Screening procedures typically are quick assessments intended to identify students with a baseline performance qualifying them for services. Effective screening measures have strong specificity, and in turn, students in need of services are identified as true "fails." Previous studies have investigated sensitivity and specificity levels of screenings measures, demonstrating a reduced level of specificity, creating an inflation in the results of false positives. The objective of this study was to investigate the effectiveness of speech and language screening measures in pre-school children enrolled at Head Start programs and the follow-up that occurs as a result of these screenings and discuss methods to maximize desirable outcomes for children. A total of 139 files with information on follow-up of services were evaluated. The majority of files lacked any evidence regarding follow-up as well as the reception of services. The study leads to suggestions for revisions to aid in improvements of the current screening set-up and, more importantly, follow-up process. These include, but are not limited to: bilingual translations, the importance of speech and language advocacy in early development; a FAQ sheet for parents, revised pre-screening/consent, and final report post-screening forms. (author abstract)