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Indicator of Parent Child Interaction
Kathleen M. Baggett, Ph.D. & Judith J. Carta, Ph.D.
Juniper Gardens Children’s ProjectUniversity of Kansas
Society for Research in Child DevelopmentBoston, MAMarch 2007
IPCI
This research was supported by Federal Grant #90-FY0052-01; HHS; ACF
A General Outcomes Measure: For checking growth in parents’ responsiveness to their child in ways that promote positive social-emotional behavior.
IPCI
Home Visiting Nurses
Mental HealthTherapists
Part CEI
Home Visitors
EHSHome
Visitors
Parent-Child Interaction
IPCI
Provide quick snapshots of parent-child interaction that can be taken repeatedly to:
Help interventionists know when intervention is neededHelp interventionists see when they are making a differenceHelp interventionists know when an intervention change is neededHelp supervisors facilitate intervention-planningHelp program directors understand when programs need improvement
While there are many measures of parent-child interaction, tools designed specifically for practitioners to guide intervention decision-making have been lacking.
Practitioners need practical tools that can:
Purpose:
•Monitor progress
•Identify risky interactions
•Guide intervention decision-making
IPCI
Decision Making Model for Generating Options
Progress Monitoring for all children
If cautions are identified, increase monitoring
If concerns are identified, Begin intervention
Children for whom concerns
are identified:
receive intervention
Children for whom
cautions are identified:
receive increased frequency ofprogress monitoring
All Childrenreceive routine progress monitoring
3-Tiered Model for Individualizing Services Based on Child & Family Needs
Administered in family homes or other caregiving settings (biological home, foster home, center-based care) Children 3-42 months of age and a familiar caregiver
Four semi-structured activities are observed for a total of 10 minutes
Free Play Looking at Books Distraction Task Dressing
14 items are rated on a 4-point scale following observation
Videotaping is not required (but useful for intervention purposes)
IPCI Administration
IPCI Activities
Looking at Books
Distraction Dressing
Free play
IPCI Activities
Free play (4 minutes)
“Whatever it is that you and your child like to do together- something your child loves”
Free play video clips
IPCI Activities
Looking at Books (2 minutes)
“Here are some books for you and your child to look at together- however you and your child would like to spend time with these books is fine.”
Looking at Books video clips
IPCI Activities
Distraction Task (2 minutes)
“There are times when parents need to keep children away from things- either because they may be dangerous or just inappropriate”. Let’s see how your child responds when there are materials that are off limits. Please keep child on the blanket and away from the recorder and keys”.
Distraction clip
IPCI Activities
Dressing (2 minutes)
“Whatever it’s like to get dressed in the morning” (shirt, socks, shoes)
Distraction clip
Caregiver Facilitators Conveys acceptance
and warmth Makes descriptive
comments Follows child’s lead Maintains and extends Uses stress reducing
strategies
Caregiver Interrupters Uses criticism, harsh
tone Uses intrusions and
restrictions Rejects child’s bid
Child Engagement Positive feedback Sustained engagementFollow-through
Child Distress Fuss, cry Tantrum Frozen, watchful,
withdrawn
IPCI Domains and Behaviors
The IPCI’s Home:
With other early childhood general outcomes
measures
Early Communication IndicatorEarly Social IndicatorEarly Problem Solving IndicatorEarly Motor Indicator
Types of IPCI Reports
• Home Visitors and Supervisors
• Program Administrator
• Agency Administrator
Home Visitor and Supervisor Reports
For:
Progress monitoring
Sharing data with families
Guiding intervention decision-making
Reflective supervision
Mental health consultation
Caregiver Facilitators
0
10
20
30
40
50
60
70
80
90
100
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Age (Months)
% o
f C
are
giv
er
Fa
cili
tato
rs
Engagement & Facilitators to be shown to parentsPlacement on site is similar to WTC graph
Mean Caregiver Facilitators Caution Concern
Child Engagement
