An exploratory case study was undertaken to examine child and caregiver outcomes in a diverse sample of 21 infants/toddlers with severe disabilities who received services from an urban, Part C program where caregiver-focused intervention was emphasized. Purposive sampling and mixed methods were used to collect data on child developmental change, rate of progress, and caregiver self-efficacy. Analyses revealed that (a) child developmental gains were significant across all subscales of the "Early Learning Accomplishment Profile-Revised" (ELAP-R) with large effect sizes, (b) individual rates of progress were highly variable as measured by proportional change index (PCI) scores, (c) caregivers attributed improvement in self-efficacy and parenting competence to involvement in this program, (d) caregivers whose child received services at home reported slightly greater levels of self-efficacy than those whose child was seen in a center-based context, and (e) location of service produced equally significant, positive changes in child outcome. Implications for research and practice were discussed. (Contains 3 tables and 1 figure.)