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NCAST Parent-Child Interaction Teaching Scale (PCI-T)

Assessment Rating:
A
A – Psychometrics Well-Demonstrated
See entire scale
Developer(s):

Kathryn E. Barnard, RN, PhD, FAAN

Description / Purpose:

The NCAST Parent-Child Interaction Teaching (PCI-T) Scale is an observational tool that measures the quality of dyadic interaction, predicts cognitive and social-emotional outcomes, and serves as an outcome evaluation tool of parenting quality and parent interventions. It is well-accepted that a safe, sensitive, and responsive caregiver provides the basis for positive overall child health outcomes. The scale is correlated/predictive of social and emotional outcomes and cognitive/language outcomes and child IQ. In the nationally representative sample (Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), the Teaching scale predicted both insecure attachment and cognitive development.

The NCAST Parent-Child Interaction Teaching (PCI-T) Scale was developed by Dr. Kathryn Barnard at the University of Washington School of Nursing. The Teaching scale is a binary scale consisting of 73 items: 50 caregiver items and 23 child items. Additionally, there are also contingency scores for both parents (20) and children (12). Contingency items measure the presence of dyadic exchange (serve-and-return engagement). Assessing the parent/caregiver’s sensitivity to the child’s cues, response to their distress, and provision of social, emotional, and cognitive growth fostering. The child is assessed for their ability to exhibit clear cues and their responsiveness to the parent/caregiver. The Teaching scale is reliable with an alpha of .87 and serves as a valid indicator of parenting; since 2000 the PCI-T has been used in over 100 published, peer reviewed studies and is considered a gold standard of parent-child interaction measurement.

Target Population: Parent/Caregiver dyads with children from birth to 36 months of actual or corrected age from all backgrounds. It has been used in a broad US population with Caucasian, African American, and Hispanic parents, and in multiple international settings. It has been validated in Japan, China, South Korea, and with Aboriginal Canadians, Mexican Americans, and with Native American populations in the United States.

Time to Administer: The Teaching Scale can be observed and coded live in 15–20 minutes, or it can be filmed and coded later, which would require approximately 30–40 minutes.

Completed By: Public health nurses, home visitors, social workers, early intervention therapists, psychologists, and allied health professionals

Modalities Available: Pen and Paper

Scoring Information: Two-sided paper scales are marked with a pen. The Teaching manual provides specific descriptions for each of the 73 items. Scoring can be done by hand (summing tallies), and the resulting numbers can be entered into a simple calculation program to calculate standard deviations from the mean samples.

Languages Available: Chinese, English, Japanese, Korean — the rating for the measure is based solely on the English version of the measure.

Training Requirements for Intended Users: The minimum degree required is a baccalaureate. Training to use the scale is provided by certified trainers, who are recertified annually. The training includes video instruction, practice coding, and the submission of reliability samples (5 dyads) to Parent-Child Relationship Programs (PCRP) for review and certification. Training duration is 24-hours total, which can be completed either in person or via synchronous e-learning classrooms. Trainees are allowed three attempts for certification, and more than 90% achieve reliability on their first attempt. Annual recertification is necessary to maintain reliability.

Availability: The tool is available through the Parent-Child Relationship Program’s website/web store. You must have documented reliability to purchase and use the scale. A Teaching set (Administration/Testing manual, a pad of 50 scales, and the administration kit) is priced at $195. This cost also includes certification. Additional scales are available at $25 for a pad of 50 scales/assessments. Training costs are determined by independent trainers. If training is conducted through Parent-Child Relationship Programs for 2.5 days in person or a 5½-day virtual training. Please visit pcrprograms.org for training costs and dates.

Contact Information

Company: Parent-Child Relationship Programs
Website: www.pcrprograms.org
Name: Kimberlee Shoecraft
Email: shoeck@uw.edu or pcrp@uw.edu
Phone: (206) 543-8528

Summary of Relevant Psychometric Research

This tool has received the Measurement Tools Rating of "A – Psychometrics Well-Demonstrated" based on the published, peer-reviewed research available. The tool must have 2 or more published, peer-reviewed studies that have established the measure’s psychometrics (e.g., reliability and validity, sensitivity and specificity, etc.). Please see the Measurement Tools Rating Scale for more information.

Show relevant research...

