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Ghrist/ Use of the PICCOLO 1
Evaluating PICCOLO Scores Against the Crowell: Is the PICCOLO Valid with Parents of
Maltreated Children in the Child Welfare System?
Felicia Ghrist
August 22, 2014
Wayne State University
Advisor: Ann Stacks, Ph.D.
Ghrist/ Use of the PICCOLO 2
Abstract
Child abuse and neglect can result in the state taking custody of children and requiring
their parents to improve caregiving skills and ensure child safety. Improvements they make are
often judged subjectively by caseworkers who observe parenting time. Without an objective
measure of parenting for social workers to use, critical decisions about reunification and custody
can be based on personal opinions. The PICCOLO is an inexpensive, accessible and objective
measure that may be useful in child welfare. Unfortunately, the PICCOLO has not been tested in
a sample of maltreated dyads. This study compares parent-child interactions using the
PICCOLO and the Crowell procedure using 10 pre- and post-test video recorded parent-child
dyads (20 total videos) participating in the Wayne County Baby Court Project. Results suggest
that the PICCOLO subscales correlate with Crowell subscales in a maltreated sample. Further
research is needed to examine if the PICCOLO is indeed an alternative, objective measure for
community programs that service the child welfare system.
Ghrist/ Use of the PICCOLO 3
Introduction
The Parenting Interactions with Children: Checklist of Observations linked to Outcomes
(PICCOLO) is a newly developed assessment tool that is becoming popular with clinicians
because of the short amount of time required to become reliable, relative low cost, and freedom
of use in a variety of settings. It has been studied with many populations such as minorities,
fathers, and children with disabilities. The PICCOLO has not been validated for use with
maltreating dyads and current practice does not include using standardized assessments of
parenting during parenting time in child welfare. Typically the foster care worker, who may not
have any formal training in assessing parent-child interactions, will report to the court the quality
of parenting. Assessing parenting in maltreating samples is important because sensitive parenting
is associated with positive developmental outcomes, while maltreatment is associated with
poorer developmental outcomes. Interruptions in child development-especially in infancy and the
toddler years-can have long lasting consequences in language, cognitive, behavioral development
and mental health. Evaluating sensitive parenting across contexts allows caseworkers an
objective way to observe and measure parenting and improvements in parenting as a result of
services. It can also help the child welfare system to document well-being.
Relational Context of Development in Infancy
Sensitive parenting includes specific behaviors such as responsiveness and emotional
support. These behaviors provide the child with an opportunity to explore, understand and
practice language in a safe, stimulating, collaborative environment (Pungello, Iruka, Dotterer,
Ghrist/ Use of the PICCOLO 4
Mills-Koonce & Reznick, 2009) and as a result support the development of cognition, language
and behavior.
Language Development
Language development in infancy, including infants understanding of language (receptive
language) and use of words (expressive language) is associated with positive outcomes
throughout schooling. For example, oral language at age 3 is associated with early reading skills,
which are further associated with high school graduation (Hernandez, 2011; National Institute of
Child Health and Human Development (NICHD) Early Child Care Research Network, 2005).
Demographic risks (low SES and parental education) and parenting are associated with language
development in infancy. To better understand how demographic risk and parenting interact to
influence language, Pungello and colleagues (2009) conducted a longitudinal study with parent-
infant dyads beginning when the infant was 12 -months and ending when the infants were 36
months. This study assessed parenting at 12- and 24-months and observed associations with
growth in language. More specifically, children with sensitive mothers had higher receptive and
expressive communication scores and showed an accelerated rate of receptive and expressive
growth from 18 to 36 months compared to children whose mothers were less sensitive when their
children were infants. This work supported earlier findings that both maternal and paternal
sensitivity, positive regard, and cognitive stimulation are associated with higher language scores
at age 2 and 3-years (Tamis-Lemonda, Shannon, Cabrera & Lamb, 2004). Parents who provide
cognitive stimulation label objects, explain the function of objects, and ask questions and expect
an answer. Pancsofar & Vernon-Feagans, (2006) showed that fathers who use a variety of word
roots and ask more open-ended questions have children with higher expressive language scores.
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Cognitive Development
Like language development, infants’ cognitive development is influenced by
demographic and parenting factors. A series of studies using the Early Head Start Research and
Evaluation Project examined the effects of demographic risk and parenting on child cognitive
outcomes across infancy. Findings suggest that maternal and paternal sensitivity, positive
regard, and cognitive stimulation are associated with higher cognitive scores at age 2 and 3-
years, after controlling for demographic risk. (Tamis-Lemonda, et al, 2004). Similarly, Lugo-Gil
and Tamis-Lemonda (2008) found that quality of parenting mediated the association between
family economic resources and children’s cognitive development at 14, 24 and 36 months. In this
study they also found that parenting remained stable over time. Provision of cognitive
stimulation when the child was 4 years old was associated with children’s cognitive ability at age
8, whereas the use of threats and coercion to obtain desired behavior was associated with lower
cognitive ability (Byford, Kuh, & Richards, 2011).
