ecPROMIS Caregiver-Child Relationship Scale🔗

Name

ecPROMIS Caregiver-Child Relationship Scale - Infant (<1 year old)
ecPROMIS Caregiver-Child Relationship Scale - Child (1 - 5 years old) (ecPROMIS)

Table Namemh_cg_pms__cc__inf mh_cg_pms__cc__1to5
Construct

Relationships

Study Visits

Infant: V03, V05
Toddler: V03, V05, V07

TypeRemote Questionnaire (Parent on Child; 1-2 min)
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).

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 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.

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.

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 caregiver-child 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.

The Caregiver-Child Relationship Scale includes 5 items each rated on a 5-point scale (1 = Never; 2 = Rarely; 3 = Sometimes; 4 = Often; 5 = Always). Responses of "Decline to Answer" are treated as missing. A total score is only calculated when at least 3 of 5 items are answered and otherwise will be missing. If all 5 items are completed, the total score is the sum of the item scores. If 1 or 2 items are missing, a prorated score is calculated as follows:

Prorated Score = (Sum of answered items ÷ Number of answered items) × 5

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