In this article we examined predictive validity of Student Risk Screening Scale for Internalizing and Externalizing (SRSS-IE) scores for use with elementary-age students (N = 4,465) from 14 elementary schools. Results indicated elementary school students with high levels of risk according to fall SRSS-IE scores -- especially those with externalizing behaviors -- were more likely to have lower oral reading fluency scores, lower Measures of Academic Progress (MAP) reading scores, more nurse visits, and more days spent in in-school suspension compared to students at low risk for externalizing or internalizing behaviors. Educational implications, limitations, and future directions are presented. [This paper was published in "Journal of Emotional and Behavioral Disorders" v27 n4 p221-234 Dec 2019 (EJ1234430).]