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Because of improvements in neonatal care in India, there is an increase in the survival rate of high-risk newborns; however, subsequent developmental support systems are inadequate. There is minimal documented research that examines the role of pediatricians as key stakeholders in the early intervention (EI) process in India. The aim of this study was to document perceptions and practices of pediatricians in Gujarat state, India, regarding identification of children at risk for developmental problems, referral procedures, access to EI services in their community, and relevant educational needs.An exploratory survey was courier mailed to the entire population of pediatricians in Gujarat. Analyses were based on survey responses from 192 pediatricians.Pediatricians infrequently used developmental assessment tools to identify children with delays, even when a child had biological or established risk conditions. The top 3 barriers to screening were insufficient time, lack of treatment choices, and lack of knowledge regarding referral options. The main deterrent for making referrals was the paucity of EI services. Nearly half the pediatricians reported receiving inadequate training for early detection of childhood disabilities during their medical education. A key continuing education need was learning about developmental screening techniques.Although more research is needed, it is clear that Gujarat's pediatricians consider early identification of children with developmental concerns as their role. Findings underscore the importance of providing them with more resources and training to promote the developmental aspects of children's health.