To address a gap regarding the development of preschool children with physical congenital anomalies and the adaptational responses of their caretakers, 37 children with anomalies and 44 control children were assessed. Children were administered the Stanford-Binet and the Preschool Language Scale, and the children and their mothers were observed in a series of semi-structured situations. Performance on linguistic and intellectual tests was related to socioeconomic status, not to medical risk. Children with anomalies were more socially reticent and compliant than peers, and their mothers were more controlling and nonverbally active during a teaching task. Results are discussed in terms of Bell's lower-limit adaptational pattern.