1. TREATMENT SENSITIVITY OF THE DYADIC PARENT-CHILD INTERACTION CODING SYSTEM-II Jenny Klein, B.S., Branlyn Werba, M.S., and Sheila Eyberg, Ph.D. University of Florida, Gainesville, FL
ABSTRACT
METHODS
The Dyadic Parent-Child Coding System-II (DPICS-II) is a behavioral coding system designed to assess the quality of parent–child social interactions. DPICS-II has been standardized with normal and clinical samples of mother-child and father-child dyads and has shown strong inter-rater reliability and preliminary evidence of convergent and discriminant validity. However, no study has assessed the ability of DPICS-II to detect meaningful changes in behaviors that occur during PCIT. The degree to which a measure reflects expected change as a result of treatment is referred to as treatment sensitivity. The purpose of this study was to determine the treatment sensitivity of the DPICS-II categories to changes resulting from Parent-Child Interaction Therapy. Participants were 46 mother-child dyads who completed PCIT. All individual categories and the common composite categories of DPICS-II were examined for 46 mother-child dyads during each of the three DPICS-II situations using paired-samples t tests with Bonferroni corrections. Results indicated that most parent behavior categories changed significantly in expected directions following PCIT, and these changes differed according to the level of parental directiveness implicit in each situation. Few of the experimental child verbalization categories yielded evidence of treatment sensitivity individually or in the composite prosocial behavior category, although the standard child behavior categories, including the inappropriate behavior composite and the compliance ratio, showed clear evidence of sensitivity to PCIT.
Procedures
Mother-child interaction sessions were taped at pre-treatment and post-treatment (4 months later)
During each assessment session, all parent and child categories from DPICS-II were coded in the three 5-minute standard situations:
Child-Directed Interaction
parent follows child’s lead in play
Parent-Directed Interaction
parent chooses activity and directs child to participate
Clean-Up
parent directs the child to clean up all the toys
All new individual categories were examined in each DPICS-II situation
New parent and child composite categories examined
Prosocial Behavior
Inappropriate Behavior
Participants
46 mother-child dyads
Female primary caregivers
age range
mean age 34
Children
age range 3 - 6
mean age 4.43
78 % boys
39% single parent families
Racial/ethnic composition
80% Caucasian
9% African-American
11% Hispanic, Asian, or mixed
Eyberg Child Behavior Inventory
greater than 2 SD above mean
Parenting Stress Index
greater than 98th percentile
Table 4. Child Behavior Change from Pre to Post Treatment
Child-Directed Parent-Directed Clean-Up Interaction Interaction
Category t t t
Criticism **
Smart Talk ** **
Play Talk **
Whine ***
Prosocial Behavior * * *
Inappropriate Behavior * *
Compliance Ratio * *
Note: Child Inappropriate Behavior = CR, ST, WH, YE. Child Prosocial Behavior = AK, AN,UP, LP, BD, LA, PP
*paired-comparison t tests significant at p < .01
**paired-comparison t tests significant at p < .008
***paired-comparison t tests significant at p < .007
INTRODUCTION
DISCUSSION
Treatment sensitivity was supported by differential changes in mother and child behaviors according to the directiveness of the DPICS-II situation being examined.
Child compliance increased significantly in PDI and CU, but not CDI.
Unexpected findings require further study:
Total number of verbalizations for mothers decreased significantly in PDI and CU
Prosocial behavior decreased significantly for children in all three situations (total child verbalizations did not)
Child verbalization categories not sensitive to treatment change in child problem behaviors and not recommended for future use
Future studies should examine further the validity of DPICS-II parent composite categories as well as the Child Inappropriate Behavior Composite
Behavioral observation data are the hallmark of behavioral assessment and are required for rigorous study of treatment outcome. Behavioral observation is currently one of the most frequently used and intensively evaluated methods of behavior assessment (Haynes & O’Brien, 2000). Behavioral coding systems are systematic and precise methods of data collection that allow researchers to extensively evaluate quantifiable behavioral data and ultimately form valid inferences and conclusions. For example, direct observation data can be used to determine the effectiveness of a treatment program on observed behavior change. Despite the importance of these instruments, few standardized systems for observational assessment exist due to the complexity of their development and standardization.
The Dyadic Parent-Child Coding System-II is a behavioral coding system designed to assess the quality of parent–child social interactions (Eyberg, Bessmer, Newcomb, Edwards, & Robinson, 1994). DPICS-II has been used in treatment outcome investigations to provide a systematic method of recording parent and child behaviors and to determine how behavior changes over the course of treatment. This revised system has been standardized with normal and clinical samples of mother-child and father-child dyads and has shown strong inter-rater reliability and preliminary evidence of convergent and discriminant validity. However, no study has examined the treatment sensitivity of this system.
The purpose of this study was to determine the treatment sensitivity of DPICS-II following completion of Parent-Child Interaction Therapy. Specifically, we examined the utility of specific and composite DPICS-II categories for measuring change in frequency of several mother–child interaction variables and overall behavior change from pre to post treatment, as measured by DPICS-II. Hypotheses were made for the categories during each assessment situation of PCIT, Child-Directed Interaction, Parent-Directed Interaction, and Clean-Up. Analyses were conducted separately for each situation.
RESULTS
Table 1.
Child- Directed Interaction: Mother Behavior Change from Pre to Post Treatment
Category t
Labeled Praise **
Behavior Description **
Reflective Statement **
Information Question **
Descriptive/Reflective
Question **
Direct Command **
Criticism **
Total Praise *
Total Commands *
Inappropriate Behavior 2.93*
Prosocial Behavior *
Note. Parent Inappropriate Behavior = CR and ST. Parent Prosocial Behavior = AK, AN, UP, LP, BD, LA, PP.
* paired-comparison t tests significant at p < .01
**paired-comparison t tests significant at p < .005
Table 2.
Parent-Directed Interaction: Mother Behavior Change from Pre to Post Treatment
Category t
Labeled Praise **
Information Question **
Descriptive/Reflective
Question **
Direct Command **
Indirect Command **
Criticism **
Smart Talk **
Total Praise *
Total Commands *
Inappropriate Behavior 4.83*
Prosocial Behavior *
Total Verbalizations *
Note. Parent Inappropriate Behavior = CR and ST. Parent Prosocial Behavior = AK, AN, UP, LP, BD, LA, PP.
*paired-comparison t tests significant at p < .01
**paired-comparison t tests significant at p < .005
Table 3.
Clean-Up: Mother Behavior Change from Pre to Post Treatment
Category t
Labeled Praise **
Contingent Praise **
Information Question **
Descriptive/Reflective
Question **
Direct Command 6.49**
Indirect Command **
Criticism **
Total Praise *
Total Commands *
Inappropriate Behavior 5.74*
Total Verbalizations *
Note. Parent Inappropriate Behavior = CR and ST. Parent Prosocial Behavior = AK, AN, UP, LP, BD, LA, PP.
*paired-comparison t tests significant at p < .01
**paired-comparison t tests significant at p < .005