# MOTHER-CHILD INTERACTION AND CLINICAL JUDGMENT

> **NIH NIH R01** · YALE UNIVERSITY · 1994 · $261,645

## Abstract

Acute febrile illness in children represent about 20% of visits to
pediatricians and are a powerful challenge to a mother's ability to
respond to distress in her child.  These illness represent an opportunity
to strengthen bonds between mothers and children, to advance physicians'
under standing of clinical judgment and to improve the use of health care
resources.

The proposed study integrates child development and clinical judgment
methodologies.  It seeks to demonstrate that the mother-well child
interaction will predict the mother-ill child interaction.  Both
interactions will be correlated with the reliability, specificity and
sensitivity of mother;s and pediatricians, judgment during illness, with
test ordering by pediatricians and with subsequent use of medical
resources.  It will further demonstrate that maternal, infant and social
milieu characteristics are associated with both the mother-well and
mother-ill child interaction and hence with clinical judgment, test
ordering and utilization of resources.

The study will enroll 300 children: 100 at each a hospital Health Center,
an urban and suburban private practice.  The mother-well child
interaction will be assessed by the primary pediatrician and a Research
Associate at 2 weeks, 6, 15 and 24 months by a global rating system
(Emotional Availability Scales, EAS) and, on a subsample, the method of
Bornstein.  All acute illness over the next 30 months of life (proposed
N=1000) will be assessed by tandem independent scoring of the Acute
Illness Observation Scales by mother and pediatricians; from this
scoring, the reliability, specificity and sensitivity of judgments will
be calculated.  The mother-ill child interacts on of a subsample of
patients will be assessed using the EAS and the method of Bornstein.
Data about test ordering and use of resource during the illness will be
gathered by interview and by review of medical records.  Maternal, infant
and social milieu characteristics will be assessed at 2 weeks, 6, 15 and
24 months using the Beck Depression Inventory, the Parenting Sense of
Competence Scale, the Rothbart, the Patenting Social Support Index and
the Caldwell Home Scales.

Documenting hypothesized relationships will advance our understanding of
the phenomenologic basis of interpreting distress in children and of
clinical judgment during acute illness.  Such understanding will result
in more reliable judgments with higher specificity and, hence, more
apposite use of medical resources.

## Key facts

- **NIH application ID:** 2199989
- **Project number:** 1R01HD026575-01A2
- **Recipient organization:** YALE UNIVERSITY
- **SAM.gov UEI:** FL6GV84CKN57
- **Principal Investigator:** PAUL L MCCARTHY
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1994
- **Award amount:** $261,645
- **Award type:** 1
- **Project period:** 1994-07-01 → 1998-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/2199989

## Citation

> US National Institutes of Health, RePORTER application 2199989, MOTHER-CHILD INTERACTION AND CLINICAL JUDGMENT (1R01HD026575-01A2). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/2199989. Licensed CC0.

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