Early childhood is important for future cognitive and educational outcomes. Programs overcoming barriers to engagement in early education for Indigenous children must address family cultural needs and target developmental delays. This systematic review identifies culturally adapted programs to improve cognitive, emotional and developmental delays among young children, in response to an identified priority of a remote Indigenous community. Five databases (the Cochrane Library, Embase, Medline, Scopus and CINAHL) were searched for English language papers in January 2018. Study quality was assessed and findings analysed thematically. Findings were presented to the community at an event with key stakeholders, to determine their inclusion and face validity. Seven relevant studies, published between 1997-2013, were identified by the researchers and each study was supported by the community for inclusion. Two studies focused on Native American children and five studies included children from non-Indigenous disadvantaged backgrounds. Findings were reported narratively across four themes: Storytelling to improve educational outcomes; Family involvement improved development; Culturally adapted Cognitive Behavioral Therapy to reduce trauma; Rewards-based teaching to improve child attention. Limited published research on culturally adapted and safe interventions for children with cognitive, emotional and developmental delay exists but these four themes from seven studies identify useful components.