Behavior problems and parental expectations and practices were studied in a sample of 58 toddlers with developmental disabilities who were consecutively referred to a mental health clinic. The majority of children (70.7%) exceeded the clinical cut-off score for significant behavior problems including tantrums, aggression, defiance, and hyperactivity, and 77.6% met the DSM-IV criteria for a psychiatric diagnosis with oppositional defiant disorder being the most common. Consistent with previous research, child behavior problems were related to parental use of verbal and corporal punishment and were detrimental to the quality of the parent-child relationship. A new finding was that parental expectations also were positively related to the emergence of early child behavior problems.