With the recent mandate for early intervention services, the pediatrician is more involved than ever in the identification and evaluation of children with developmental disabilities. Developmental surveillance at routine visits and listening to parental concerns are crucial in the early diagnosis of developmental delay so that therapeutic interventions can be provided at a time when there is a good chance of decreasing disability and family stress. Medical evaluations and consultations must be prudent and based on a thorough history and physical. The pediatrician must have the knowledge and skills to coordinate medical care and to counsel and provide support to the child and family as they receive habilitative services and come to terms with the developmental diagnoses.