care index

Overview Course: CARE Index - from birth to 24 months

Family Relations Institute

infancy attachment

Attachment in infancy
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The CARE-Index is the simplest and most versatile of the DMM measures. It assesses mother-infant interaction from birth to about two years of age based on a short, videotaped play interaction of 3-5 minutes. Once the coder is trained, coding of an interaction takes about 15-20 minutes. The measure assesses mothers on three scales: sensitivity, control and unresponsiveness. There are also four scales for infants: cooperativeness, compulsivity, difficultness, and passivity. These scales tend to be related to the maternal scales in the order listed.

The scales

1. Are highly correlated with the infant Strange Situation assessment patterns of attachment
2. Differentiate abusing from neglecting, abusing-and-neglecting, marginally maltreating, and adequate dyads
3. Can be used during intervention, and
4. Can be used to assess the effectiveness of intervention.

The information derived from the CARE-Index can be used as quasi-continuous or categorical data by researchers. In addition, however, the procedure is easily applied to "live" observations made by nurses, infant teachers, clinicians, and social workers. Needless to say, such observations cannot be treated as reliable when video is not used, but the method is effective in the same way that other guided observations or interviews are; furthermore, specific training of what to look for sharpens both one's observation and one's ability to tell others exactly what the dyad did and why it should be interpreted in a particular manner.

Training courses

The course is taught from videotapes and depends upon both adult and infant behavior. Non-verbal behavior, interpersonal strategies, and developmental processes are emphasized. Adult patterns consist of sensitivity, controlling, and unresponsivity; the infant patterns are cooperative, difficult, compulsive compliant, caregiving or attention, and passive. The course includes a preliminary reliability test based on a standardized set of American mother-infant dyads. During the course, participants generate a set of videotapes that reflect their intended applications and culture(s). These tapes are used to assess the participant's competence in administering the procedure.

A second course on toddlers (15-30 months) is now offered. The patterns include a wider array of compulsive patterns and coercive patterns (both aggressive and passive) as well as combinations.

As with all courses offered by Dr. Crittenden, participants are given a written and signed statement of their percent agreement with the standard. This reliability can be reported in research articles. Evidence of reliability should be requested if the participant will code data for another researcher.

In addition, courses are offered from time to time for people who wish to become trainers. There are also advanced clinical seminars offered to international groups of experienced coders. These are held in central Italy and on the coast of Nova Scotia, Canada.

To inquire about the course in general, interested parties can contact Dr. Crittenden directly. To register for courses, individuals should check the local events section listed on this web page and contact the relevant organizer. Dr. Crittenden does not handle registration or fee payment. Requests to run a new course can be directed to Dr. Crittenden.

Studies Using The CARE-Index

Risk studies

1. Adolescent mothers

2. Drug abusing mothers; drug exposed infants

3. Maternal psychiatric disorder

4. Handicapping conditions

5. Maltreated infants

Normative Studies

Predictive Longitudinal Studies

Intervention Studies

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