Improving Parent Child Relationships: Using the Feeding

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Improving Parent Child Relationships Using the
Feeding Teaching Scales to Plan Effective
Interventions

• Denise Findlay
• NCAST-AVENUW Programs
• University of Washington School of Nursing

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Overview of our hour together.

• History of NCAST-AVENUW
• Theoretical Basis of the Scales
• Barnard Model
• Concepts of the Scales
• Why use Feeding Teaching?
• Validity and Reliability whats that?
• Administration of the scales
• Intervention
• Video examples

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History of NCAST Feeding Teaching Scales

• Tasked by USPHS in the early 70s to develop a
  way to predict child health outcomes
• NCAP (Nursing Child Assessment Project) began
• Scales revised for easier use in 1979 and
  training done via satellite
• Learners used inter-rater reliability
• Revised again in 1994essentially unchanged
  except for clarification
• Began reliability on tape in 1994 for gold
  standard

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Theoretical Basis of the Scales

• Primary focus of caregiving in early months is to
  establish routines, patterns of interaction and
  patterns of communication.
• Commonly held view that caregivers and children
  mutually influence one another.
• It is within this framework, that in thousands of
  parent/child interactions, childrens emotional,
  intellectual, and physical needs are met or not.
  

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Concepts of the Scales

• Contingency
• Positioning
• Verbalness
• Sensitivity
• Affect
• Engagement/disengagement

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Sensitivity to Cues

• The caregivers ability to recognize and respond
  to the childs cues.
• Caregivers who recognize cues and respond
  sensitively promote a healthy sense of self in a
  child.
• When might mom have difficulty being sensitive to
  and reading her babys cues?

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Response to distress

• The caregivers ability to soothe or quiet a
  distressed child.
• A necessary skill, promotes parental confidence
  when you can soothe/settle a child.
• By responding to a childs distress you are
  helping them learn emotion regulation.

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Growth Fostering Opportunities

• Contains the affective domain as well as the
  types of learning experiences made available by
  the caregiver.
• Social emotional as well as cognitive growth
  fostering are essential elements of the parent
  child interaction.

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Clarity of Cues

• The infants ability to send clear cues to the
  caregiver.
• The caregiver needs this information so they can
  modify/adapt their behavior.

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Responsiveness to Caregiver

• The infants ability to respond to the
  caregivers attempts to communicate and interact.
• Provides important feedback to promote a healthy
  relationship.

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Why use Feeding Teaching?
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Validity

• It measures what it is supposed to measure and
  agrees with other tools that measure similar
  things.
• Scores are stable over time and across different
  ways of gathering data.

Reliability
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Administration of the Feeding Scale
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Administration of the Teaching Scale
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Some recent studies using NCAST Teaching Scale

• Emotional Availability study (2004)
• US Early Childhood Longitudinal Study
• (ECLS B)
• 8600 infants representative of US populations

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What do I do with the information on these
Scales?

• Strengths
• Concerns
• Further assessments needed
• Interventions you could try

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When scoring PCI look for trends, such as
caregiver scores no on many items around
verbalness. Interventions can then be done
concerning verbal communication.
Trends
In scoring your feeding interaction you do such
a nice job of letting your baby eat at his
pace. He really likes the way you cuddle and
rock him. Some parents think because their baby
cant understand words yet, it isnt important
to talk to them. What are your thoughts about
that?
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Another way to intervene
One of the ways to determine when intervention
should occur is to compare the subscale scores,
total scores, and contingency scores against the
mean score for that particular group. w
hen gt1 standard deviation below the mean
Intervention
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Example of when to intervene based on standard
deviations
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Case Example

• Ari came in to the parenting center for help with
  her baby. She was feeling inadequate and didnt
  know how to handle her baby
• Video clips.

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Implementation into practice

• Create a venue for sharing challenges and
  successes with your co-workers.
• Bring scales to your meetings, co-workers, or
  your supervisor for guidance
• and support.

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• How we are, is as important as
• what we do. -Jeree Pawl