A growing literature documents the deleterious effects of radiation therapy in children treated for malignant brain tumors. However, the clinical relevance of previous research has been limited by reliance on global IQ and achievement test scores. The present study of a sample of long-term survivors of medulloblastoma examined their cognitive and socioemotional functioning in depth with standardized psychologic measures. Participants' levels of intellectual functioning ranged from moderately mentally retarded to low average, with marked scatter across individual skills. Thirty-nine percent of participants had formal learning disabilities, with achievement substantially below their learning potential. In terms of specific areas of deficit, almost one half the patients tested (47%) showed considerable impairment in perceptual-motor coordination, fine-motor dexterity, attention and concentration, sequencing, and memory, particularly visual memory. More than one half of the sample (54%) was also described as displaying severe impairment in terms of maladaptive behaviors. Results are discussed in terms of the implications for special education, everyday skills, and psychosocial program development.