One hundred, ninety adolescent mother-infant dyads judged to be at extreme risk for relationship failure and possible child maltreatment were assessed by a trained nurse/social worker team within 24 hours of delivery of the infant. The statewide Central Registry of child maltreatment reports was later examined to learn which mothers had been reported since the initial assessment 12 to 27 months earlier. The subsamples of this resulted in 172 Non-CPS mother-infant dyads and in 18 CPS-involved mother-infant dyads. Comparison of differences revealed that the key signals of risk were the personal, environmental, and educational isolations from those elements critical to the successful rearing of a child. Necessary, but absent, elements of successful maternal-infant relationship were found to include: knowledge of child care techniques and alternatives discipline and parent-skills; more appropriate assessments of mother-infant dyads; and greater social support for the mother's seeking and finding other appropriate child care helpers.