The purpose of this review is to present a new framework, EI SMART (early intervention: sensorimotor development, attention and regulation, relationships, and therapist support) for identifying key components that could contribute to more effective interventions for infants at high risk of atypical neurodevelopmental outcome. We present a clinical consensus of current challenges and themes in early intervention, based on multidisciplinary group discussions, including parents of high‐risk infants, supported by a literature review. Components to include in early intervention programmes are: (1) promotion of self‐initiated, developmentally appropriate motor activity; (2) supporting infant self‐regulation and the development of positive parent‐infant relationships; and (3) promotion of early communication skills, parent coaching, responsive parenting, and supporting parental mental well‐being. Such multimodal programmes may need to be evaluated as a package. What this paper adds Early intervention programmes should address sensorimotor development, attention, self‐regulation, and early communication skills. Therapist input to the programme should include parent coaching and support for parental mental well‐being.

Infants who require admission to a neonatal unit and who ultimately present with complex neurodevelopmental difficulties often require more sustained engagement with early intervention services during admission and beyond. However, there is little research exploring families' experiences of early intervention (EI) therapy received throughout a neonatal unit admission and continuing through transition into the community setting. This study was designed to explore parents' perceptions of EI therapy for infants with complex emerging neurodevelopmental difficulties. Using a descriptive qualitative approach, interviews were conducted with 6 mothers whose infants had been admitted to a neonatal unit and were receiving EI therapy services for their child. Interviews were audio-recorded and transcribed and then thematically analyzed. Four key themes emerged articulating the parent experiences during their evolving relationship with therapy providers in the neonatal unit and following discharge: (a) a vulnerable start—adjusting to the unexpected; (b) becoming a mother—becoming a family; (c) the therapy journey; and (d) a new reality. Attributes that enhanced the developing parent–provider relationship were identified including the importance of developing collaborative communication styles, supporting families in developing their expectations of the parent–provider relationship, and ensuring clarity in the nature, scope, and contribution of EI therapy to their child and overall family development. Early introduction of EI therapists during an infant's admission to a neonatal unit can serve to strengthen the parent–provider relationship by offering a support continuum during a vulnerable time.