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The aim of this study was to compare ratings of mother-child relationship quality from diverse assessment perspectives. The quality of the mother-child relationship was rated in a sample of 34 mothers with substance-use difficulties and their children using the Emotional Availability Scales (EAS; Z. Biringen, 2008), based on videotaped observation of a 20-min, free-play session. These ratings were compared to clinician ratings on the Parent-Infant Ratings Global Assessment Scale (PIR-GAS; ZERO TO THREE, 2005) and maternal ratings on the Parenting Stress Index-Short Form (PSI-SF; R.R. Abidin, 1995). Ratings on the Emotional Attachment and Emotional Availability (EA2) Clinical Screener (EA2 Clinical Screener) and adult dimensions of the EAS (particularly maternal sensitivity), but not child dimensions, were associated with clinician ratings on the PIR-GAS. In contrast, child dimensions of the EAS, but not adult dimensions, were associated with maternal ratings on the Child scales of the PSI-SF (particularly parent-child difficult interactions). While clinician ratings seem to be more sensitive to maternal contributions to the relationship, maternal ratings seem to emphasize child behaviors. Results highlight the importance of multimethod assessment in fully capturing the transactional nature of the mother-child relationship in high-risk samples. The validity of the EA2 Clinical Screener as an index of the quality of mother-child relationship in a high-risk, substance-exposed sample is also supported.

The current study examined the mental health diagnostic profiles of infants and young children prenatally exposed to substances using the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised (DC:0–3R) diagnostic system. Participants were 46 biological mother–infant dyads who were engaged in a clinical program for mothers with substance‐use problems and their young children (aged 10–41 months). Diagnostic information was reported for each of the five axes listed in the DC:0–3R diagnostic system based on file reviews. In addition, the children's socioemotional and adaptive behaviors were assessed using the Child Behavior Checklist, Infant–Toddler Social Emotional Assessment, the Social‐Emotional Scale, and the Adaptive Behavior Assessment System (2nd ed.). In this sample of young children with prenatal substance exposure, a broad range of socioemotional symptoms were evident, with almost one third of the children meeting criteria for at least one Axis I mental health diagnosis. In addition, the majority of dyads demonstrated features of a disordered relationship. Children in more problematic relationships demonstrated higher levels of socioemotional and adaptive functioning difficulties and were more likely to have an Axis I diagnosis than were children in adapted relationships. The importance of early intervention efforts aimed at infants with prenatal substance exposure and their biological mothers is highlighted, with a particular focus on enhancing the quality of the mother–child relationship.

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