This study examines the usefulness of a screening process implemented in the context of a Head Start home visit and compares families who screened positive for substance abuse with those who did not on an array of child and family indicators important for healthy child development. The sample included 1,105 low-income families with preschool-age children enrolled in Head Start programs. Families were interviewed using the Family Map, an interview tool used to screen on a wide range of areas important for healthy child development. Children identified as having a positive screen for family problems with alcohol and other drugs (9.1%) were more likely to be at risk on 10 of 11 additional areas assessed. (Contains 3 tables.)