This paper is the result of an intensive case study by an Organisation for Economic Cooperation and Development (OECD) review team, whose purpose was to investigate early childhood education and care (ECEC) in the United States, 1 of 12 countries participating in the OECD review between 1998 and 2000. The paper draws on information provided by a U.S. Department of Education background report, formal and informal discussions, document analysis, literature surveys, and observations of the review team. The paper's introductory chapter outlines the rationale of the OECD review and describes the goals and framework of the review visit and the paper. The remaining chapters are: (1) "Major ECEC Policy Priorities in the USA: A Brief Overview"; (2) "Contextual Issues Shaping ECEC Policies in the USA"; (3) "Current ECEC Policy and Provision in the USA"; (4) "Issues Arising from the Review Visit"; and (5) "Policy Implications from a Review Team Perspective." The paper's appendices present review team members, information on the U.S. background report, and a program of the review visit. (Contains 28 references.) (EV)