We previously reported outcome at 6, 12, 24, 40 and 54 months as part of an ongoing study of High Risk (HR) VLBW infants with chronic lung disease and/or Grade III or IV IVH (N=75), Low Risk (LR) VLBW infants with acute lung disease and/or Grade I or II IVH (N=118) and Full Term controls (FT) (N=114). The results of cognitive, neurologic and social function have shown HR have more impairment than LR and FT, LR have deficits in specific areas compared to FT and that LR persist in functioning in the low normal range. Premature children are at risk for social, behavioral and learning problems at school age and in adolescence. A potential precursor is problems in the development of self regulation or executive processing skills including organizing and regulating behaviors, ability to formulate goals and ability to take an active role in social and non-social situations. We evaluated our children to determine if there were differences in the three groups in acquisition of these types of skills. As part of their evaluation at 40 and 54 months, the children were evaluated with observational measures of self regulation and executive processing skills including the number of trials it took to obtain rewards in search tasks and the number of episodes spent in independent goal-directed toy play. Social initiating skills were evaluated by observational measures as the child interacted with the mother during daily activities and toy play. The results on the search task at 40 months showed HR scored significantly lower than FT but not LR children. In episodes of goal directed play, HR and LR children were significantly different (p<.001) from FT but were not different from each other. In social initiating, HR were significantly different (p<.05) from LR and FT. At 54 months the results on the search task showed that HR scored significantly different from LR and FT (p<.01) and LR and FT did not differ from each other. In episodes of goal directed play, HR and LR differed from FT. In initiating, there were no differences between groups. Between 40 and 54 months, there was an improvement in certain areas in the premature groups. The LR group improved in increased sophistication of goal directed toy play and the HR group improved in social initiations. Further research is needed to determine if improved social initiations with caregivers generalizes to better social interactions with peers and teachers at school age.