Behavior and Mental Health
A large body of literature suggests that parenting is also a strong predictor of early
behavior and mental health. The development of a secure attachment is an important social-
emotional milestone in an infant’s first-year of life; decades of research confirm the relationship
between sensitive parenting and a secure attachment (Nievar & Becker, 2008). A secure
attachment in turn is associated with children’s curiosity, persistence, self-regulation, interest in
their environment, more positive social behavior and peer competence throughout schooling
(Cicchetti, Rogosch, & Toth, 2006). The context in which a parent is sensitive is important. For
Ghrist/ Use of the PICCOLO 6
example, sensitivity to a child’s distress may be more predictive of early behavior and social
outcomes than sensitivity to the infant’s neutral or positive affect. Leerkes, Blankson, &
O’Brian, (2009) found that mother’s sensitivity to their infants’ distress at 6 months of age was
associated with increased social competence at 24 months and fewer behavior problems at 24
and 36 months. Leerkes (2011) also found that only sensitivity during a distressing task
predicted attachment security. While positive parenting facilitates optimal development in
infancy, parenting that is abusive or neglectful is associated with poor infant outcomes
(Eisenburg et al., 2005).
Poor Outcomes Associated with Infant Maltreatment
Infants and toddlers who are maltreated exhibit high rates of behavioral and
developmental problems (Smyke & Breidenstine, 2008) that can result in long term negative
outcomes such as: school failure, mental health problems, and serious physical health problems
(Gilbert, et al., 2009). Child maltreatment includes physical abuse, neglect, and psychological
maltreatment. Physical abuse includes physical acts that cause or could cause physical injury to
a child, for example burning, shaking, or punching. Neglect is defined as the failure of a
caregiver to provide for the child’s basic needs, including food and shelter. Psychological
maltreatment is an act or omission in parenting, for example emotional or verbal abuse, that
causes or could cause developmental harm (U.S. Department of Health and Human Services,
2012).
Baseline data from the National Survey of Child and Adolescent Well-Being II (NSCAW
II) was used to examine indicators of well-being of children who had come into contact with the
child welfare system (Casanuva, Dolan, Smith, Ringeisen, & Dowd, 2012). Results from this
study suggest that infants and toddlers reported for maltreatment have high rates of
Ghrist/ Use of the PICCOLO 7
developmental concerns. For example, nearly half of the children in this sample of 5,873 were
under the age of 5. Children under 72 months had mean scores on Preschool Language Scale
(PLS-3) that were one standard deviation below the normative mean and 18.7% had scores that
were 2 standard deviations or more below the mean. Children under 48 months had mean scores
on the Battelle Development Inventory, 2nd addition (BDI-2) that were about one-half of one
standard deviation below the normative mean and 18.7% had scores that were 2 or more standard
deviations below the mean.
Another study using data from NSCAW II found that just over 1/3 of infants 12 to 18
months-old demonstrated social and emotional problems and just over 1/5 had low social
competence scores (McCue et al., 2012). This study supports previous findings related to social
and emotional difficulties among young children with maltreatment histories. For example, one
study found 82% of maltreated children were classified with a disorganized pattern of attachment
(Carlson, Cicchetti, Barnett, & Braunwald, 1989). Abusive parenting and frequent placement
changes may contribute to this high rate of disorganized attachment. For example, frightening
parental behavior has been linked to the development of disorganized patterns of attachment in
infancy (Madigan, Bakermans-Kranenburg, van Ijzendoorn, Moran, Pederson, & Benoit (2006),
which in turn is associated with deviant levels of hostility and aggressive behavior towards adults
and peers (Lyons-Ruth, 1996) and behavior problems as toddlers (Madigan, Moran, Schuengal,
Pederson, & Otten, 2007). Furthermore, continued disruptions in primary caregiving, as is often
the case for infants in the child welfare system, can negatively impact an infant’s ability to form
a secure attachment relationship and to manage their behavior and emotions (Dozier, Zeanah,
&Bernard, 2013). These social and emotional risks put children at risk for later mental health
problems. A longitudinal analysis by Thompson & Tabone (2010) found that compared to a
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demographically at-risk sample without alleged maltreatment, child maltreatment prior to age 4
predicted increased levels of anxiety, depression and attention problems through age 10.
The Child Welfare System’s Mandate to Support Well-Being
The studies above showcase how maltreated children’s well-being is compromised
despite the fact that the child welfare system (CWS) is required to ensure children’s safety,
permanency, and well-being. Great strides have been made to ensure both permanency and
safety, but less reporting has been done in the area of child well-being (Casanueva et al., 2012).
To support infant well-being, the courts and the child welfare system must place a greater
emphasis on parenting and offer effective programming that can show measureable differences
in parenting. Most parents in the child welfare system are required to attend a parenting
intervention, but are not required to demonstrate improvement (Barth et al., 2005). In order to
recognize improvements in parenting, assessments of skills must be done before and after
intervention.
