indicator of parent child interaction kathleen m. baggett, ph.d. & judith j. carta, ph.d....

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:

kbaggett@ku.edu

Judith Carta

carta@ku.edu

IGDI website: http://www.igdi.ku.edu/