Parent-Child Interaction and Developmental Outcomes in Medically Fragile, High-Risk Children

Abstract

We examined the relation between parents' responsiveness and directiveness with their 2-year-olds and the children's developmental outcomes at age 5 1/2 in 88 preterm children with intraventricular hemorrhage. At age 2, each participant was videotaped in a free-play setting with the primary caregiver. These videotapes were evaluated and coded using the Maternal Behavior Rating Scale (MBRS) and the Parent/Caregiver Involvement Scale (P/CIS). The Stanford-Binet Intelligence Scale, Fourth Edition (SB-IV) was administered to the children at age 5 1/2. Evidence of statistically and clinically significant relations between interaction at age 2 and development at school age was yielded. Higher rates of responsiveness on all measures were associated with favorable developmental outcomes on the SB-IV. Greater amounts of directiveness on both the MBRS and the P/CIS were related to less favorable developmental outcomes. Findings suggest that the critical aspects of directiveness may lie in the appropriateness of the directives for the individual child and in the manner in which the directives are given. Implications for intervention with parents of medically fragile infants are discussed.