Findings related to instructional intervention and decision making from four in-depth ecological case studies were integrated and analyzed. The case studies focused on four early childhood special education (ECSE) programs that were characterized by a variety of approaches to ECSE decision making and by urban, suburban, and rural locations. The considerable variability found among the programs' intervention practices appeared to be influenced by demographic characteristics and available funds, program experience, and staff experience. Consistencies were seen across programs for team approaches to interventions, formulations of individualized education programs, and individualization of intervention practices. Trends affecting program effectiveness included availability of specialists, frequent change of program location, lack of formal evaluation of the intervention program, and relationship between ECSE efforts and those of regular education programs. (Author/CB)