ISSUES AND PURPOSE: The goal of this pilot study was to understand attention behaviors in extremely low-birth-weight (ELBW) children within the context of parent-child interactions and their relation to the child's independent performance. DESIGN AND METHODS: Parent-child and child-alone puzzle matching tasks, demographics, and IQ were measured in a sample of 15 4-year-olds who weighed <1000 g at birth and were free from major disability. RESULTS: A self-regulated and efficient strategy during the parent-child puzzle was related to using an efficient strategy when working alone. Attention regulation during the parent-child puzzle was related to accuracy in the child-alone task. Parents appeared to be regulating attention appropriately. PRACTICE IMPLICATIONS: Understanding the mechanisms of attention regulation in ELBW children could lead to specific interventions to support parents in strengthening their children's self-regulatory functioning.