Assessments allow social workers to know their clients’ strengths and limitations in order
to target interventions and to report changes in parent-child interactions to the court (Hurlburt,
Nguyen, Reid, Webster-Stratton & Zhang, 2013). Unfortunately, the best observational methods
to assess improvement in parenting were developed for research and are too costly and require
extensive training (Roggman et al, 2013a). As a result, they are impractical for community
intervention programs where time and funding are often lacking (Beatty et al., 2011). Judges
presiding over child welfare cases want objective measures when making a decision about
whether or not it is safe to send a child home (Edwards, 1994). It is critical that an objective and
practical measure of parenting is integrated into child welfare reporting (Dozier, Zeanah, &
Bernard, 2013).
Ghrist/ Use of the PICCOLO 9
A Promising Measure of Parenting for the Child Welfare System: The PICCOLO
A newly developed parenting assessment tool, The Parenting Interactions with Children:
Checklist of Observable Outcomes (PICCOLO), was developed for practitioners to use with
families at high demographic risk. It may be ideal for use in the child welfare system, because
training is relatively quick and cost effective and has been tested with a diverse group of over
2000 low-income families. Impoverished and minority families are over-represented in the child
welfare system. Research on this assessment suggests that scores on the PICCOLO are correlated
with secure attachment and other positive outcomes (Roggman et al., 2013a), but have not been
used with maltreated samples or been compared to well-established, gold-standard assessments
designed for research with maltreating dyads.
The purpose of this study is to further validate the PICCOLO for use with maltreating
dyads by comparing scores on the PICCOLO to those on the Crowell (Heller, Aokie, &
Schoffner (1998), and assessing whether adding a challenging task to the PICCOLO might be
advantageous. Challenging tasks are more likely to elicit negative emotions from children and
assessing parent sensitivity to negative emotions is most predictive of children’s social-
emotional outcomes (Leerkes, et al., 2009; Leerkes, 2011).
Research Hypotheses
The present study explores the correlations among subscales on the PICCOLO and
Crowell parenting assessments. It is hypothesized that:
(1) PICCOLO scores assessed during free play and teaching tasks will be correlated with
Crowell scores. More specifically, it is expected that:
Ghrist/ Use of the PICCOLO 10
(1a) The Affection subscale on the PICCOLO will be positively correlated with the
Positive Affect and Emotional Responsiveness subscales on the Crowell.
(1b) The Responsiveness subscale on the PICCOLO will be positively correlated with the
Emotional Responsiveness Subscale on the Crowell.
(1c) The Encouragement subscale on the PICCOLO will be positively correlated with the
Emotional Responsiveness subscale on the Crowell.
(1d) The Teaching subscale on the PICCOLO will be positively correlated with the Behavioral
Responsiveness Subscale on the Crowell.
(2) Compared to PICCOLO scores assessed during free play, PICCOLO scores assessed during
the teaching task will be more strongly correlated with Crowell subscale scores.
(2a) The Affection subscale on the PICCOLO, coded during the teaching task will be most
strongly correlated with the Positive Affect and Emotional Responsiveness subscales of the
Crowell.
(2b) The Responsiveness subscale on the PICCOLO, coded during the teaching task will be most
strongly correlated with the Emotional Responsiveness Subscale of the Crowell.
(2c) The Encouragement subscale on the PICCOLO, coded during the teaching task, will be most
strongly correlated with the Emotional Responsiveness subscale of the Crowell.
(2d) The Teaching subscale on the PICCOLO, coded during the teaching task, will be most
strongly correlated with the Behavioral Responsiveness Subscale of the Crowell.
Ghrist/ Use of the PICCOLO 11
Method
Study Description
Analyses in this study were based on 20 previously recorded videos of 10 parent-child dyads
(each dyad completed a pre- and post-test) participating in the Wayne County Baby Court
Project. The goal of Baby Court is to ensure that infants and toddlers in the child welfare system
grow up in permanent nurturing homes that support optimal development and that parents,
whenever possible, are the infant’s permanent caregiver. The project follows the Miami Child
Well-Being Model, which is anchored on the following principles: (1) the needs of vulnerable
infants and toddlers are best met by a collaborative court informed by the science of child
development, (2) young children exposed to maltreatment require evidence informed therapeutic
intervention that addressed the parent-child relationship directly and (3) the decision-making
process is improved when special insight regarding the child’s well-being, the parent-child
relationship, and the parent’s ability to protect and care for the child is made available (Miami
Child Well-Being Court Initiative, 2013).
Parent-child dyads are eligible for Baby Court if the infant is under court jurisdiction as a
result of maltreatment, and the parent is working toward reunification, and does not suffer from
serious untreated substance abuse. As part of the study evaluation participants participate in a
parenting assessment at a university research lab. This occurs shortly after the infant is placed in
foster care, and again before the court decides whether it is safe for the child to return home,
approximately 10 months after the pre-test. During the assessment, parents are videotaped
interacting with their children and are interviewed. A clinician and member of the evaluation
team, trained in the Crowell, codes the videos.
