There is growing evidence among researchers and international organisations that quality of Early Childhood Education and Care (ECEC), and ultimately the outcomes for children and families--especially disadvantaged ones--is dependent on well-educated and competent staff, and that a lack of higher pre-service training can be partly compensated by in-service training of a sufficient intensity and length. In this article an overview is given of three qualitative studies of the competences needed to work in ECEC with children and families at risk. These three studies focus on ECEC practitioners who have played an active role in a change process aimed at developing a new pedagogical approach to working with children and parents with disadvantaged backgrounds. The three studies also strengthen the view that pedagogical support, sustained over long periods of time and developed by specialised staff (such as pedagogical coaches), is seen as a successful way to develop reflective thinking on practice and to construct new knowledge and practices when working with families and children. To conclude, the article tries to define how in-service training can be organised in a comprehensive way.