The Kids First program at the University of Arkansas Medical School (UAMS) is an outgrowth of the Infant Health and Development Program, a randomized trial of an early intervention approach for premature, low birth weight children, which showed that intensive intervention had significant initial benefits in the cognitive development and behavior of these children, particularly for those in undereducated and poor families. When the UAMS decided to expand the Kids First network of early intervention centers, it considered four key indicators of child well-being in determining where to establish new sites: (1) the local rates of low birth weight; (2) low maternal education; (3) children living in poverty; and (4) special education placements. Kids First services can include nursing; speech, occupational, and physical therapy; and nutritional intervention, along with the daily classroom educational interventions. Interdisciplinary teams work with parents. Core developmental services address cognitive, gross and fine motor, language, social-emotional, and self-help domains of development. UAMS has resources that are not available to many rural early intervention programs--for example, the ability to offer above-average salaries to professionals and paraprofessionals, and access to high-speed Internet and e-mail connections. The authors recommend even more extensive use of technology in rural areas, including: (1) the use of video conferencing for professional development of staff members located in rural areas; (2) sending residents in pediatrics, community, and preventive medicine, and other specialties to local centers; and (3) continuing medical education in rural communities for Kids First referring physicians.