Early childhood education is the cornerstone of an education system. However, to the population of children at risk of developmental disabilities (CARDD), challenges early childhood teachers need to face are not only early identification of these children, but also development and implementations of productive interventions to reduce influences of existing deficits on their personal development and maximize these children's potential to learn. According to a statistic report by World Health Organization (2011), in a majority of countries in the world, around 14% 36 to 35% of children aged between 2 to 9 years old are at risk of developmental disorders. Seeking to provide a good understanding of teacher preparation for identifying and intervening CARDD, the present study investigated: a) the confidence level of over 3,000 teachers in a wide range of instructional activities (e.g., confidence in facilitating teaching and learning, facilitating social development, collaborating with parents and other related personnel) across 238 kindergartens, and b) the needs of early childhood teachers in supporting CARDD in Hong Kong. The role of integrated programme placing/not placing in these investigated kindergartens is also taken into account in understanding potential differences of teachers' confidence in identifying, teaching and intervening CARDD. Implications to professional development, improvements of existing facilities and resources to assist early childhood teachers in identifying and supporting children with developmental disabilities are discussed.