This study attempted to identify the specific difficulties in cognitive performance of 3-year-old very low birth weight (VLBW) subjects and to examine the relationship between these difficulties and styles of parental interaction with these children. Three groups of subjects were compared: (1) VLBW, 42 infants born weighing less than 1.5 kg; (2) their siblings (n = 15); and (3) a normal control group (n = 40). All subjects were examined individually on a series of cognitive measures of language, memory, reasoning and visual-motor integration. The interaction between VLBW subjects and their parents was observed and analyzed using criteria of mediated learning experience (MLE). Findings suggest no significant differences between the VLBW subjects and the other groups on most measures used. VLBW subjects were, however, found to perform poorly, as compared to others, on a test requiring auditory sequential memory and on a measure of receptive vocabulary. Birth weight was not found to correlate significantly with any of the cognitive measures. Observations of MLE occurring during the interaction between the parents and their children were found to be significantly correlated with the cognitive performance of VLBW children.