This paper synthesizes current thinking, issues, and practices related to the use of paraprofessionals in the provision of early intervention and preschool services to children with disabilities, birth through 5 years of age, and their families. Information was gathered from 31 state and jurisdiction coordinators of preschool services under Part B of the Individuals with Disabilities Education Act (IDEA) and coordinators of IDEA Part H. Findings revealed that 18 states had a policy for assuring quality personnel for either early intervention or preschool services that includes the use of paraprofessionals; that 5 more states indicated that a policy was in the planning stage; and that 8 states indicated that no policy exists. Ten states reported that they had established a new occupational category; of these, eight were at the paraprofessional level. Fourteen states had developed or were developing personnel standards for paraprofessionals, and 10 states had developed or were developing a credentialing process. Case examples of two states are presented: Illinois, where the Department of Education is the lead agency for both Part B and Part H programs; and Utah, where the State Board of Education is the lead agency for Part B and the Department of Health is the lead agency for Part H programs. Names and addresses of state resources for information on paraprofessional personnel policies and practices are listed. Appendixes contain a copy of the data collection instrument and a chart reporting each state's response. (JDD)