Ghrist/ Use of the PICCOLO 12
For this project, pre- and post-test videos were re-coded using the PICCOLO so that PICCOLO
scores could be compared to already assigned Crowell scores. The PICCOLO coders were blind
to study IDs, pre- and post-test status, and Crowell scores.
Sample Characteristics
Ten parent-infant dyads (2 fathers, 8 mothers) participated in this study. Parents ranged in
age from 15-23 years (M =19.7 years), 100% were African-American, and the majority were
single, never married (80%). Parents’ highest grade completed ranged from 9th grade to two
years in college (M=10.9), in general parents were very low income; and the mean annual
income was $8,602.50 (range $0-$20,040). Among the children, just over half were female
(60%), and they ranged in age from 11 to 32 months (M= 20.5), all were African-American. At
the time of the pretest 20% of the infants were living with their biological parent, 30% were
living with a relative, and 50% were living in a foster home.
Measures
Demographic data, including parent and infant age when the petition was filed, race, level
of education, and history in the child welfare system were collected via interview during the pre-
test laboratory visit and a court records review after the case was closed.
The Crowell Procedure (Heller et al., 1998) was used to assess parent-child interactions
in the Baby Court Project. The Crowell is a 40 minute parent-child interaction task that is
comprised of 8 episodes/tasks. First, parents are asked to play as they would at home for 10
minutes with previously selected toys that promote pretend play (free play). Next, they are asked
to have their child clean up the toys (clean up task). In the third task, the parent is asked to blow
bubbles and have the child pop them. Next, they engage in four time-limited teaching tasks that
Ghrist/ Use of the PICCOLO 13
get progressively harder so that the assessor can see how the parent responds when the child is
frustrated. The interaction is video-taped and each episode is scored along seven child domains
and five parent domains. These episode scores yield one overall score for each domain. Scores
for each domain and the overall score range from 1 (poor) to 7 (excellent). Only the parent
domains will be used in this study. These domains are: Behavioral Responsiveness, Emotional
Responsiveness, Positive Affect, Withdrawn/Depressed, and Irritability/Anger. Behavioral
Responsiveness assesses whether the parent’s responses to the child’s needs are developmentally
appropriate. Emotional Responsiveness assesses emotional support and attention given to child
regarding assigned tasks. Positive Affect assesses parent’s positive interaction with the child.
Withdrawn/Depressed assesses parent’s negative interaction with the child. Irritability/Anger
assesses parent’s irritability, anger, and/or hostility displayed toward the child.
Each Crowell videotape was re-coded using the PICCOLO (Roggman et al., 2013b),
which assesses four domains of parent behavior during a 10 minute parent-child free play.
Following the work of Leerkes and colleagues (2009, 2011) in this study the PICCOLO coding
was also used on the most difficult teaching task to assess parenting in a challenging task that
pulls for child negative emotion. The PICCOLO contains twenty-nine items that are evaluated
on a 3-point scale ranging from 0 (behavior is absent) to 2 (behavior is clearly seen) and then
summed for a total domain score; higher scores indicate more of the behavior. These domains
are: Affection (7 items), Responsiveness (7 items), Encouragement (7 items), and Teaching (8
items). Affection scores represent the degree to which the parent displays warmth, physical
closeness, and positive expressions toward the child. The Responsiveness subscale indicates the
parent’s response to child’s cues, emotions, words, interests, and behavior. Encouragement
assesses the degree to which the parent actively supports explorations, effort, skills, initiative,
Ghrist/ Use of the PICCOLO 14
curiosity, and play shown in child. The Teaching subscale looks at shared conversation and play
between the parent and child, the parent’s provision of cognitive stimulation and explanations
and whether the parent asks the child questions.
Results
Analysis Plan and Descriptive Statistics
Prior to any analyses all study variable were inspected for normality. The
Withdrawn/Depressed scale on the Crowell was skewed and a log transformation corrected the
skew. The transformed variable was used in the correlational analyses. Descriptive statistics for
Crowell and PICCOLO subscale scores are reported in Table 1
Correlations between the PICCOLO and the Crowell
Correlations were used to assess the relationship among subscales of the PICCOLO and
the Crowell. It was expected in hypothesis 1a that Affection subscale of the PICCOLO
measured during free play and teaching would be positively correlated with the Positive Affect
and Emotional Responsiveness on the Crowell. This hypothesis was partially supported. There
was a significant relationship between Affection coded in free play and Positive Affect (r = .54,
p < .05). There was a significant relationship between Affection coded in teaching and
Emotional Responsiveness (r = .56, p < .01) and Positive Affect ( r = .69, p < .001). Contrary to
the hypothesis, Affection coded in free play was not significantly correlated with Emotional
Responsiveness.
