Abstract The overall objective of this paper is to assess the clinical significance of neurocognitive impairments (NCI) among children with psychiatric disorders. One hundred and fifty‐three children referred to a mental health clinic underwent neuropsychological testing. Their parents were interviewed to obtain background information and data on their children's behavior. Parents and teachers also filled out behavior checklists. The results suggest that neurocognitive impairments are: (1) more strongly associated with externalizing rather than internalizing psychiatric diagnoses; and (2) are correlated with psychiatric symptoms at school, but not at home. The implications for understanding the impact of neurocognitive impairments on the situational specificity of psychiatric symptoms are discussed.