This report documents a study which used naturalistic procedures and a case study approach to examine and describe four early childhood special education programs and their decision making processes. Data collection procedures included: observation of meetings, classroom activities, screening, and assessment procedures; interviews with various staff and administrative personnel; file searches; and parent surveys. Descriptions of each school program site include information on institutional characteristics, funding, screening and referral processes and decisions, diagnosis, intervention procedures, placement, and exit and follow-up procedures. Findings indicate that "Program A" reflected a systematic approach featuring short-term, data-based intervention designed to meet the needs of a large urban population. "Program B" offered an interdisciplinary, comprehensive, well-planned screening and intervention program for pre-kindergarten youngsters. "Program C" used a sophisticated, data-based approach to decision making for screening, referral, diagnostic assessment, intervention, and exit featuring qualified personnel and dynamic leadership. "Program D" reflected adaptations involved in providing services in a rural area where the relatively low incidence of handicapping conditions makes services harder to obtain. References are included and appendices contain parent surveys, meeting summaries, evaluative instruments, and other forms and materials used by the four programs. (CB)