Evaluating the quality of the maternal-infant relationship is a challenge to researchers and clinicians interested in infant development and quality of early parenting. The purpose of this article is to describe and critique commonly used measures of maternal-infant interaction to assist researchers in making informed decisions about measuring this variable. The measures reviewed are valuable approaches to assessment of parent-child interaction for research; several are adaptable for clinical use as well. In selecting the most appropriate measure for a particular study, investigators are encouraged to consider the conceptual model on which the instrument is based, accessibility of training, extent of previous use, evidence of reliability and validity, and specific requirements for equipment, specialized laboratory setting, administration, and scoring. Using maternal-infant interaction measures that are appropriate for clinical practice could assist psychiatric-mental health nurses and other mental health clinicians to identify problematic aspects of interaction that may be amenable to treatment with interpersonal, cognitive, behavioral, and psychoeducational strategies.
Ainsworth, M. D. S., & Bell, S.N. (1970). Attachment, exploration, and separation: Illustrated by the behavior of one-year-olds in a strange situation. Child Development, 41, 49-67.
2.
Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Lawrence Erlbaum.
3.
Androzzi, L., Flangan, P., Seifer, R., Brunner, S., & Lester, B. (2002). Attachment classification among 18-month-old children of adolescent mothers. Archives of Pediatric Adolescent Medicine, 156, 20-26.
4.
Barnard, K.E., Hammond, M.A., Booth, C.L., Bee, H.L., Mitchell, S. K., & Spieker, S. J. (1989). Measurement and meaning of parent-child interaction. In F. Morrison, C. Lord, & D. Keating (Eds.), Applied developmental psychology (Vol. 3, pp. 40-80). San Diego, CA: Academic Press.
5.
Beck, C. T. (1995). The effects of postpartum depression on maternal infant interaction: A meta analysis. Nursing Research, 44, 298-304.
6.
Beck, C. T. (1998). The effects of postpartum depression on child development: A meta analysis. Archives of Psychiatric Nursing, 12, 12-20.
7.
Beeghly, M., Frank, D.A., Rose-Jacobs, R., Cabral, H., & Tronick, E. (2003). Level of prenatal cocaine exposure and infant caregiver attachment behavior. Neurotoxicology and Teratology, 25, 23-28.
8.
Black, M., Schuler, M., & Nair, P. (1993). Prenatal drug exposure: Neurodevelopmental outcome and parenting environment. Journal of Pediatric Psychology, 18, 605-620.
9.
Black, M. M., Dubowitz, H., Hutcheson, J., Berenson-Howard, J., & Starr, R. H. (1995). A randomized clinical trial of home intervention for children with failure to thrive. Pediatrics, 95, 807-814.
10.
Bowlby, J. (1958). The nature of a child’s tie to his mother. International Journal of Psychoanalysis, 39, 350-373.
11.
Bowlby, J. (1969). Attachment and loss (Vol. 1). New York: Basic Books.
12.
Brazelton, T.B. (1963). The early maternal infant adjustment. Pediatrics, 32, 931-938.
13.
Brazelton, T. B., Koslowski, B., & Main, M. (1974). The origins of reciprocity: The early mother infant interaction. In M. Lewis & L. A. Rosenblum (Eds.), The effect of the infant on its caregiver (pp. 49-76). New York: John Wiley.
14.
Britton, H. L., Gronwaldt, V., & Britton, J. R. (2001). Maternal postpartum behaviors and mother-infant relationship during the first year of life. Journal of Pediatrics, 138, 905-909.
15.
Burns, K., Chethik, L., Burns, W. J., & Clark, R. (1991). Dyadic disturbances in cocaine-abusing mothers and their infants. Journal of Clinical Psychology, 47, 316-319.
16.
Byrne, M. W., & Keefe, M. R. (2003). Comparison of two measures of parent-child interaction. Nursing Research, 52, 34-41.
17.
Censullo, M. (1991). Dyadic Mutuality Code manual. Wellesley, MA: Wellesley College Center for Research on Women.
