This report of a 13-state conference on the needs of young children in the Appalachian region examines present conditions and changes over the past decade. The conference was organized around three central questions: (1) what are the needs of Appalachian children for healthy development? (2) how do existing child development programs meet these needs? and (3) what do Appalachian programs need in order to improve their delivery of services? Conference recommendations include: emphasis on early intervention, with recognition of family context and cultural background; development of manpower, including administrative manpower; greater utilization of public information resources to obtain financial support; development of information and referral systems; improvement of communication among programs and states; establishment of a network for legislative information; development of a data base on needs and services; and an increase in parent involvement. Included with the text are tables of data on health manpower, employment and per capita income for the region, as well as information on a variety of projects funded from several sources. Appendices include suggested fundraising and proposal writing procedures and a series of charts showing the distribution of health care personnel, nutrition services, and infant mortality rates in the Appalachian area. (BF)