0
10
20
30
40
50
60
70
80
90
100
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Age (Months)
% o
f C
hild
En
ga
ge
me
nt
Graph to show parentsPlacement is similar to WTC graph
Mean Child Engagement Concern
IPCI Domain Reports
Key Element Reports- Cg Facilitators
Acceptance
0
1
2
3
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Age (Months)
Descriptive Language
0
1
2
3
1 4 7 10 13 16 19 22 25 28 31 34 37 40 43
Age (Months)Follow Child's Lead
0
1
2
3
1 4 7 10 13 16 19 22 25 28 31 34 37 40 43
Age (Months)
Responds to Distress
0
1
2
3
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43
Age (Months)
Introduces/Extends
0
1
2
3
1 4 7 10 13 16 19 22 25 28 31 34 37 40 43
Age (Months)
Administrator Reports
For reporting:
Program staff involvement in progress monitoring
Frequency of performance monitoring for children and families based on benchmarks
Number of children whose interactions with caregivers are at or above benchmark at the end of particular interventions as compared to at the beginning
Number of children whose interactions with caregivers are at or above benchmark at the end of a program as compared to at entry
Psychometric Studies
Early Head Start sample (Center on Challenging Behavior; Department of Ed)
Early Head Start University Partnership in Measurement (Developing Meaningful Outcome Measures; ACF)
Study Sample
• Culturally diverse– African-American; African Refugees; Latino;
• Very low to middle SES• Multiple Risks
– Teen mothers– Parent low education– High potential for child maltreatment– Maternal depression and anxiety– Substance Abuse– Domestic partner abuse– Functional homelessness
Research Questions:
– How comparable is the IPCI to other measures of parenting & child social-emotional functioning?
– How stable is the IPCI?
– Does the IPCI differentiate parents who are different in the quality of their parenting styles (as determined by other criterion measures)?
– Does the IPCI differentiate children who are different in their levels of social-emotional competence (as determined by another measure) ?
EHS Pilot Study Measures
Parent/Caregiver Measures
HOME IT (Bradley & Caldwell, 1979)– Total– Responsivity– Acceptance
Adult Adolescent Parenting Inventory (AAPI-2; Bavolek & Keene, 1999)
– Expectations– Empathy– Corporal Punishment – Role Reversal– Power/Independence
CESD (Depression)
Child Measure
Brief Infant Toddler Social Emotional Assessment (BITSEA; Carter & McGowan, 2005)
Longitudinal, Cohort Design
• 3 age cohorts of children
• 1-11 Months
• 12-23 Months
• 24-42 Months
• Received monthly IPCI assessments over a 6-month period
• Pre- and post-assessment
• Demographic interview
• HOME
• AAPI-2
• BITSEA
• CESD (Maternal depression)
Pilot Study Participants
• 64 children and their parents in the Midwest – 42 families in an inner-urban EHS program (KS)– 12 families with typically developing children in a rural setting (IA)
• Ethnicity– 36.9% African-American– 26.2% Latino– 32.3% Euro-American– 4.6% Other
• Child Gender– Female 52.3%– Male 47.7%
• Child Disability Status– 24.1% Identified disability– 75.9% Non disability status
• Parent Education Level– 33.8% Did not graduate from highschool– 29.2% Highschool only– 15.4% Some college– 21.6% Graduated from college
Psychometric Summary
• Reliability– Overall inter-observer agreement = 92% (R=86-100%)– Mean parent behavior inter-observer agreement = 92% (R= 75-100%)– Mean child behavior inter-observer agreement = 91% (R= 83-100%)
• IPCI child domain scores were correlated significantly with parent domain scores in the expected direction
• Concurrent validity shown with the HOME & AAPI – (r = .47 - .63 for Parent Facilitators; r = .33-.67 in expected directions for Parent Interrupters;)
• IPCI child domain scores were differentiated by IPCI parent domain scores
• IPCI parent domain scores were differentiated by HOME score classification (top third v. bottom third for Home Total; Responsivity)
• IPCI child domain scores were differentiated by BITSEA Problem Score Classifications (Concern v. No Concern)
Correlations Between IPCI Parent Support & Other Parent Measures
IPCI AAPI-2Appropriate role
HOME Total CESD
Parent/Cg
Support
.62*** .60***
Acceptance/
Warmth
.64*** .55*** -.47***
Descript.
