This paper begins with an overview of the legislation shaping early intervention in the United States. A review of recent theoretical developments in working with families and children, cultural perspectives, language, communication and education of deaf individuals, and early childhood practices reveals marked contrasts between traditional and current approaches to early intervention, in particular as it regards services to families with young children who are deaf or hard of hearing. A set of paradigm shifts is discussed, including the trends from medical to socio-cultural models of treatment, from child-centered and professional to family-centered treatment, from isolated to interdisciplinary service delivery, from monocultural to multicultural practitioner perspectives, from auditory/oral and English learning to visual/gestural and American Sign Language learning, from diagnostic prescriptive to developmentally appropriate programming, and from teacher-directed to child-directed educational planning. Strengths, weaknesses, and practical requirements of each model are discussed in brief. (Contains 22 references.) (PB)