Mental retardation has been categorized into severe mental retardation where genetics plays a very important role and mild mental retardation, in which genetics in some instances plays a role but in which cultural factors also matter a great deal. The pathogenetic, clinical and behavioral characteristics of genetically determined disorders associated with mental retardation differ greatly-as exemplified by two genetic disorders that have been clarified recently, namely Rett syndrome and the Williams syndrome. In the work-up of the developmentally disabled child, previous studies have shown that genetic studies are of have great importance and high yield. Early biochemical diagnosis in newborn screening has tremendous potential and has been strongly supported by NICHD-the PKU story being so much part of what NICHD has done. We must gain a better understanding of structure/function relationships, which becomes more and more possible with neuroimaging. A better understanding of neural plasticity can lead to correction by early intervention.