Participants included 106 infants and toddlers living in rural Paraguay and their primary caregiver. Children ranged in age from birth to 24 months and belonged to two distinct groups, including 46 children who had never participated in Pastoral del Niño, an early child development program, and 60 children who had participated in Pastoral for at least half the child's life. This article describes a study comparing the cognitive development and caregiving environment of rural Paraguayan infants and toddlers, from birth to 24 months, who were participating in Pastoral del Niño with that of children who were not participating in Pastoral programs. Cognitive (BSID-II) scores differed between the two groups, with Pastoral infants and toddlers scoring signifcantly higher at 0–4 months and 20–24 months. IT-HOME scores were signifcantly higher for Pastoral children at 0–4 months, 5–9 months, 10–14 months, and 15–19 months. Overall, best predictors for BSID-II scores included health, nutrition, and education variables, while best predictors for IT-HOME scores included caregiver education, lingualism, and community participation.