Infants born extremely premature are increasing in incidence and survival rates. This longitudinal study examined caregiver-child interaction in a new generation of extremely premature infants. Caregiver-child interaction and child developmental status were assessed in 41 primary caregivers and their infants at three periods (9-13 and 21-25 months adjusted age and 33-36 months chronological age). Caregiver interaction was stable over the three ages and significantly lower than cross-sectional comparison samples randomized from the Nursing Child Assessment Satellite Training computer database. Caregiver interaction was related to later child interaction but not developmental status. Implications for intervention and developmental surveillance are discussed.