Reports suggest children with physical disability are at greater risk than peers for negative caregiver interactions. The environmental, parental, and child characteristics associated with variation in caregiver practices among families of children with (n = 450) and without physical disability (n = 450) in a nationally representative sample from the U.S. Agreement and variation about the shared meaning of “caregiver practices” were measured using consensus analysis. Associated parent, child, and family characteristics were identified using regression analysis. Parents did not spank, hit back, yell, ignore, put to work, or make fun of their children as a punishment. Parents maintained rules set about eating, bedtime, chores, and watching television. They reported playing with children, preparing food for them, going to religious services, reading, singing songs, and telling stories with their children. They reported not being involved in organized exercise and art classes. Child’s socio-emotional skills and behaviors (β = −.331), socio-economic status (β = −.223), the influence of religion on raising child (β = −.180), race/ethnicity of the parent (β = −.071), and physical disability (β = −.104) explained 24 % of the variance in caregiver practices (F = 32.34, p < .000). More negative caregiver practices are associated with families of children with lower levels of socio-emotional skills and behaviors, lower socio-economic status, less religious influence on child rearing practices, who are not Euro-American, or whose children have physical disability. Children’s socio-emotional skills and behaviors explained the largest amount of variance in caregiver practices, not disability status. Health professionals working with children with physical disability should target developing socio-emotional skills to support positive child-parent interactions and promote positive outcomes.