Pediatric clinical assessment of mother-child interaction: concurrent and predictive validity

This study examines whether clinical assessments of mother-infant interactions collected at 8-month health supervision visits are associated with standardized measures of the home environment and mother-child interaction collected at later dates in other settings, and whether these clinical assessments are associated with the child's future developmental and behavioral status. The observation component of the Pediatric Review of Children's Environmental Support and Stimulation (PROCESS) was collected on 46 consecutive mother-infant pairs during an 8-month health supervision visit. The Home Observation Measurement of Environment (HOME) Inventory was collected on these infants' families at 12 and 36 months of age, and mother-child interaction was assessed in a laboratory setting at 30 months. The Bayley Scales of Infant Development were collected at 12 and 24 months, and the Stanford Binet Intelligence Test and the Achenbach Child Behavior Checklist were collected at 36 months of age. The 8-month clinical ratings were strongly associated with the measures of the home environment and mother-child interaction and with child developmental and behavioral problem status at 36 months. These findings attest to the power and usefulness of systematic observations of maternal behavior by the clinician during health supervision visits.