Bee, H. L., Barnard, K. E., Eyres, S. J., Gray, C. A., Hammond, M. A., Spietz, A. L., Snyder, C., & Clark, B. (1982). Prediction of IQ and language skill from perinatal status, child performance, family characteristics, and mother-infant interaction. Child Development, 53(5), 1134–1156. https://doi.org/10.2307/1129003

Sample:

Participants — 193 basically healthy working class and middle-class mothers and their infants

Race/Ethnicity — 85% Caucasian

Summary:

First-time mothers and their infants participated in a 4-year longitudinal study that focused on the relative potency of several clusters of variables for predictions of intellectual and language outcomes during the preschool years. The study found that the NCAST Parent-Child Interaction Teaching Scale was highly related to subsequent language and IQ outcomes.

Luster, T., & Vandenbelt, M. (1999). Caregiving by low-income adolescent mothers and the language abilities of their 30-month-old children. Infant Mental Health Journal, 20(2), 148–165. https://doi.org/10.1002/(SICI)1097-0355(199922)20:23.0.CO;2-1

Sample:

Participants — 76 teenage mothers and their children

Race/Ethnicity — 63% African American, 30% Caucasian, 5% Biracial, and 3% Hispanic

Summary:

The study examined whether the caregiving practices of low-income, teenage mothers during the first 2 years of their children’s lives were predictive of individual differences in the language abilities of their 30-month-old children. This question was addressed with a sample of teenage mothers and their children who were participating in a family support program. Scores on the NCAST Parent-Child Interaction Teaching Scale at 12 months were significant predictors of scores on the Preschool Language Scale—3, the Expressive One Word Picture Vocabulary Test, and Receptive One-Word Picture Vocabulary Tests of the children at 30 months. In addition, the HOME and NCAST Parent-Child Interaction Teaching Scale based on interactions between caregivers and infants 12 months of age were highly correlated (r = .53).

Magill-Evans, J., Harrison, M. J., & Ogden Burke, S. (1999). Parent-child interactions and development of toddlers born preterm. Western Journal of Nursing Research, 21(3), 292–312. https://doi.org/10.1177/01939459922043893

Sample:

Participants — Canadian mothers and fathers of 49 healthy preterm and 54 full-term infants

Race/Ethnicity — 96% White

Summary:

Parents of healthy preterm and full-term infants were observed interacting with their child at 3 and 12 months using the NCAST Parent-Child Interaction Teaching Scale. Each parent completed the Parenting Stress Index at both times. At 18 months adjusted age, the children were assessed using the Bayley Scales of Infant Development, Sequenced Inventory of Communication Development-Revised, and MacArthur Communicative Development Inventory. Maternal NCAST scores at 12 months predicted 18-month cognitive development (Bayley MDI score). Maternal and paternal NCAST scores predicted 18-month receptive language (Sequenced Inventory of Communication Development-Revised). Cronbach’s alphas for NCAST scores at 3 and 12 months in this study were 0.74 to 0.80 for the Parent score and 0.69 to 0.73 for the Child score.

Kolobe, T. H. (2004). Childrearing practices and developmental expectations for Mexican-American mothers and the developmental status of their infants. Physical Therapy, 84(5). 439–453. https://doi.org/10.1093/ptj/84.5.439

Sample:

Participants — 62 mother-infant pairs

Race/Ethnicity — 100% Hispanic

Summary:

The study examined the relationship between maternal childrearing practices and behaviors and the developmental status of Mexican-American infants. The NCAST testers met the 90% interrater reliability standard required for certification. Results showed that the NCAST Parent-Child Interaction Teaching Scale was positively correlated with the infants‘ cognitive development. In addition, the NCAST Parent-Child Interaction Teaching Scale was highly correlated with the HOME Inventory (r=0.68).

Oxford, M., & Spieker, S. (2006). Preschool language development among children of adolescent mothers. Journal of Applied Developmental Psychology. 27(2), 165–182. https://doi.org/10.1016/j.appdev.2005.12.013

Sample:

Participants — 154 children born to adolescent mothers

Race/Ethnicity — Not Specified

Summary:

The study assessed predictors of low language development of preschool aged children of adolescent mothers. Subscales from the NCAST Parent-Child Interaction Teaching Scale and the HOME inventory were used to categorize the caregiving environment prior to age 3. Items were aggregated across three different time points (12, 18, and 30 months of age). Results showed that that children of adolescent mothers who were categorized with low scores on the NCAST Parent-Child Interaction Teaching Scale and HOME were three times more likely to be at least one standard deviation below the mean (score < 85) on preschool language when the child was 4.5 years of age, even after controlling for maternal verbal ability and other contextual risk factors. Taken together, the NCAST Parent-Child Interaction Teaching Scale and the HOME inventory had a Cronbach's alpha reliability of 0.77.

