We examine whether children with early unilateral brain injury show an IQ decline over the course of development. Fifteen brain injured children were administered an IQ test once before age 7 and again several years later. Post-7 IQ scores were significantly lower than pre-7 IQ scores. In addition, pre-7 IQ scores were lower for children with larger lesions, but children with smaller lesions and higher pre-7 IQ scores showed a greater IQ decline over time. These findings suggest that the cognitive outcomes of children with early lesions, particularly those with relatively small lesions, change over the course of development.