1. Indicator of Parent Child Interaction Kathleen M. Baggett, Ph.D. & Judith J. Carta, Ph.D. Juniper Gardens Children’s Project University of Kansas Society for Research in Child Development Boston, MA March 2007 IPCI This research was supported by Federal Grant #90-FY0052-01; HHS; ACF

2. A General Outcomes Measure: For checking growth in parents’ responsiveness to their child in ways that promote positive social- emotional behavior. IPCI

3. Parent- Child Interaction EHS Home Visitors Part C EI Home Visitors Mental Health Therapists Home Visiting Nurses IPCI

4. Provide quick snapshots of parent-child interaction that can be taken repeatedly to:  Help interventionists know when intervention is needed  Help interventionists see when they are making a difference  Help interventionists know when an intervention change is needed  Help supervisors facilitate intervention-planning  Help program directors understand when programs need improvement  W hile 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:

5. Purpose: Monitor progress Identify risky interactions Guide intervention decision- making IPCI

6. Decision Making Model for Generating Options If cautions are identified, increase monitoring If concerns are identified, Begin intervention Progress Monitoring for all children

7. Children for whom concerns are identified: receive intervention Children for whom cautions are identified: receive increased frequency of progress monitoring All Children receive routine progress monitoring 3-Tiered Model for Individualizing Services Based on Child & Family Needs

8.  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

9. IPCI Activities Looking at Books DistractionDressing Free play

10. 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

11. 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

12. 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

13. IPCI Activities Dressing (2 minutes) “Whatever it’s like to get dressed in the morning” (shirt, socks, shoes) Distraction clip

14.  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 engagement  Follow-through  Child Distress  Fuss, cry  Tantrum  Frozen, watchful, withdrawn IPCI Domains and Behaviors

16. The IPCI’s Home:  With other early childhood general outcomes measures  Early Communication Indicator  Early Social Indicator  Early Problem Solving Indicator  Early Motor Indicator

18. Types of IPCI Reports Home Visitors and Supervisors Program Administrator Agency Administrator

19. Home Visitor and Supervisor Reports For:  Progress monitoring  Sharing data with families  Guiding intervention decision-making  Reflective supervision  Mental health consultation

20. IPCI Domain Reports

21. Key Element Reports- Cg Facilitators

22. 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

23. 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)

24. 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

25. 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) ?

26. 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)

27. 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)

28. 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

29. 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)

30. Correlations Between IPCI Parent Support & Other Parent Measures IPCIAAPI-2 Appropriate role HOME TotalCESD 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

31. 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

32. Correlations Between IPCI Parent Interrupting Behavior & Other Parent Measures IPCIAAPI-2 parent 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**

33. Are IPCI Child Behaviors Differentiated by Level of IPCI Parent Support Behavior? 65.82 90.99 1.70 5.35 F=20.57; p<.001 F=14.28; p<.001

34. Are IPCI Child Behaviors Differentiated by Level of IPCI Parent Interrupting Behavior? 62.25 84.69 F=16.98; p<.001

35. Differences in IPCI Parent Behavior Based on HOME Classification Status 60.32 84.14 20.18 12.92 F=2.57; p<.01 F=2.49; p<.01

36. Does the IPCI differentiate children who are identified with a disability versus those who are not? F=4.77; p<.05 F=9.39; p<.01

37. Does the IPCI differentiate children who vary in levels of social-emotional problem concerns as measured by the BITSEA? F=5.76; p<.05 78.08 56.68 77.08 63.26 10.19 25.32 F=5.67; p<.05 F=11.7; p<.001

38. Does the IPCI differentiate children who vary in levels of social-emotional problem concerns as measured by the BITSEA? F=2.17; p<01 2.32 7.86 13.21 34.86 F=2.08; p<.05

39. 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

40. Contact Information Kathleen Baggett: kbaggett@ku.edu Judith Carta carta@ku.edu IGDI website: http://www.igdi.ku.edu/http://www.igdi.ku.edu/