Ghrist/ Use of the PICCOLO 15
Table 1. Descriptive Statistics for Parenting Variables
Subscale Name N Mean SD Range Possible Range
PICCOLO
Affection FP 19 10 2.03 7-14 0-14 Affection TT 20 8.5 3.43 2-13 0-14
Responsiveness FP 19 7.89 2.62 5-14 0-14 Responsiveness TT 20 7.15 2.91 2-11 0-14 Encouragement FP 19 6.89 2.23 3-10 0-14
Encouragement TT 20 7.10 3.83 2-13 0-14 Teaching FP 19 8.53 2.41 5-12 0-16
Teaching TT 20 4.65 2.98 1-11 0-16 Crowell
Behavioral Resp. 20 3.65 .93 2-5 0-7
Emotional Resp. 20 4.25 .97 3-6 0-7 Positive Affect 20 4.95 .95 3-6 0-7
Withdraw/ Depressed 20 1.55 .83 1-3 0-7 Irritability/Anger 20 1.80 1.11 1-4 0-7
*Note FP= Free Play; TT=Teaching Task
It was expected in hypothesis 1b that Responsiveness subscale on the PICCOLO and the
Crowell Emotional Responsiveness subscale would be positively correlated. The hypothesis was
partially supported. The only significant relationship was between Responsiveness coded during
the teaching task and Emotional Responsiveness (r = .62, p < .01). It was expected in
hypotheses 1c that the Encouragement subscale on the PICCOLO and the Crowell Emotional
Responsiveness subscale would be positively correlated. This hypotheses was partially
supported. The only significant relationship was between Encouragement coded in the teaching
task and Emotional Responsiveness (r = .54, p < .05). It was expected in hypotheses 1d that
Teaching subscale on the PICCOLO and the Crowell Behavioral Responsiveness subscale would
be positively correlated. These hypotheses were not supported. Correlation statistics for
Crowell and PICCOLO subscale scores assessed in free play are reported in Table 2.
Ghrist/ Use of the PICCOLO 16
Table 2. Correlations among Coded PICCOLO Free Play and Crowell Domains
1 2 3 4 5 6 7 8 9
1. Affection --
2. Responsiveness .63** --
3. Encouragement .49* .62** --
4. Teaching .53* .52* .60** --
5. Behavioral Resp. -.09 -.13 .14 .28 --
6. Emotional Resp. .34 .07 .37 .54* .80** --
7. Pos. Affect .54* .46* .54* .46* .40 .65** --
8. Withdraw/Dep -.33 -.13 -.29 -.39 -.56* -.71** -.71** --
9. Irritability/Anger -.49* -.35 -.72** -.22 -.17 -.44 -.62** .42 --
Note. *p < .05, ** p < .01. Variable Definitions: 1.Affection 2. Responsiveness 3. Encouragement 4. Teaching 5. Behavioral
Responsiveness 6. Emotional Responsiveness 7. Positive Affect 8. Withdrawn/ Depressed 9. Irritability/Anger
Table 3. Correlations among Coded PICCOLO Teaching Task and Crowell Domains
1 2 3 4 5 6 7 8 9 1. Affection -- 2. Responsiveness .84** --
3. Encouragement .72** .79** -- 4. Teaching .65** .70** .72** --
5. Behavioral Resp. .49* .53* .43 .37 -- 6. Emotional Resp. .56** .62** .54* .56** .80** --
7. Pos. Affect .69** .58** .43 .54* .40 .65** -- 8. Withdraw/Dep -.61** -.61** -.41 -.43 -.56* -.71** -.71** --
9. Irritability/Anger -.71** -.70** -.71** -.68** -.17 -.44 -.62** .42 --
Note. *p < .05, ** p < .01. Variable Definitions: 1. Affection 2. Responsiveness 3. Encouragement 4. Teaching 5. Behavioral Responsiveness 6. Emotional Responsiveness 7. Positive Affect 8. Withdraw/Depressed 9. Irritability/Anger
Ghrist/ Use of the PICCOLO 17
Parenting Assessed during Free Play versus a Teaching Task
The next set of hypotheses addressed whether it is important to assess parenting in a
variety of contexts. Hypothesis 2a, that Affection subscale on the PICCOLO coded during the
teaching task would be more strongly correlated with Positive Affect and Emotional
Responsiveness than the Affection subscale coded during free play and this was supported. The
Affection subscale coded during teaching was more strongly correlated with Emotional
Responsiveness and Positive Affect (r = .56, p < .01; r = .69, p < .001, respectively) than it
was when assessed in a free play episode (r = .34, NS; r = .54, p < .05, respectively). It was
expected in hypothesis 2b that the Responsiveness subscale on the PICCOLO coded during the
teaching task would be more strongly correlated with the Emotional Responsiveness subscale of
the Crowell than Responsiveness coded during free play. This hypothesis was supported. For
the Responsiveness subscale, scores for the teaching task were more strongly correlated with
Emotional Responsiveness (r = .62, p < .01) than those coded during the free play episode (r =
.07, NS). It was expected in hypothesis 2c that the Encouragement subscale on the PICCOLO
coded during the teaching task would be more strongly correlated with the Emotional
Responsiveness subscale of the Crowell than the Emotional Responsiveness coded during free
play. This hypothesis was supported. The Encouragement subscale coded during the teaching
task was more strongly correlated with Emotional Responsiveness (r = .54, p < .05) than it was
when coded during free play episode (r = .37, NS). It was expected in hypothesis 2d that the
Teaching subscale of the PICCOLO coded during the teaching task would be more strongly
correlated with the Behavioral Responsiveness subscale of the Crowell than the Behavioral
Responsiveness coded during free play. This hypothesis was not supported. For the teaching
subscale in both the teaching task and free play there were no significant correlations (r = .37,
Ghrist/ Use of the PICCOLO 18
NS; r = .28, NS, respectively). Correlation statistics for Crowell and PICCOLO subscale scores
assessed during the teaching task are reported in Table 3.
