From an Early Learning Consultant . . .
Using the PCI Feeding and Teaching Scales in Practice
The NCAST Feeding and Teaching Scales have been invaluable tools for 120 of my students who gained reliability certification in the past three years. They include nurses, social workers, psychologists, speech therapists, and researchers who work in family homes or professional centres with high needs families as well as with the general population in well-baby clinics. Both scales are simple and practical. They can help you accurately assess the quality of parent-infant interactions, plan non-threatening interventions that build on observed family strengths, and measure change post-intervention even after relatively short periods.
The following are samples of my students’ responses to the workshop evaluation question:
What was most useful?
- Everything – clear instruction, sequential approach.
- All of it.
- The opportunity to review and discuss videos in practice.
- Practice videos; group discussion; practice tape scoring exercises.
- Practical exercises (e.g. learning baby cues in depth, ambiguous and unambiguous statements, etc).
- Activities to recognise cues. Practical examples, e.g. acting out disengagement and engagement cues.
- Practice session. Working through workbook descriptions for Feeding Scale. Cases in workbook!
- Examining strengths & challenges demonstrated by comparing different aspects of the scales.
- Having reinforcement of the cues and meanings.
I can recommend the Feeding and Teaching Scales to all practitioners and researchers who work with families and children aged zero to three. Dr. Kathryn Barnard told our instructor training group in 2004 that people who study the PCI Scales never see a parent-child pair in quite the same way again. My experience supports this. You develop a new perspective and enhanced insight into everyday interactions and their consequent impact on children’s developmental potential. Furthermore, you find simple and direct ways to effect improvements where needed.
Early Parenting Consultant and NCAST PCI Instructor
From the Program Director, PACT Therapeutic Nursery, Baltimore . . .
Using PCI Feeding & Teaching Scales, BabyCues and Keys to Caregiving
Words can not express the value we have found in using NCAST materials in our program. The PACT Therapeutic Nursery provides a warm and nurturing nursery setting to infants and toddlers and their families who are currently living in homeless shelters. These families have experienced frequent trauma and the effects can be long lasting. The children often have delays in speech and language, heightened separation anxiety and blunted levels of play. We have used NCAST Keys to Caregiving to help develop a number of program components which assist families in building bonds that protect their little ones. Specifically, we have used the NCAST concept of the Teaching Loop to help parents become engaged in a therapeutic process we call ‘Wee Cuddle & Grow’. Parents and children participate in play sessions where parents gain skills and knowledge on how to become their baby’s best teacher. Parents learn through a strengths based approach how to determine if their baby is ready to play and learn, how to read their cues effectively and how to provide positive interactions which foster social, emotional and cognitive growth. We have also used the NCAST Teaching Scale as an outcome measure. Results of these outcomes are stated in our article Targeted Interventions for Homeless Children at a Therapeutic Nursery, Zero to Three, March 2006. NCAST has given us strong roots to help our program become a leader in providing best practices with very young homeless children and their families.
NFP Nurses Trained in the PCI Feeding and Teaching Scales
All of the Nurse Family Partnership nurses in Louisiana are trained to reliability on the NCAST PCI Feeding and Teaching scales. It’s always an eye-opening, and sometimes a challenging, experience, but most say, “I can never look at parent-infant interactions the same way again!” By maintaining their skills through regular re-reliability training, the nurses are able to draw upon their clinical experiences to deepen their understanding of parent-infant relationships. I believe these scales profoundly enable the observer – and as a result, the parent – to appreciate the richness and to take advantage of the opportunities in everyday interactions. They provide a fundamental, essential perspective for the NFP nurse home visitor. Thank you NCAST!
Paula D. Zeanah, PhD, MSN, RN
Director, Louisiana Nurse Family Partnership Program
NYC Public Health Nurses trained in PCI Feeding & Teaching Scales, Promoting Maternal Mental Health During Pregnancy
“There is so much to learn by just watching a feeding interaction!” “My client loves the BabyCue cards – we play “Guess the Cue” on my visits with her – she will be so ready to read and hear her baby’s cues.” “My moms are so patient with their children – the Teaching scale observation really provides me with ways to talk to moms about showing their infant new skills.”
