Developmental disabilities are a heterogeneous group of chronic conditions that may result in substantial activity limitations. The type and number of limitations may vary by impairment characteristics. Economic and social constraints may impact activity limitations beyond those attributable to their impairment. Using the International Classification of Functioning (ICF), Disability, and Health conceptual framework, this study tests the hypothesis that activity limitations in young adulthood are not inevitable consequences of childhood impairment. The Metropolitan Atlanta Developmental Disabilities Follow-up Study of Young Adults, a cohort of young adults ages 21-25, is used to examine the relationship between childhood impairment and activity limitations in young adulthood. For young adults with isolated impairment, activity limitations are not probable outcomes. This situation is not the case for those with severe intellectual disability and/or multiple impairments. The type and extent of activity limitations vary by impairment characteristics. With the goal of improving and preventing activity limitations in young adults with various types and severities of childhood impairment, additional research is needed to further identify areas for secondary and tertiary prevention of the consequences of childhood impairment. The conceptual framework of the ICF provides a useful tool for testing hypotheses to pinpoint areas of intervention. (Contains 4 tables.)