The assessment of representational risk (ARR): Development and psychometric properties of a new coding system for assessing risk in the parent-infant relationship

There are few clinically valid tools that can be used to assess potential parent-infant relational risk. This study describes the development and initial validation of the assessment of representational risk (ARR) coding system to be applied to the parent development interview (Slade, A., Aber, J. L., Bresgi, I., Berger, B., & Kaplan, M. (2004). The Parent Development Interview - Revised. Unpublished protocol. New York, NY: The City University of New York.) for assessing potential risk in caregivers' representations of their infant, themselves as parents, and their relationship. The ARR was developed and validated in three samples in England. A review of the literature informed the selection of 10 items. It had a three-factor structure that was used to inform subscales: hostile, helpless, and narcissistic caregiving representations. The subscales and total risk scores showed good criterion validity for discriminating between high and low risk samples and good concurrent validity with measures of parental psychopathology and parent-infant interaction. The ARR is a potentially valuable coding system for identifying risk in early attachment relationships.

Feasibility of training service providers on the AMBIANCE-Brief measure for use in community settings

The Atypical Maternal Behavior Instrument for Assessment and Classification-Brief (AMBIANCE-Brief) was developed to provide a clinically useful and psychometrically sound assessment of disrupted parenting behavior for community practitioners. With prior evidence of this tool's reliability and validity in laboratory settings, this study aimed to determine whether providers from family service agencies could become reliable in the use of the level of disrupted communication following a brief training. Providers (N = 46) from three agency sites participated in a 2-day AMBIANCE-Brief training and, at the end of the training, coded eight videotaped mother-child interactions. Novice participant coding was compared to expert consensus ratings using intraclass correlations. On average, participants' interrater agreement was good (ICC_mean  = .84, SD = 0.10), with 89% meeting the reliability standards of ICC ≥ .70. In response to queries, 100% of participants indicated that they would recommend the AMBIANCE-Brief training to their colleagues, 85% reported that the AMBIANCE-Brief measure would be useful or very useful for their clinical practice, and 56% of participant clinicians believed that parents would find the measure acceptable or very acceptable for integration into intervention or support planning. Altogether, these findings speak to the feasibility of using the AMBIANCE-Brief in community settings. Future studies are needed in diverse clinical and community contexts to evaluate whether use of this assessment tool can inform more targeted interventions tailored to the specific needs of families.