These are just a few of the comments I have heard the Nurse-Family Partnership nurse home visitors say about working with the Parent-Child Interaction tools – NCAST Feeding and/or Teaching Scale. The Nurse Family Partnership (NFP) program is one of the top priorities for the NYC-Department of Health and Mental Hygiene and NCAST PCI tools are a requirement of the program. Initially, the nurses were overwhelmed with the learning required for the NFP services. However, they soon discovered how useful the observations are to help moms learn about their strengths in parenting skills and to discuss ways the parent-child relationship can grow.
An added benefit to the NFP-NYC program is the “Promoting Maternal Mental Health” training provided by NCAST Programs. The training provides a wealth of information about maternal mental health and ways to intervene with clients. It is a program that nurses complete on a Wednesday and use it on Thursday. This does not happen often. The target population is often isolated and without a supportive group of friends and family. The interventions come ready for nurses to adapt as needed for his or her clients. New York City has made it a required course for Nurse Family Partnership.
Sandra True RN, MPH
Retired 2007 Deputy Director Nurse Family Partnership Program New York City Department of Mental Health & Hygiene
From the Director of Nursing, Queen Elizabeth Centre, Australia . . .
Hospital Nurses Trained in the PCI Feeding and Teaching Scales
Using the evidence based NCAST tools in our early parenting programs here at Queen Elizabeth Centre (QEC) in Noble Park , Australia has strengthened our practice approach and improved outcomes for parents and children participating in our programs.
Increasing our knowledge of infant behaviour, states and communication patterns has helped parents to get to know and understand their infant. Many have provided feedback indicating they feel an increased understanding of their child rather than just learning parenting strategies.
The PCI feeding and teaching and environment scales guide the focus for our interventions with families.Focusing on interactions and providing strengths based feedback to families supports our partnership approach and has helped to engage families in the process of sustainable change.
Within QEC's Parent Assessment programs, the PCI scales act to strengthen the objectivity and consistency of risk assessments based on direct observations of family's interactions and enable us to provide comparisons with the broader parenting population.
Director of Nursing, Queen Elizabeth Centre, Noble Park , Australia
What trainees are saying about the Promoting First Relationships® Program
In my nine years of experience working with homeless families, the Promoting First Relationships Program has been the most relevant technique I have learned to help parents promote their child's development. - Social Worker
I loved the training. I thought it was wonderful, and gave me practical knowledge to put right into play. This was one of the best training I have ever received in my line of work. It was easy to implement. I was impressed with the positive focus of the program, and the very comfortable learning atmosphere the trainers provided. - Nurse Consultant
Promoting First Relationships is such a different way of working with families. In particular for CPS involved families, it may be the first time that someone has ever really noticed that they are doing well and celebrated this. PFR provides us with a way to encourage and reflect on parents' interactions and to increase and build upon the strengths that they bring to parenting. - Social Worker
The most important thing I learned in this program was to identify my daughter's cues and the ways to interact with her positively. I went into this training thinking this was more work and very stressful. In the end, this bonding with my daughter and being able to interact with her relieved my stress. It was a pleasant experience. It was comforting and safe. It was just invaluable - and it lasted. - Parent
The child was going through a lot of changes in his life and seemed unsettled. I realized how important I was to him as an attachment figure. I learned this little boy needed the attention from me. He bonded to me and I needed to respond to this. When I wasn't in the room, his behavior got worse. I began to make a point of connecting with him every hour. This made a difference. - Child Care Providers
I think that my Promoting First Relationships training was very, very valuable. I think that whether or not you specialize in seeing families with children 0-5 years, it's valuable for any clinician to do home based work that's really strengths based and has a great foundation based on attachment. I think that the families I've seen have benefitted from this immensely. - Mental Health Therapist