Despite an emphasis on family-centered practices in early intervention, the translation of this philosophy into practice is unclear. We, therefore, measured practices of 250 early intervention service providers in Spain, with the Families in Natural Environments Scale of Service Evaluation. We analyzed the "difficulty" of practices, through Rasch analysis, and reasons for the discrepancy between typical and ideal practices, through qualitative analysis. Results showed that the typical high-quality practices were "working with families" and "demonstrating strategies," whereas the typical low-quality practices were "identifying family supports" and "letting the family set the agenda for the home visit." Lack of training was the most frequently reported reason for the discrepancy. Rasch analyses showed that the items participants were most likely to score low were identifying family supports, addressing families' satisfaction with routines, and letting families set the agenda for the visit.