&NA;Professional development is one of the key provisions that state education and early intervention administrators must address for occupational therapists and other early childhood professionals who provide early intervention and preschool services under the Individuals with Disabilities Education Act. This article discusses issues in developing effective professional development programs for pediatric occupational therapists who work with very young children and their families, focusing on: 1) clinical and contextual trends affecting occupational therapy practice; 2) professional preparation at the university level; 3) continuing competency of therapists in the field; and 4) recommendations for ensuring that occupational therapists are both prepared and supported to provide quality early childhood services.