The American Journal of Occupational Therapy 463 Ptransactional arent���child interaction represents a system of mutually adap- tive responses between members of the dyad (Barnard et al., 1989). The quality of the parent���child relationship has been linked with the child���s overall development (McGrath & Sullivan, 1999 Moore, Saylor, & Boyce, 1998 Sumner & Spietz, 1994). Maternal style of interaction has been explored more than paternal style as the mother has long been considered a cen- tral influence on the child���s development. However, new social trends have led to diverse family environments, changing family structures and functions, and a shift in caregiving patterns to a coparent role for both parents (Cabrera, Tamis-LeMonda, Bradley, Hofferth, & Lamb, 2000). Some researchers have explored the unique ways in which both parents interact with their children. Lamb (1997) reported that both mothers and fathers are capable of being responsive to their children although fathers often appear less able. While both parents are equally involved in play, fathers spend less time in childcare than mothers (Bailey, 1994). Fathers engage in more physical, tactile, and arous- ing play than mothers (Clarke-Stewart, 1978). They are more task-oriented and focused on the goal of the activity when interacting with children both with typical (Conner, Knight, & Cross, 1997) and atypical development (Girolametto & Tannock, 1994). In several studies using the Nursing Child Assessment Teaching Scale (NCATS) (Sumner & Spietz, 1994), fathers of typically developing children have scored lower than mothers for items related to fostering the infant���s cognitive growth (Brophy-Herb, Gibbons, Omar, & Schiffman, 1999 Harrison, Magill-Evans, BRIEF REPORT Mothers��� and Fathers��� Interactions With Children With Motor Delays Eftichia Ganadaki, Joyce Magill-Evans KEY WORDS ��� Nursing Child Assessment Teaching Scale ��� observational pilot study ��� toddlers Eftichia Ganadaki, MSc, OT, is Occupational Therapist, Chania, Crete, Greece. Joyce Magill-Evans, PhD, OT(C), is Professor, University of Alberta, Room 2-64, Corbett Hall, Edmonton, Alberta, Canada T6G 2G4 joyce.magill-evans@ualberta.ca OBJECTIVE. In early intervention programs, parents are often asked to teach their child new skills. As fathers are increasingly involved in intervention, clinicians need more information on fathers��� unique interac- tive style. This pilot study compared mothers��� and fathers��� parent���child interactions during a teaching episode to identify similarities and differences in order to better understand parents��� strengths. METHODS. The Nursing Child Assessment Teaching Scale was used to observe 10 mothers and 10 fathers interacting with their 10- to 28-month-old children in their homes. The children were receiving early inter- vention for a motor delay. The Caregiver Scores (parent���s contribution to the interaction) of mothers and oth- ers were compared using paired t tests. RESULTS. Mothers had more optimal interactions as indicated by significantly higher Caregiver scores than fathers, t (9) = 3.83, p = .004. The subscales with statistically significant differences were Caregiver Contingency and Cognitive Growth Fostering. Children���s scores when they interacted with their mothers or fathers did not differ. CONCLUSION. When observing fathers teaching their child new skills, therapists should remember that fathers of children with motor delays (and typically developing children) may use a more task-oriented com- munication style with less consideration of the child���s actions than do mothers. Ganadaki, E., & Magill-Evans, J. (2003). Brief report���Mothers��� and fathers��� interactions with children with motor delays. American Journal of Occupational Therapy, 57, 463���467.

