This paper provides a review of the literature on the needs of young children in the United States who are at risk for failure and offers suggestions for early intervention and societal change. The problem is documented in sections concerning: a definition of "at risk," the importance of the first years of life, prevention, successful programs of intervention, cost effectiveness of early intervention, today's family, the important factor of poverty, the role of societal organization, and resilience in children. The next broad section looks at dysfunctional families, in discussions of substance abuse, sexual abuse, violence, mental health, homelessness, stress, the value of home visitations, and family stability versus family instability. Healthy families are considered in a section on family strengths. The remaining sections address what needs to be done, with consideration given to: prerequisites for academic success and collective responsibility; the role of schools, governments, employers, communities, and mass media; higher levels of learning; final recommendations; and a hopeful look to the future. (Contains 90 references.) (DB)