Throughout the 1990s, interest in and support for our youngest citizens has expanded considerably in the public and private sectors. Throughout the United States, researchers, policy makers, business leaders, media, and parents have recognized the significance of early care and education to fostering children's early learning and development. Yet, despite recent attention to and activity concerning early care and education, persistent challenges pervade the delivery of services for young children and their families. Historically our nation, while voicing commitment to young children and their families, has layered an insufficient number of piecemeal and idiosyncratic services upon one another, constantly reinforcing – rather than alleviating – an inequitable, nonsystem of early care and education. Although innovative efforts have been launched to redress this situation, like the direct services themselves, these efforts have been without significant coordination or collaboration.

Given the increasing utilization of early care and education services, the significant attention being accorded to young children, and the willingness of the public to act more aggressively on this issue than ever before, how can we create a strategic approach to advancing early care and education in the United States? In this chapter, we tackle these issues, first discussing the status of American early care and education today, particularly recent changes in demographics, service delivery, and attitudes. We then delve into the pervasive problems that have plagued the field throughout its history. Given this context, we describe some current innovative efforts in early care and education.