Preschool children’s engagement/social interaction skills can be seen as aspects of positive functioning, and also act as protective aspects of functioning.On the other hand, hyperactivity/conduct problems are risk aspects that negatively affect children’s everyday functioning. Few studies have investigatedsuch orchestrated effects on mental health in young children over time. The aims of the study are rst, to identify homogeneous groups of children havingsimilar pathways in mental health between three time points. Second, to examine how children move between time points in relation to risk and protectivefactors. Alongitudinal study over 3 years, including 197 Swedish preschool children was used. Questionnaire data collected from preschool teachers.Statistical analysis using person-oriented methods with repeated cluster analyses. Children high in engagement/social skills and low in conduct problemscontinue to function well. Children with low engagement/social skills exhibiting both hyperactivity and conduct problems continue to have problems.Children with mixed patterns of protective factors and risk factors showed mixed outcomes. The stability of children’s pathways was quite high if theyexhibited many positive protective factors but also if they exhibited many risk factors. Children exhibiting a mixed pattern of protective and risk factorsmoved between clusters in a less predictable way. That stability in mental health was related to the simultaneous occurrence of either many protectivefactors or many risk factors supports the notion of orchestrated effects. The results indicate that early interventions need to have a dual focus, includingboth interventions aimed at enhancing child engagement and interventions focused on decreasing behavior problem.