The objective of this study was to explore the relationship among extremely low birthweight (ELBW), psychopathology, and impairments in adaptive functioning in a regional cohort of 7–8-year-old children with a birthweight of 501–1,000 g compared to a sample of full-term controls. One-hundred twenty-nine of 143 (90%) ELBW survivors and 145 controls, born between 1977 and 1981, agreed to participate in the study. The children were assessed at a mean, unadjusted age of 7.8 years. Results showed that parents of ELBW children were more likely than parents of controls to report specifically problems of attention-deficit hyperactivity disorder (ADHD). There were few differences between the groups in terms of impairments in adaptive functioning. Further analyses showed that the relationship between ELBW and ADHD could not be explained by confounding psychosocial risk factors, nor were ELBW children from disadvantaged environments more likely to have ADHD problems than ELBW children from nondisadvantaged environments. The relationships between ELBW and ADHD problems appeared to be associated with the lower IQ of the ELBW subjects.