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To distinguish Cuban children clinically referred because of ADHD from an at-risk community sample and a community control group in terms of symptoms, associated difficulties and impairment of family and peer relations. Parents and teachers of 1,036 children (6-8 years old) completed an established ADHD rating scale and a behavioral screening measure, including peer functioning.We also administered a structured clinical interview and measures of family impairment to the clinical sample and to an at-risk community-based subsample. Although both clinical and at-risk groups displayed more externalizing and internalizing symptoms than controls, referred children were not only characterized by higher levels of ADHD symptoms, but also by greater impairment of family and peer relations than at-risk community children or community controls. The findings suggest that …