Velocardiofacial syndrome (VCFS), the most common microdeletion syndrome, is increasingly diagnosed in young children because of advances in diagnostic testing. The result is an increase in the number of young children with VCFS referred for early intervention (EI) services. We describe early development of children with VCFS and strategies to guide EI services. Effective outcomes and preparation for school require an integration of strategies specific to the needs of the young child with VCFS within the guiding principles of EI.