18.
Censullo, M., Bowler, R., Lester, B., & Brazelton, T. B. (1987). An instrument for the measurement of infant-adult synchrony. Nursing Research, 36, 244-248.
19.
Clark, R. (1999). The Parent-Child Early Relational Assessment: A factorial validity study. Educational and Psychological Measurement, 59, 821-846.
20.
Clark, R., Hyde, J. S., Essex, M. J., & Klein, M. H. (1997). Length of maternity leave and quality of mother-infant interactions. Child Development, 68, 364-383.
21.
Clark, R., Musick, J., Stott, F., Klehr, K., & Cohler, B. (1984, April). Mother-child dyads at risk: Development of rating scales for early identification of disturbances in affect and behavior.Paper presented at the International Conference on Infant Studies, New York.
22.
Clark, R., Paulson, A., & Conlin, S. (1993). Assessment of developmental status and parent-infant relationships: The therapeutic process of evaluation. In C. Zeanah (Ed.), The handbook of infant mental health (pp. 191-209). New York: Guilford.
23.
Conoley, J. C., & Impara, J. C. (Eds.). (1995). The twelfth mental measurements yearbook. Lincoln: University of Nebraska Press.
24.
Cusson, R. M. (1993). Instruments in neonatal research: Measuring attachment behavior. Neonatal Network, 12(4), 69-71.
25.
Field, T. M., Healy, B., Goldstein, S., Perry, S., & Bendell, D. (1988). Infants of depressed mothers show “depressed” behavior even with nondepressed adults. Child Development, 59, 1569-1579.
26.
Field, T.M., Pickens, J., Prodromidis, M., Malphurs, J., Fox, N., Bendell, D., et al. (2000). Targeting adolescent mothers with depressive symptoms for early intervention. Adolescence, 35(138), 381-414.
27.
Field, T. M. (1980). Interactions of preterm and term infants with their lower- and middle-class teenage and adult mothers. In T. M. Field, S. Goldberg, D. Stern, & A.M. Sostek (Eds.), High-risk infants and children: Adult and peer interactions (pp.113-132). New York: Academic Press.
28.
Field, T. M., Hossain, Z., & Malphurs, J. (1999). “Depressed” fathers’ interactions with their infants. Infant Mental Health Journal, 20, 322-332.
29.
Field, T. M., Scafidi, F., Pickens, J., Prodromidis, M., Pelaez-Nogueras, M., Torquati, J., et al. (1998). Polydrug-using adolescent mothers and their infants receiving early intervention. Adolescence, 33(129), 117-143.
30.
Gianino, A. F. (1985). The stability of infant coping with interpersonal stress. Unpublished doctoral dissertation, University of Massachusetts, Amherst.
31.
Grych, J. H., & Clark, R. (1999). Maternal employment and development of the father-infant relationship in the first year. Developmental Psychology, 35, 893-903.
32.
Horowitz, J.A., Bell, M., Trybulski, J., Munro, B.H., Moser, D.M., Hartz, S. A., et al. (2001). Promoting responsiveness between mothers with depressive symptoms and their infants. Journal of Nursing Scholarship, 33, 323-329.
33.
Huber, C. J. (1991). Documenting quality of parent-child interaction: Use of the NCAST scales. Infants and Young Children, 4, 63-75.
34.
Hutcheson, J. J., Black, M. M., & Starr, R. H., Jr. (1993). Developmental differences in interactional characteristics of mothers and their children with failure to thrive. Journal of Pediatric Psychology, 18, 453-466.
35.
Izard, C. E., & Dougherty, L. (1980). A system for identifying affect expressions by holistic judgments (AFFEX). Newark: University of Delaware, Instructional Resources Center.
36.
Keefe, M. R., Froese-Fretz, A., & Kotzer, A. M. (1997). The REST regimen: An individualized nursing intervention for infant irritability. MCN, American Journal of Maternal Child Nursing, 22, 16-20.
37.
