Table of Contents


Nursing Child Assessment Teaching Scale (NCATS)

Sumner & Spietz (1994)

The Teaching Scale is used with infants and young children birth to 3 years of age.  The scale provides a format for observing and rating childgiver-child interactions during a novel situation for the purpose of assessing the dyad's strengths as well as areas needing improvement.

The Teaching Scale consists of 73 items organized into six subscales.  Four subscales describe the parent's behavior during the interaction: Sensitivity to Cues, Response to Distress, Social-Emotional and Cognitive Growth Fostering.

The remaining two subscales (Clarity of Cues and Responsiveness to Caregiver) describe the child's behavior during the interaction.  The Teaching Scale is scored following the observation of a session in which the caregiver is asked to teach the child a defined age-appropriate activity.

The NCATS score have been found to be predictive of various measures of subsequent child functioning.  For example, NCATS total scores at one and four months were significantly predictive of children's expressive language scores at 36 months (Sumner & Spietz, 1994).  Also NCATS total scores at three and twelve months have been found to be predictive of measures of infant mental development and receptive language skills at 18 months (Magill-Evans & Harrison, 1999). Higher NCATS total scores at three and twelve months are associated with higher infant attachment scores.  As expected, NCATS scores tend to be lower for mothers identified as abusive, substance abusing, or from multi-problems families (e.g., health problems, alcohol or drug abuse, child abuse or neglect, compared to mothers without these characteristics (Sumner & Spietz, 1994).

NCATS Subscale Description
Caregiver Total Score Composite score representing skills the caregiver brings to the Interaction.
Sensitivity to Cues Assesses the caregivers ability to recognize and respond to the child's cues.
Responses to Distress Assesses the parent's ability to soothe or quiet a distressed child.
Socio-emotional growth fostering Assesses parent's ability to facilitate social and emotional growth and ability to communicate a positive feeling tone.
Cognitive growth fostering Assesses the type of learning experiences the caregiver makes available for the child.
Child Total Score Composite score representing the skills the child brings to the interaction.
Clarity of Cues Assesses the infants ability to send clear cues to the caregiver.
Responsiveness to Caregiver Assesses the infants ability to respond to the caregiver's attempts to communicate and interact.

Home Observation for Measurement of the Environment (HOME) Scale - Infant - Toddler version

Caldwell & Bradley, 1984

The HOME is an observation and interview instrument that measures the quality of stimulation, support and structure available to children in their home environments.

The Infant-Toddler version of the scale was designed for use with children between the ages of 0 and 3 years of age and has six subscales measuring the following aspects of the home environment:

  1. Emotional and verbal responsiveness of the parent,
  2. acceptance of the child's behavior,
  3. organization of the physical environment and routine activities,
  4. provision of appropriate play materials,
  5. parental involvement with the child, and
  6. opportunities for variety in daily stimulation.

Caldwell and Bradley (1984) reported an internal consistency estimate for the HOME total scale of .89.  Internal consistency estimates for the subscales ranged from .44 to .89.

Convergent validity for the HOME scales has been reported.  Sumner & Speitz (1994) reported moderate positive correlations between HOME scores and another measure of the quality of parent-child interaction. Further, in the present study higher HOME total scores were associated with lower child physical abuse risk as expected.

Predictive validity of the HOME subscales has also been reported.  Several studies report that HOME scores are predictive of children's intellectual development and language acquisition (e.g., Keown, Woodward, & Field, 2001: Molfese, DLalla, & Bunce, 1997; Murray & Yingling, 2000).

Home Subscale Description
Responsivity Describes the extent to which the parent responds to the child's behavior, offering verbal, tactile, and emotional reinforcement for desired behaviors and communicating freely through words and actions.
Acceptance Assesses parental acceptance of challenging child behavior and the avoidance of restrictive or physically punishing behaviors.
Organization Examines the extent to which there is regularity and predictability in the family's schedule, to the safety of the physical environment, and the utilization of community services as part of the family support system.
Learning Materials Assesses the provision of appropriate play and learning materials capable of stimulating development.
Involvement Assesses the extent to which the parent is actively involved in the child's learning and provide stimulation for increasingly mature behaviors.
Variety Assesses the extent to which there is inclusion in daily life of people and events that bring variety into the child's life.

Child Abuse Potential (CAP) Inventory

Milner (1986)

The CAP Inventory is a 160-item, forced-choice (i.e., agree or disagree) self-report questionnaire designed to screen for child physical abuse risk. Scores on the physical abuse scale are computed as a weighted sum of 77 items, with scores ranging from 0 to 486.  The CAP Physical Abuse scale is comprised of six subscales: distress, rigidity, unhappiness, problems with child/self, problems with others, and problems with family.  The CAP also contains three validity scales which may be used to identify cases that are faking good, faking bad or responding randomly.

Internal consistency estimates for the CAP Inventory abuse scale are high (over .90 for samples of HFI recipients, general population, maltreating parents).  Previous research has documented adequate test-retest reliabilities for the CAP Inventory abuse scale in general population samples (.91 for 1-day, .90 for 1-week, .83 for 1-month, and .75 for 3-months).

Higher scores on the CAP reflect higher child physical abuse potential.  Respondents with scores above 166 and 215 are considered to at medium- and high-risk for CPA, respectively.

Numerous studies report construct validity data for the CAP abuse scale 1. CAP Inventory abuse risk scores are significantly associated with measure of aggression in parents 2 and, with one exception 3, the use of harsh discipline strategies in parents 4.

Numerous studies report construct validity data for the CAP Inventory abuse scale.  Individual classification rates based on discriminant analysis of child physical abusers and matched comparison parents are in the mid-80% to low-90% range.  Data on the specificity of the CAP Inventory abuse scale in various low-risk groups indicate 100% correct classification of nuturing foster parents, low-risk mothers, and nurturing mothers.  Prospective research has revealed a significant association between CAP Inventory abuse scores and subsequent physical child abuse 5.

CAP Subscale Description
Distress Presence of personal adjustment problems which result from parenting stress that appear to be related to abusive behavior.
Rigidity Identifies rigid parenting styles, and assesses parent's attitudes toward the appearance and behavior of children.
Unhappiness Assesses general unhappiness with life, as well as unhappiness specific to problems in interpersonal relationships.
Problems with child/self Measures the degree to which the parent describes children and/or self in a negative manner.
Problems with family Measures a variety of problems in family interactions.
Problems with others Assesses general difficulties in social relationships.

1 (see Milner, 1986, 1994, 2003)

2 (McCurdy, 1995; Miller, Smyth, & Mudar, 1999; Montes et al., 2001; Nayak & Milner, 1998: Sachs & Hall, 1991; Zelenko, Huffman, Lock, Kennedy, & Steiner, 2001)

3 (Dopke & Milner, 2000)

4 (Chilamkurti & Milner, 1993; Dolz, Cerezo, & Milner, 1997; Dopke, Lundahl, Dunsterville, & Lovejoy, 2003; Haskett, Scott & Fann, 1995; McCurdy, 1995; Miller et al., 1999; Monroe & Schellenbach, 1989, Montes et al., 2001; Schellenbach, Monroe, & Merluzzi, 1991; Wissell, Lewko, Carreire, & Radford, 1990)

5 (Milner, Gold, Ayoub, & Jacewitz, 1984)