Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Nursing Science

Research Advisor

J. Carolyn Graff, Ph.D.


Kristen Archbold, Ph.D. Andrew J. Bush, Ph.D. Monica Oxford, Ph.D. Mona N. Wicks, Ph.D.


mother-child interaction, NCAT, nursing child assessment teaching scale, other-child relationship, parent-child interaction, psychometric evaluation


The mother-child relationship (MCR) has received an increasing amount of attention over the last several decades regarding its effect on long-term child development. Because the quality and quantity of interactions in the MCR have been established as important predictors of the child’s development, early identification of areas in the relationship requiring support and intervention is essential for promoting positive child outcomes. Observational assessment of the mother and child is considered best practice in evaluating maternal-child interaction (MCI). The Nursing Child Assessment Teaching (NCAT) scale is an instrument that has been used to quantify the quality of interaction in the MCR during the first 36-months of a child’s life. While studies have shown the NCAT scale as both a reliable and valid instrument, limited evidence exists confirming theoretical congruence between the scale and the Barnard Model it is based on. These analyses were conducted using data from two large, demographically different samples, the Nursing Child Assessment Satellite Training (NCAST) database and the Conditions Affecting Neurocognitive Development and Learning in Early Childhood database. Item response theory, confirmatory factor analysis, and multiple indicators multiple causes modeling were used to examine the psychometric properties of the NCAT scale and describe the interactions between mothers and children from these samples. Results of analyses offer support for the Barnard Model and the potential for instrument abbreviation, which may provide researchers and practitioners a more concise, reliable way of measuring MCI. In addition, the predictive validity of both the full NCAT scale and resulting abbreviated NCAT scale (NCAT-AB) was established by obtaining Pearson correlations and associated probabilities for MCI at 12-months, measured by the NCAT and NCAT-AB, and child cognitive and language development at 36-months, as measured by the Bayley Scales of Infant and Toddler Development, Third Edition. This study provided critical appraisal of the NCAT scale, supported the continued use of the NCAT scale in evaluating MCI, and contributed to the growing body of literature surrounding the importance of the MCR on early child development.




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