Discussion
The purpose of this study was to investigate if the PICCOLO, a brief measure of
parenting interactions, is a valid assessment of parenting in maltreating samples by comparing it
to the Crowell, a more in-depth research measure. As expected, many of the PICCOLO scores
were highly correlated with the Crowell scores and compared to the PICCOLO scores assessed
in free play, those assessed in the teaching task scores were more strongly correlated with
Crowell overall scores.
It is important that offending parents of maltreated children be objectively observed to
measure positive parenting behaviors and the PICCOLO appears to be a useful measure of
parenting for maltreating dyads. Using the PICCOLO to assess strengths and changes in
parenting as a results of services may help case workers and judges to incorporate parenting, an
indicator of well-being, into their permanency decisions. It is important to remember that no cut-
off has been established on the PICCOLO for maltreating dyads so PICCOLO scores alone
should not be used as a basis to make permanency decisions.
The findings also suggest that adding a teaching or challenging task to the protocol may
be beneficial. The teaching task is designed to challenge the dyad by asking the parent to have
the child complete a task that is above his or her developmental level. These tasks often elicit
negative emotion from the child. Parent support of children’s negative emotions has important
implications for development (Eisenberg, Cumberland, & Spinrad, 1998). The findings from this
study which suggest stronger correlations between teaching tasks and overall Crowell scores and
Ghrist/ Use of the PICCOLO 19
findings by Leerkes and colleagues (2011) which suggested that parent’s sensitivity measured in
a challenging task verses sensitivity in free play was more predictive of child well-being indicate
that for parents in the child welfare system.
One advantage of the PICCOLO is that it assesses teaching behaviors, which are
associated with children’s cognitive, language, and socioemotional development (Roggman et
al., 2013a). This is important because of the high rates of development delays in infants and
toddlers reported for maltreatment. Understanding and providing additional support for parents
in this area may be an important intervention for reducing developmental delays and supporting
children’s development when they are returned home. It was expected that Teaching would be
correlated with Behavioral Responsiveness on the Crowell, which includes similar measures of
parent behavior in regards that support to the child is developmentally helpful (Heller et al.,
1998). While these subscales were not correlated, Teaching was associated with other Crowell
subscales including Emotional Responsiveness and Positive Affect during both the free play and
teaching tasks and Irritability/Anger during the teaching task. This suggests that there is a
component to Teaching that includes positive affect during difficult situations rather than
measure their ability to give helpful hints or strategies that contribute to completing a task.
One of the strengths of the Crowell is that it assesses negative parenting behaviors like
withdrawal, anger and hostility. While no hypotheses was made about relationships between
these subscales and PICCOLO subscales, there were interesting negative correlations between
anger as assessed in the Crowell and several dimensions on the PICCOLO, especially when
parenting was assessed during the teaching task. The Affection subscale was negatively
associated with Anger (r = -.71, p < .01) during the teaching task. Parents who are high on
Affection are consistently warm and regard their child positively throughout the dyad whereas
Ghrist/ Use of the PICCOLO 20
parents who are high on Anger more often exhibit hostility towards their child. Parents who
regard their child positively may have children that are more compliant and better adjusted which
may cause less overall stress on the parent and reduce the frequency of difficult child behavior.
Responsiveness on the PICCOLO was also negatively associated with Anger on the Crowell (r =
-.70, p < .01) during the teaching task. Parents who are highly responsive are able to anticipant or
better understand their child’s needs and respond positively. When parents endorse higher Anger
scores their irritation with the child may distract them from what their child’s behaviors are
trying to communicate, instead the parent interprets behaviors negatively and is unable to fulfill
child’s expectations or wants. This may lead to a strained parent-child relationship that promotes
miscommunication and creates unnecessary challenges which may lead to developmental delays
in the child.