Lugo-Gil, J., & Tamis-LeMonda, C. S. (2008). Family resources and parenting quality: Links to children’s cognitive development across the first 3 years. Child Development, 79(4), 1065–1085. https://doi.org/10.1111/j.1467-8624.2008.01176.x

Sample:

Participants — 2,089 low-income mothers and their children

Race/Ethnicity — 40% White, 35% Black and 25% Hispanic

Summary:

Reciprocal associations among measures of family resources, parenting quality, and child cognitive performance were investigated in an ethnically diverse, low-income sample of children and families. Results indicated that maternal supportiveness at 14 months predicted NCAST Parent-Child Interaction Teaching Scale Caregiver total at 24 months (large effect size, r=.52). Moreover, similarly strong prediction was found for NCAST Parent-Child Interaction Teaching Scale at 24 months predicting maternal supportiveness at 36 months (large effect size, r=.53) Finally, the NCAST Parent-Child Interaction Teaching Scale at 24 months was highly correlated with the Bayley Mental Development Index (MDI) at 24 and 36 months.

Zaslow, M., Bronte-Tinkew, J., Capps, R., Horowitz, A., Moore, K. A., & Weinstein, D. (2009). Food security during infancy: implications for attachment and mental proficiency in toddlerhood. Maternal and Child Health Journal, 13(1), 66–80. https://doi.org/10.1007/s10995-008-0329-1

Sample:

Participants — Nationally representative sample of infants and toddlers (n=8944) from the Early Childhood Longitudinal Study—9-month (2001–2002) and 24-month (2003–2004) surveys

Race/Ethnicity — Children: 43% Non-Hispanic White, 21% Other, 20% Hispanic, and 16% Non-Hispanic Black

Summary:

The study examined the associations between household food security (access to sufficient, safe, and nutritious food) during infancy and attachment and mental proficiency in toddlerhood. Structural equation modeling was used to examine the direct and indirect associations between food insecurity at 9 months, and attachment and mental proficiency at 24 months. Parenting practices were measured at 9 months using the NCAST Parent-Child Interaction Teaching Scale. Results showed that the total score on the NCAST Parent-Child Interaction Teaching Scale predicted both insecure attachment and cognitive development at 24 months of age.

Fuller, B., Bein, E., Bridges, M., Halfon, N., Jung, S., Rabe-Hesketh, S., & Kuo, A. (2010). Maternal practices that influence Hispanic infants’ health and cognitive growth. Pediatrics, 125(2), e324–e328. https://doi.org/10.1542/peds.2009-0496

Sample:

Participants — A representative U.S. sample of 8114 newborns, including 1450 newborns of Hispanic mothers

Race/Ethnicity — 59% White, 19% Black, 15% Mexican, and 7% Non-Mexican Hispanic Heritage

Summary:

The study compared the mean attributes of infants in subgroups that vary in maternal practices, family attributes, and acculturation levels. The NCAST Parent-Child Interaction Teaching Scale items summed into four alternative subscales were significantly correlated with a concurrent measure of a child’s Bayley MDI (short form), with correlations ranging from r=.16 to r=.30. Field staff members achieved interrater reliability of 0.90 for each observational NCAST assessment conducted in the home.

Suchman, N. E., DeCoste, C., Castiglioni, N., McMahon, T. J., Rounsaville, B., & Mayes, L. (2010). The Mothers and Toddlers Program, an attachment-based parenting intervention for substance using women: Post-treatment results from a randomized clinical pilot. Attachment & Human Development, 12(5), 483–504. https://doi.org/10.1080/14616734.2010.501983

Sample:

Participants — 47 mothers enrolled in outpatient substance use treatment and caring for a child between birth and 36 months of age

Race/Ethnicity — Not Specified

Summary:

This is a report of post-treatment findings from a completed randomized pilot study testing the preliminary efficacy of The Mothers and Toddlers Program (MTP), a 12-week attachment-based individual parenting therapy for mothers enrolled in substance abuse treatment and caring for children ages birth to 36 months. Forty-seven mothers were randomized to MTP versus the Parent Education Program (PE) – a comparison intervention providing individual case management and child guidance brochures. At posttreatment, MTP mothers demonstrated better caregiving behavior than PE mothers, as measured by the NCAST Parent-Child Interaction Teaching Scale [moderate effect (d=.50)]. All coding met the NCAST reliability standard.

Date Reviewed: May 2023