This paper argues that there is a critical need to reframe the fundamental policy questions which fragment early childhood intervention services and health care, in order to construct an integrated system of comprehensive services that includes basic health care and developmental support for all children and their families and that provides appropriate educational/therapeutic services for those with special needs. The core principles and goals of Part H of the Individuals with Disabilities Education Act should be incorporated into a universal system of health supervision, developmental facilitation, and family support. This approach requires: a more sophisticated approach to systematic screening for early identification and management of disability; major changes in medical training; a commitment to a joint agenda by the health care and early intervention professional communities; and a collaborative process of parent and professional monitoring and managing over time. The paper defines the essential features of pediatric health supervision, the goals of developmental and behavioral surveillance, and the principles of early childhood intervention. (Contains 17 references.) (JDD)