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Objective: To determine whether adding a parent training program utilizing the Developmental Individual-difference Relationship-based (DIR/Floortime®) approach for children with developmental disabilities can improve their capacities for attention and initiation. Methods: Forty-eight pairs of parents and their preschool children with developmental disabilities were randomly assigned to three 1-hour one on one DIR/Floortime® parent training sessions during a 4-month period or to a control group. Results: Between-group comparison demonstrated a significant difference in favor of the intervention group for attention (F(1, 46) = 34.52, p = .031, ph 2 = .099) and initiation composite scores (F(1, 46) = 6.55, p = .014, ph 2 = .127). Effect sizes were medium to large for the attention composite score (Cohen's d = .526) and initiation composite score (Cohen's d = .653) respectively. Conclusion: Adding a modest home-based DIR/Floortime® parent training approach may yield clinically meaningful improvements in attention and initiation for children with a range of developmental challenges.