Kivijarvi, M., Voeten, M.J., Niemela, P., Raiha, H., Lertola, K., & Piha, J. (2001). Maternal sensitivity behavior and infant behavior in early interaction. Infant Mental Health Journal, 22, 627-640.
38.
Klaus, M. H., & Kennell, J. H. (1976). Maternal infant bonding. St. Louis, MO: Mosby.
39.
Lamb, M. E., Thompson, R. A, Gardner, W., & Charnov, E. L. (1985). Infant-mother attachment: The origins and developmental significance of individual differences in strange situation behavior. Hillsdale, NJ: Lawrence Erlbaum.
40.
Logsdon, M. C., Wisner, K. L., Hanusa, B. H., & Phillips, A. (2003). Role functioning and symptom remission in women with post-partum depression after antidepressant treatment. Archives of Psychiatric Nursing, 17, 276-283.
41.
Martinez, A., Malphurs, J., Field, T., Pickens, J., Yando, R., Bendell, D., et al. (1996). Depressed mothers’ and their infants’ interactions with nondepressed partners. Infant Mental Health Journal, 17, 74-80.
42.
Mercer, R. T., & Ferketich, S. L. (1995). Experienced and inexperienced mothers’ maternal competence during infancy. Research in Nursing & Health, 18, 333-343.
43.
Murray, L. (1992). The impact of postnatal depression on infant development. Journal of Child Psychology and Psychiatry, 33, 543-561.
44.
NCAST-AVENUW. (n.d.). Parent child interaction program (section). Retrieved February 25,2003, from http://www.ncast.org/p-pci.asp
45.
Pridham, K., Lin, C. Y., & Brown, R. (2001). Mothers’ evaluation of their caregiving for premature and full-term infants through the first year: Contributing factors. Research in Nursing & Health, 24, 157-169.
46.
Pridham, K. F., Schroeder, M., Brown, R., & Clark, R. (2001). The relationship of a mother’s working model of feeding to her feeding behaviour. Journal of Advanced Nursing, 35, 741-750.
47.
Raack, C. B. (1989). MICS (Mother/Infant Communication Screening): The manual. Schaumburg, IL: Community Therapy Services.
48.
Rubin, R. (1963). Maternal touch. Nursing Outlook, 11, 828-831.
49.
Sharp, D., Hay, D., Pawlby, S., Schmucker, G., Allen, H., & Kumar, R. (1995). The impact of postnatal depression in boys’ intellectual development. Journal of Child Psychology & Psychiatry, 36, 1315-1336.
50.
Sumner, G., & Spietz, A. (1994). NCAST caregiver/parent-child interaction teaching manual. Seattle: NCAST Publications, University of Washington, School of Nursing.
51.
Tronick, E., Als, H., & Brazelton, T. B. (1980). Monadic phases: A structural descriptive analysis of infant mother face to face interaction. Merrill-Palmer Quarterly, 26, 3-24.
52.
Tronick, E. Z., & Weinberg, M. (1997). Depressed mothers and infants: Failure to form dyadic states of consciousness. In L. Murray & P. J. Cooper (Eds.), Postpartum depression and child development (pp. 54-61). New York: Guilford.
53.
Uddenberg, N., & Englesson, L. (1978). Prognosis of postpartum mental disturbance: A prospective study of primiparous women and their 4 and 1/2 year old children. Acta Psychiatria Scandinavia, 58, 211-212.
54.
Walker, L. O., Crain, H., & Thompson, E. (1986). Mothering behavior and maternal role attainment during the postpartum period. Nursing Research, 35, 352-355.
55.
Weinberg, M. K., & Tronick, E. Z. (1994). Beyond the face: An empirical study of infant affective configurations of facial, vocal, gestural, and regulatory behaviors. Child Development, 65, 1503-1515.
56.
Weinberg, M. K., Tronick, E. Z., Cohn, J. F., & Olson, K. L. (1999). Gender differences in emotional expressivity and self-regulation during early infancy. Developmental Psychology, 35, 175-188.
