In this article, we examined predictive validity of "Student Risk Screening Scale--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 with students at low risk for externalizing or internalizing behaviors. Educational implications, limitations, and future directions are presented.