Page Last Updated: May 14, 2026

ecPROMIS Child-Caregiver Relationship Scale🔗

Infant Version (<1 year old)Child (1–5 Years) Version
Table Namemh_cg_pms__cc__infmh_cg_pms__cc__1to5
ConstructRelationships
Study VisitsV03, V05V05, V07, V09
Administration
  • Child-specific: Yes
  • Respondent: Primary Caregiver
  • Method: Self-administered remotely (1–2 min estimated duration)
Quality Control
  • Examine missingness by counting items answered per participant.
  • Check age is within expected ranges.
  • Review summary statistics and visualizations (item frequencies, age, prorated scores).
Responsible Use Warning ▸

The HBCD dataset includes many variables that may be important for sound and comprehensive analysis. The inclusion of additional variables will depend on the research question(s) and methodological approach. Users are encouraged to take time to explore the full range of available variables — especially those that may serve as controls, contextual indicators, confounders, mechanisms, or modifiers — to ensure thoughtful and well-supported analytic decisions. Other important considerations may include developmental functioning, broader family supports, and early adverse and protective exposures.

Data Warning ▸

Data Interpretation
The ecPROMIS assesses normative variations in child behavior and should be interpreted within the context of the child's age and developmental stage. This is not clinical or diagnostic instrument.

Administration at V05 (<1 year vs. 1–5 years)
At V05 (10–17 months), the standard administration is the child (1–5 years) version of the ecPROMIS Child–Caregiver Relationship Scale. A small subset of participants (N=11) were administered both the child and infant (<1 year) versions at this visit. Although data from both instruments are valid, we recommend using the 1–5 years version for V05 analyses to ensure consistency across participants, as most were administered only the 1–5 years version.

Please review the Known Issues & Pending Updates page for updates that may affect data use.

Instrument Details🔗

The ecPROMIS (Early Childhood Patient-Reported Outcome Measurement Information System) is a set of primary caregiver report questionnaires that offer clinicians and researchers a brief, efficient, and precise way to evaluate young children’s well-being. One of its key components is the Child–Caregiver Relationship Scale, which evaluates the degree to which young children develop close, satisfying relationships with caregivers.

For the HBCD study, the ecPROMIS Child–Caregiver Relationship Form was developed based on the ecPROMIS Parent-Report Short Form v1.0 – Social Relationships: Child–Caregiver Interactions 5a. Because the original measure was designed for children aged 1–5 years, an adapted version was created for infants under 1 year (i.e. 3-9 month old infants from visit V03), replacing the term ‘my child’ with 'my baby' per the guidance of ecPROMIS developers.

HBCD Modification Details ▸

General Language Modications
Measure instructions and individual items that reference gendered pronouns (‘his/hers’, ‘he/she’) were edited to either eliminate the pronouns entirely or replace with ‘my child’ when eliminating pronouns was not grammatically possible. In contrast to other measures, following consultation with measure creators, the term “parent” was not replaced with “parent/caregiver.”

The wording changes are minimal, should have no effect on data, and were approved by the measure creators. Because ecPROMIS measures are copyrighted, however, it is important that publications account for and note edits made to individual items.

The child-caregiver ecPROMIS was originally developed to assess children aged 1 to 5 years old. Language adjustments were made for developmental appropriateness for infants and approved by the HealthMeasures (ecPROMIS) team.

Scoring Procedures ▸

The Child-Caregiver Relationship Scale includes 5 items answered on a scale of 1-5:
1 = Never   2 = Rarely   3 = Sometimes   4 = Often   5 = Always   Decline to Answer = missing

If all items are answered, their sum is used as the total score. If fewer than three items are completed, the score is set to missing. If at least three items are answered but some are missing, a prorated score is calculated as:

\[ \text{Prorated Score} = \left( \frac{\text{Sum of answered items}}{\text{Number of items answered}} \right) \times \text{5} \]

References🔗

Blackwell, C. K., Lai, J.-S., Kallen, M., Bevans, K. B., Davis, M. M., Wakschlag, L. S., & Cella, D. (2022). Measuring PROMIS® Social Relationships in early childhood. Journal of Pediatric Psychology, 47(5), 573–584. https://doi.org/10.1093/jpepsy/jsac031

Cella, D., Blackwell, C. K., & Wakschlag, L. S. (2022). Bringing PROMIS to Early Childhood: Introduction and quaptative methods for the development of Early Childhood Parent Report instruments. Journal of Pediatric Psychology, 47(5), 500–509. https://doi.org/10.1093/jpepsy/jsac027

Edwards, R. C., Planalp, E. M., Bosquet-Enlow, M., Akshoomoff, N., Bodison, S. C., Brennan, M. B., Ciciolla, L., Eiden, R. D., Fillipi, C. A., Gustafsson, H. C., McKelvey, L. M., Morris, A. S., Peralta-CarcelĂŠn, M., Poehlmann, J., Wakschlag, L. S., Wilson, S., & HBCD Child Behavior and Caregiver-Child Interaction Workgroup. (2024). Capturing the complexity of child behavior and caregiver-child relationships in the HEALthy Brain and Child Development (HBCD) Study using a rigorous and equitable approach. Developmental Cognitive Neuroscience, 69, 101422. https://doi.org/10.1016/j.dcn.2024.101422

Lai, J.-S., Kallen, M. A., Blackwell, C. K., Wakschlag, L. S., & Cella, D. (2022). Psychometric considerations in developing PROMIS® measures for early childhood. Journal of Pediatric Psychology, 47(5), 510–522. https://doi.org/10.1093/jpepsy/jsac025

Park, C. H., Blaisdell, C. J., & Gillman, M. W. (2022). The NIH ECHO program: An impetus for the development of early childhood PROMIS tools. Journal of Pediatric Psychology, 47(5), 497–499. https://doi.org/10.1093/jpepsy/jsac010