Psychiatric and behavioral consequences of congenital rubella are reported for 243 children studies during the preschool period, and for 205 of these who were re-examined at ages 8 to 9. At preschool 37% were retarded, with the skew toward severe and profound; 15% had reactive behavior disorder and 7% had autism. At school age retardation diminished to 25%, but neurotic problems and behavioral pathology due to neurologic damage both increased. There were two remissions and three new instances of autism.