This study conducted in a pediatric hospital was initiated to determine whether an educational program focusing on the identification and referral of children at risk for developmental disturbances or variation would increase nurses' ability to identify such children and increase the actual number of referrals. Data analysis comparing pre-and post-intervention referral rates revealed fewer children being referred than should have been. The number of referrals did not differ significantly between pre-and post-education groups. Implications for policy and practice are discussed.