It has been estimated that the occurrence of mental health problems in children will increase 50 percent by the year 2020 and will exceed all other causes of childhood illness (NIMH, 1998). Youth with serious emotional disturbance (SED) are being cared for in residential treatment. In recent years there has been little research conducted with this population. Measuring outcomes for SED youth is complex. Behavioral checklists are typically employed in this research. Nursing education prepares one to recognize the significance of developmental trajectories when working with children. Developmental psychopathology compels the researcher to consider outcomes of treatment for SED youth from a developmental position. A key indicator of psychological, social, and emotional health is an individual?s effectiveness in social interactions or social competence. A tool has been developed for assessing social competence from a developmental perspective. The specific aims of this descriptive study are: to assess and compare social competence and behavior problems of SED youth upon admission to and prior to discharge from residential treatment; to explore the relationship between behavioral problems and social competence scores; and to explore various demographic variables, including, number of changes in family/caregivers, number of out-of-home placements, and psychiatric diagnosis, in relationship to behavior problems and social competence measures. Outcome information will serve as a catalyst for designing a model of care that will incorporate developmentally-based assessment and intervention and will be foundational to future research.