The Encouragement subscale on the PICCOLO was also negatively associated with
Anger assessed by the Crowell (r = -.71, p < .01) during the teaching task. Encouraging parents
support their children’s efforts, independence, and creativity. Hostile parents may discourage a
child from acting independently and instead try to use force or manipulation to change child’s
behaviors or direct child in making decisions based on parent’s needs. This may cause
disruptions is a child’s ability to regulate emotions in conflicts and cognitive functions in later
childhood.
Teaching on the PICCOLO was also negatively associated with Anger (r = -.68, p < .01)
during the teaching task. Parents who are rated high in Teaching share conversation with their
child in play, give explanations to questions, and provide cognitive stimulation that supports a
range of developmental outcomes. Parents who are angry with their children may not be as
vocal or interactive in play and may tend to ignore or dismiss child questions and are unable to
Ghrist/ Use of the PICCOLO 21
guide their child’s attention to completing a challenging task. This may cause a child to abandon
difficult cognitive tasks that affect later development and school readiness.
While these findings are promising they should be considered preliminary because of the
very small sample size (N=20). Future studies may want to collaborate with community agencies
and universities in varied geographical locations to produce a more representative and larger
sample.
Ghrist/ Use of the PICCOLO 22
References
Barth, R. P., Landsverk, J., Chamberlain, P., Reid, J. B., Rolls, J. A., Hurlburt, M. S., ... & Kohl,
P. L. (2005). Parent-training programs in child welfare services: Planning for a more
evidence-based approach to serving biological parents. Research on Social Work
Practice, 15(5), 353-371. Doi: 10.1177/1049731505276321.
Beatty, J. R., Stacks, A. M., Partridge, T., Tzilos, G. K., Loree, A., & Ondersma, S. J. (2011).
LoTTS parent–infant interaction coding scale: Ease of use and reliability in a sample of
high-risk mothers and their infants. Children and Youth Services Review, 33(1), 86-90.
Doi: 10.1016/j.childyouth.2010.08.016
Byford, M., Kuh, D., & Richards, M. (2011). Parenting practices and intergenerational
associations in cognitive ability. International journal of epidemiology. Doi:
10.1093/ije/dyr188.
Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. (1989). Disorganized/disoriented
attachment relationships in maltreated infants. Developmental psychology, 25(4), 525.
Doi: 10.1037/0012-1649.25.4.525.
Casanueva, C., Dolan, M., Smith, K., Ringeisen, H., & Dowd, K. (2012). Indicators of well-
being among children in the United States child welfare system. Child Indicators
Research, 5(3), 547-565. Doi: 10.1007/s12187-012-9148-4.
Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2006). Fostering secure attachment in infants in
maltreating families through preventive interventions.Development and
psychopathology, 18(03), 623-649. Doi: 10.1017/S0954579406060329.
Dozier, M., Zeanah, C. H. and Bernard, K. (2013), Infants and Toddlers in Foster Care. Child
Development Perspectives, 7, 166–171. doi: 10.1111/cdep.12033
Ghrist/ Use of the PICCOLO 23
Edwards, L. P. (1994), Improving Implementation of the Federal Adoption Assistance and Child
Welfare Act of 1980. Juvenile and Family Court Journal, 45, 3–28. doi: 10.1111/j.1755-
6988.1994.tb01469.x.
Eisenberg, N., Zhou, Q., Spinrad, T. L., Valiente, C., Fabes, R. A., & Liew, J. (2005). Relations
Among Positive Parenting, Children's Effortful Control, and Externalizing Problems: A
Three‐Wave Longitudinal Study. Child Development, 76(5), 1055-1071. Doi:
10.1111/j.1467-8624.2005.00897.x
Eisenberg, N., Cumberland, A., & Spinrad, T. L. (1998). Parental socialization of emotion.
Psychological Inquiry, 9(4), 241-273. Doi: 10.1207/s15327965plo0904_1.
Gilbert, R., Widom, C. S., Browne, K., Fergusson, D., Webb, E., & Janson, S. (2009). Burden
and consequences of child maltreatment in high- income countries. The
Lancet, 373(9657), 68-81. Doi: 10.1016/S0140-6736(08)61706-7.
Heller, S., Aoki, Y. & Schoffner, K. (1998) Caregiver-Child Structure Interaction Procedure
(Crowell) Administration and Coding: Clinical and Research. Unpublished Coding
Manual New Orleans: LA: Tulane University Health Sciences Center Institute of Infant
and Early Childhood Mental Health.
Hernandez, D. J. (2012). Double Jeopardy: How Third-Grade Reading Skills and Poverty
Influence High School Graduation. Baltimore, MD: Annie E. Casey Foundation.
Hurlburt, M. S., Nguyen, K., Reid, J., Webster-Stratton, C., & Zhang, J. (2013). Efficacy of the
Incredible Years group parent program with families in Head Start who self-reported a
history of child maltreatment. Child Abuse & Neglect, 37(8), 531-543. Doi:
10.1016/j.chiabu.2012.10.008.
