The academic performance of 129 Barbadian children (77 boys and 52 girls), who were 5-11-yr-old and suffered moderate to severe protein-energy malnutrition in the first year of life, was compared with the performance of matched comparisons, children who had no history of malnutrition. Children with a history of malnutrition were found to have lower performance on eight out of nine academic subject areas, namely, language arts, mathematics, general science, social science, reading, health, religion, and arts/crafts. Socioeconomic factors in the backgrounds of the children were also examined. A model is presented clarifying the interrelationships of malnutrition, socioeconomic status and school performance. Reduced school performance in the previously malnourished children can be largely accounted for by deficits in classroom behavior, and, to a lesser extent by a reduction in I.Q. Current socioeconomic status is not directly involved in altering academic performance whereas the early history of malnutrition and its accompanying conditions at the time of the illness are leading contributors to altered behavioral outcome and school performance.