological risk for developmental delay. (MM)