Just what are the PCI Feeding & Teaching Scales?

The Parent Child Interaction (PCI) Scales are the most widely used scales for measuring parent-child interaction today. It is a well-developed set of observable behaviors that describe the communication of and interaction between, caregiver and child in either a feeding or a teaching situation.

The scales are excellent for building upon caregiver/child strengths in the relationship and for identifying areas that might benefit from intervention.

The reliability and validity of the scales make them an exceptional choice for evaluating program outcomes and for research.

Why should I use the PCI tools?

Parent Child Interaction is the context in which the child first experiences the world. Relationships are the most important context for growth and development, and that both the parent and child bring unique characteristics to the relationship. It is critical for parents and children to be able to adapt to one another during their interaction. Parents/caregivers and children have a responsibility to “fit together” in the relationship. Dr. Kathryn Barnard first published a model of this interaction in 1976 which is still widely respected and used today. Central to this model is the concept of contingency or reciprocity. It is important to establish this pattern of contingency or reciprocity early in the relationship. Through this process, the infant/child learns that he/she can trust or mistrust the world. “When I have needs or feelings, my caregiver responds quickly and sensitively.”

There is no other tool that assesses interaction in the same way, with a gold standard and long history of documented reliability and certification that can be annually maintained.

How will learning the scales change your practice or your agency?

One of the comments we hear over and over is how learning the scales changes the way you look at interaction forever! It is understood that almost all home visitors have a real interest in helping families but don’t have honed observational skills. Learning PCI is the best way to teach observational skills. You also validate intuitive knowledge. Through the process you will learn skills to help parents and caregivers build and/or mend/repair those important early relationships with their children.

So why do we choose the Feeding situation? Feeding occurs approximately 200 times a month (that is 2400 times in that first year of life!). There is potential for reinforcing one another and building the relationship. If the feeding interaction doesn’t go well, the result may be repeated failures in relationship building. The Feeding scale can be used from birth to one year of age.

The Teaching situation puts a small amount of stress on the interaction, highlighting the verbalness, intrusiveness (or lack of), and once again, the contingency of the interaction. The Teaching scale can be used from birth to 36 months of age .

Why do we need to get reliable in the scales? I’ve heard it is difficult. Can we just take the class and skip the reliability?

Reliability ensures that the families in your community are getting objective, unbiased assessments about parent-child interaction. We all make judgments, whether consciously or subconsciously, about families, parents, children and the environment which can affect our assessment and intervention. Becoming reliable in the Feeding & Teaching scales ensures that the nurses/home visitors in your program are making accurate assessments. A recent example of this was experienced by our director while viewing a Teaching episode with a child development specialist. At the conclusion of the interaction, the specialist said “Well, that looked ok”. However, upon reviewing the tape and scoring the Teaching scale, there really was very little parent child interaction. The physical environment was pleasing, the mother and child were dressed appropriately, the mood of the interaction was not negative, however, there was no eye contact, no contingency (back and forth) between the mother and child. The Teaching scale indicated a need for further assessment which uncovered undiagnosed maternal depression.

What are the requirements for obtaining training & the costs?

We will give you a list of trainers in your state or your part of the country. You contact the instructor to make arrangements.

• Instructors are independent practitioners. Most of them are employed by an agency or university and teach NCAST as part of their position. Some are open to traveling and training privately. Most are able to open up their class to the public and charge fees according to their agency guidelines. There is no set fee from NCAST as to what instructors charge. We suggest they look at standard fees for consultants in their area.

• Costs for materials from NCAST are $200 plus S&H per learner. We only sell materials when an instructor has been secured and class date is arranged. Many instructors require training in Keys to Caregiving prior to the PCI classes. Those study guides are $18 plus S&H.

How much time should we allocate for training our staff?

It takes about 3 days to learn the Feeding Scale and about 2 1/2 days to learn the Teaching scale. One more day is needed to teach how to administer and use the scales in practice. You may space the classes out over time, i.e. every Wednesday for three weeks to learn the Feeding Scale, wait a month or two (or more), then do the one day a week course again for three weeks to learn the Teaching Scale. Use part of your scheduled meeting time or continuing education time to talk about the use of the scales in practice, bring case profiles to group settings, etc. In giving your staff the time to learn and implement the use of the scales into their practice you are sending a message that you value the special skills they have worked hard to attain.