Language
.47*** .55***
Follows lead .47*** .53***
Introduces
Extends
.47*** .42***
Responds
to Distress
.63*** .55*** -.57***
N=55 ; ***p<.001
Relationships Between IPCI Parent Behavior Scales & Child Behavior Scales
Child Positive Engagement
Child Distress
Parent/Caregiver Support
.73* -.33*
Parent/Caregiver Interruption
-.53* .46*
N=350 observations*p<.001
Correlations Between IPCI Parent Interrupting Behavior & Other Parent Measures
IPCI AAPI-2parent nurturing role
HOME Total
CESD
Parent/Cg
Interrupters-.67** -.41**
Criticize -.64** -.33* .53**
Restrictions/Intrusions
-.63** -.34* .36*
Rejects child’s bid
-.58** .46**
Are IPCI Child Behaviors Differentiated by Level of IPCI Parent Support Behavior?
0
20
40
60
80
100
Low ParentSupport
High ParentSupport
Child PositiveEngagement
65.82
90.99
0
1
2
3
4
5
6
Low ParentSupport
High ParentSupport
ChildReactivity/Distress
1.70
5.35
F=20.57; p<.001
F=14.28; p<.001
Are IPCI Child Behaviors Differentiated by Level of IPCI Parent Interrupting Behavior?
0102030405060708090
Low ParentInterrupting
High ParentInterrupting
Child PositiveEngagement
62.25
84.69
F=16.98; p<.001
Differences in IPCI Parent Behavior Based on HOME Classification Status
0
20
40
60
80
100
Low HOME High HOME
IPCI ParentSupporting
0
5
10
15
20
25
Low HOME High HOME
IPCI ParentInterrupting
60.32
84.14
20.18
12.92
F=2.57; p<.01
F=2.49; p<.01
Does the IPCI differentiate children who are identified with a disability versus those who are not?
0
0.5
1
1.5
2
2.5
DisabilityStatus
NonDisability
Child PositiveFeedback
0
2
4
6
8
10
12
DisabilityStatus
NonDisability
Child ReactivityDistress
F=4.77; p<.05
F=9.39; p<.01
Does the IPCI differentiate children who vary in levels of social-emotional problem concerns
as measured by the BITSEA?
0
10
20
30
40
50
60
70
80
No Concern Concern
IPC ChildEngagement
0
10
20
30
40
50
60
70
80
No Concern Concern
IPC ParentSupport
F=5.76; p<.05
78.0856.68
77.08
63.26
0
5
10
15
20
25
30
No Concern Concern
IPC ParentInterruption
10.19
25.32
F=5.67; p<.05
F=11.7; p<.001
Does the IPCI differentiate children who vary in levels of social-emotional problem concerns
as measured by the BITSEA?
0
1
2
3
4
5
6
7
8
No Concern Concern
IPCI ChildReactivty
F=2.17; p<01
2.32
7.86
0
5
10
15
20
25
30
35
No Concern Concern
IPC ParentInterruption
13.21
34.86
F=2.08; p<.05
Psychometric Summary
• Average training time to achieve adequate inter-rater reliability was 2 2-hour training sessions.
• Acceptable Inter-rater reliability and stability (test-retest) was demonstrated.
• Support was shown for concurrent validity of IPCI parent facilitating behavior through expected significant correlations with the HOME and the AAPI-2.
• Support was shown for concurrent validity of the IPCI parent interrupting items through expected significant correlations with the HOME, AAPI-2, CESD
• The IPCI showed sensitivity to parents who differ in quality of parent styles and children who differ in social-emotional functioning
Contact Information
Kathleen Baggett:
Judith Carta
IGDI website: http://www.igdi.ku.edu/