Ghrist/ Use of the PICCOLO 24
Leerkes, E. M. (2011). Maternal sensitivity during distressing tasks: A unique predictor of
attachment security. Infant Behavior and Development, 34(3), 443-446. Doi
10.1016/j.infbeh.2011.04.066.
Leerkes, E. M., Blankson, A. N., & O’Brien, M. (2009). Differential Effects of Maternal
Sensitivity to Infant Distress and Nondistress on Social‐Emotional Functioning. Child
Development, 80(3), 762-775. Doi: 10.1111/j.1467-8624.2009.01296.x.
Lugo‐Gil, J., & Tamis‐LeMonda, C. S. (2008). Family resources and parenting quality: Links to
children’s cognitive development across the first 3 years. Child development, 79(4),
1065-1085. Doi: 10.1111/j.1467-8624.2008.01176.x.
Lyon-Ruth, K. (1996). Attachment relationships among children with aggressive behavior
problems: The role of disorganized early attachment patterns. Journal of Consulting and
Clinical Psychology, 64(1), 64-73. Doi: 10.1037/0022-006X.64.1.64
Madigan, S., Bakermans-Kranenburg, M.J., van IJzendoorn, M.H., Moran, G., Pederson, D.R., &
Benoit, D. (2006). Unresolved states of mind, anomalous parental behavior, and
disorganized attachment: A review and meta-analysis of a transmission gap. Attachment
and Human Development, 8(2), 89–111. Doi: 10.1080/14616730600774458.
Madigan, S., Moran, G., Schuengel, C., Pederson, D. R., & Otten, R. (2007). Unresolved
maternal attachment representations, disrupted maternal behavior and disorganized
attachment in infancy: links to toddler behavior problems. Journal of Child Psychology
and Psychiatry, 48(10), 1042-1050. Doi: 10.1111/j.1469-7610.2007.01805.x
Miami Child Well-Being Court Initiative. (January 2013). The Miami Child Well-Being Court
Model: A Handbook For Clinicians. Miami, FL.
Ghrist/ Use of the PICCOLO 25
NICHD Early Child Care Research Network (Ed.). (2005). Child care and child development:
Results from the NICHD study of early child care and youth development . Guilford Press.
Nievar, M. A., & Becker, B. J. (2008). Sensitivity as a privileged predictor of attachment: A
second perspective on De Wolff and van IJzendoorn's meta‐analysis. Social
Development, 17(1), 102-114. Doi: 10.1111/j.1467-9507.2007.00417.x
Pancsofar, N., & Vernon-Feagans, L. (2006). Mother and father language input to young
children: Contributions to later language development. Journal of Applied Developmental
Psychology, 27(6), 571-587. Doi: 10.1016/jappdev.2006.08.003.
Pungello, E. P., Iruka, I. U., Dotterer, A. M., Mills-Koonce, R., & Reznick, J. S. (2009). The
effects of socioeconomic status, race, and parenting on language development in early
childhood. Developmental Psychology, 45(2), 544. Doi: 10.1037/a0013917.
Roggman, L.A., Cook, G.A., Innocenti, M.S., Jump-Norman, V. & Christiansen, K. (2013a),
Parenting Interactions with Children: Checklist of Observations Linked to Outcomes
(PICCOLO) in diverse ethnic groups. Infant Mental Health Journal, 34(4), 290-306. Doi:
10.1002/imhj.21389.
Roggman, L.A., Cook, G.A., Innocenti, M.S., Jump-Norman, V., Christiansen, K., Anderson, S.
(2013b). Parenting Interactions with Children: Checklist of Observations Linked to
Outcomes: PICCOLO User’s Guide. Baltimore, Maryland: Paul H. Brookes Publishing
Co.
Smyke, A.T., & Breidenstine, A.S. (2009). Foster Care in Early Childhood. In C. H. Zeanah
(Ed.), Handbook of Infant Mental Health (pp. 500-515) New York, NY: Guilford
Publications
Ghrist/ Use of the PICCOLO 26
Tamis‐LeMonda, C. S., Shannon, J. D., Cabrera, N. J., & Lamb, M. E. (2004). Fathers and
mothers at play with their 2‐and 3‐year‐olds: contributions to language and cognitive
development. Child development, 75(6), 1806-1820. Doi: 10.1111/j.1467-
8624.2004.00818.x
Thompson, R., & Tabone, J. K. (2010). The impact of early alleged maltreatment on behavioral
trajectories. Child Abuse & Neglect, 34(12), 907-916. Doi: 10.1016/j.chiabu.2010.06.006.
US Department of Health and Human Services, Administration for Children and Families,
Administration on Children, Youth and Families, Children’s Bureau. (2013). Child
Maltreatment 2012. Available from:
http://www.acf.hhs.gov/sites/default/files/cb/cm2012.pdf