Recent research on the growth of the brain shows that it develops more rapidly during the first three years of life than at any other time and that these early years lay the foundation for the rest of the child's development. With the increased awareness of the importance of the initial years of life, many state and local governments are developing programs that focus on the healthy development of infants and toddlers. Recent federal legislation also has shifted more authority to states and combined categorical funding streams into block grants to improve the coordination of social services. For example, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 enables states to completely redesign their welfare programs and increases the federal funds available to subsidize child care for low-income families. States now have unprecedented authority and flexibility to design comprehensive and efficient programs that address the needs of young children and their families.In March 1997, representatives from state and local children's initiatives in Colorado, Georgia, Hawaii, North Carolina, Ohio, Rhode Island, Vermont, West Virginia, and Allegheny County, Pennsylvania, gathered in Washington, D.C., to share what they have learned in developing comprehensive programs for young children. Researchers, child advocates, federal government officials, and other state representatives also participated in the meeting. This Issue Brief summarizes the challenges that state and local officials encountered in developing, implementing, and sustaining comprehensive programs for children, as well as the insights they learned in meeting those challenges. Other states that are developing or implementing children's initiatives can benefit from the experiences and lessons described in this Issue Brief.