& Sadoway, 2001 Nakamura, Stewart, & Tatarka, 2000). Evidence (Harrison et al., 2001 Nakamura et al., 2000) suggests that typi- cally developing children behave differently with their mothers than with their fathers and are more responsive (modify their behavior based on the other���s behavior) to their fathers. Based on a study of 20- month-old typically developing children, Clarke-Stewart (1978) concluded that chil- dren���s greater responsiveness to fathers may be because they were expecting a more playful interaction. Although these studies revealed important information on the unique ways in which fathers interact with their chil- dren, research on parent���child interaction when the child has special needs is less fre- quent. Among the existing studies there is agreement that interaction patterns exhib- ited with typically developing children and children with motor difficulties are similar. Any differences appear to be a matter of degree rather than of type of behavior (Barrera & Vella, 1987). These results, however, come from studies that focus only on mothers. Information on father���child interaction and differences between moth- ers��� and fathers��� interactions when a child has atypical development is limited. Occupational therapists address envi- ronmental influences on the child���s devel- opment. Understanding mothers��� and fathers��� interactions with their children with motor delays provides information to assist therapists in assessments and provid- ing appropriate intervention (Davis, 1994). While mothers are often the primary care- givers, fathers are increasingly involved in family-centered programs. Therapists may be unprepared to assess paternal behavior. There is a need for knowledge about fathers��� interactive styles. Therefore, the first question addressed in this pilot study was whether there were differences between fathers��� and mothers��� interaction patterns as measured by the Caregiver scores on the Nursing Child Assessment Teaching Scale (NCATS). A second question addressed differences on the Child NCATS score in order to ascertain whether or not differ- ences on Caregiver scores related to how the child interacted with his or her mother ver- sus father. An observational analytical design was used to compare parent���child interactions within the context of an exploratory, descriptive pilot study. Methods Individual parent���child interactions of mothers and fathers were videotaped in their homes. The NCATS was used to score the interaction from the videotape. Participants A convenience sample of 10 families with children with motor delays (associated with a diagnosis such as cerebral palsy or indicat- ed by a delay on a standardized motor mea- sure) was recruited from early intervention programs and programs at a rehabilitation hospital. Each mother���father pair of par- ents resided together, were Canadians, and were not recent immigrants. The parents were white���Caucasian except two parents from one family who were Indian and one father who was Japanese. Mothers (M = 31.7) and fathers (M = 33.7) ages and edu- cation (mothers = 13.8 fathers = 13.6) were similar. All fathers were employed full-time whereas 3 mothers were at home, 2 worked part-time from home, and 5 worked full- time. The median income was $60,000���69,000 Canadian (n = 9). The mother was identified as the major caregiv- er in all but one family where parents shared care. The sample consisted of 6 boys and 4 girls who ranged from 10 to 28 months of age (M = 21.8). Eight children were first- born and one child was a twin. The severi- ty of impairment was determined using the Gross Motor Function Classification System (GMFCS) (Palisano et al., 1997). Six children had mild motor difficulties (two with developmental delay, one with ataxia, one with hemiparesis, and two with cerebral palsy) and were walking indepen- dently. Of the remaining four children (one with hemiplegia, two with spina bifi- da, one with hydrocephalus), two scored at level II (would eventually walk without assistive devices) and two at level III (would walk with assistive devices) of the GMFCS. These four children had greater difficulties in gross motor development than fine motor skills. All four were learn- ing to use an assistive device to walk. Cognitive and language skills were not measured however, all of the children vocalized during the observations and understood verbal directions. Measures Nursing Child Assessment Teaching Scale (NCATS) (Sumner & Spietz, 1994). The NCATS, developed with mothers, guides the observation of caregiver���child interac- tions during a brief (less than 10 minutes) semi-structured teaching episode. It con- sists of 73 items that are scored only by a trained certified observer on a dichoto- mous ���yes or no��� scale. There are six con- ceptually derived subscales. Four subscales (Sensitivity to Cues, Response to Distress, Social���Emotional Growth Fostering, Cognitive Growth Fostering) represent the contributions of the caregiver during the interaction and result in a Total Caregiver score (maximum = 50). Two subscales (Clarity of Cues, Responsiveness to Caregiver) represent the child���s contribu- tions and provide a Total Child score (max- imum = 23). Contingency (behavior that considers or reacts to the actions of the sec- ond person) scores for the caregiver and the child can also be obtained. Higher scores indicate more optimal parent���child inter- actions. The developers of the NCATS report acceptable Cronbach���s coefficient alphas for the Caregiver (.87) and Child score (.76) based on studies with mothers (Sumner & Spietz). Cronbach���s alphas for fathers��� Caregiver scores were lower (.70) (Harrison et al., 2001). Scores on the NCATS discriminate between groups (e.g., pre-term and full-term infants) expected to differ in dyadic interactions (Sumner & Spietz). Gross Motor Function Classification System for Cerebral Palsy (GMFCS) (Palisano et al., 1997). The GMFCS was used to describe each child���s motor func- tion. It is an ordinal, five-level classification system representing clinically meaningful distinctions in motor function. The levels for each child in this study were described earlier. Nominal group process and Delphi survey methods with consensus among 48 experts were employed to establish content validity. Interrater reliability (��) was .55 for children under 2 years and .75 for children 2 to 12 years old (Palisano et al.). 464 July/August 2003, Volume 57/Number 4