Table 1.
Cumulative risk factor measure.
| DOMAIN | SCORING | ||
|---|---|---|---|
| PARENT - MOTHER | |||
| Presence of a diagnosed DSM-IV-TRa/DSM-5b mental illness | (0) no | unknown | (+1) yes |
| Family history of mental illness | (0) no | unknown | (+1) yes |
| Chronic medical illness | (0) no | unknown | (+1) yes |
| Maternal level of education: has not completed high school | (0) no | unknown | (+1) yes |
| Conviction history | (0) no | unknown | (+1) yes |
| Mother has history of child abuse/neglect | (0) no | unknown | (+1) yes |
| Mother has history of interpersonal violence/trauma | (0) no | unknown | (+1) yes |
| Maternal anxiety symptoms (clinical level – BAIc) | (0) no | unknown | (+1) yes |
| Mother endorses depressive symptoms (clinical level – CESD-Dd) | (0) no | unknown | (+1) yes |
| Teenage parent | (0) no | unknown | (+1) yes |
| More than 3 births | (0) no | unknown | (+1) yes |
| Has tried to quit substance use ever | (0) no | unknown | (+1) yes |
| Reports having had withdrawal symptoms when trying to stop substance use | (0) no | unknown | (+1) yes |
| Low perceived social support – Family (PSSe) | (0) no | unknown | (+1) yes |
| Low perceived social support – Friends (PSSe) | (0) no | unknown | (+1) yes |
| Is not comfortable with closeness and intimacy (RAASf) | (0) no | unknown | (+1) yes |
| Does not feel she can depend on others (RAASf) | (0) no | unknown | (+1) yes |
| Worries about being rejected or unloved (RAASf) | (0) no | unknown | (+1) yes |
| Low confidence regarding ability to cope with relapse crisis situations (DTCQg) | (0) no | unknown | (+1) yes |
| History of self-harm behaviours or suicide attempt | (0) no | unknown | (+1) yes |
| PARENT - OTHER | |||
| Secondary parent is absent from child's life | (0) no | unknown | (+1) yes |
| Presence of a diagnosed DSM-IV-TRa/DSM-5b mental illness | (0) no | unknown | (+1) yes |
| Substance use | (0) no | unknown | (+1) yes |
| Has tried to quit substance use ever | (0) no | unknown | (+1) yes |
| Conviction history | (0) no | unknown | (+1) yes |
| Difficult/dysfunctional or abusive relationship with mother of child | (0) no | unknown | (+1) yes |
| FAMILY | |||
| Maternal pregnancy/Birth of a sibling | (0) no | unknown | (+1) yes |
| New child adopted | (0) no | unknown | (+1) yes |
| More than one child in the home | (0) no | unknown | (+1) yes |
| Medical illness of parent or caregiver | (0) no | unknown | (+1) yes |
| Death of parent or important person | (0) no | unknown | (+1) yes |
| Other trauma to significant person in the child's life | (0) no | unknown | (+1) yes |
| Mother is engaged in a domestically violent relationship/Domestic violence | (0) no | unknown | (+1) yes |
| Has a primary relationship with substance user | (0) no | unknown | (+1) yes |
| Parent or caregiver traumatic divorce or separation | (0) no | unknown | (+1) yes |
| Custody dispute | (0) no | unknown | (+1) yes |
| New romantic relationship | (0) no | unknown | (+1) yes |
| New adult in household (e.g., romantic partner) | (0) no | unknown | (+1) yes |
| Parent or caregiver remarriage | (0) no | unknown | (+1) yes |
| Substance use by household member (non-parental) | (0) no | unknown | (+1) yes |
| Parental substance use relapse | (0) no | unknown | (+1) yes |
| Child protective services involvement | (0) no | unknown | (+1) yes |
| Removal of non-index child from home | (0) no | unknown | (+1) yes |
| Child put up for adoption | (0) no | unknown | (+1) yes |
| Parental unemployment or job instability | (0) no | unknown | (+1) yes |
| Poverty or near poverty (less than $10,000) | (0) no | unknown | (+1) yes |
| Head of household has no more than a semiskilled occupation | (0) no | unknown | (+1) yes |
| Inadequate, unsafe or overcrowded housing or homelessness | (0) no | unknown | (+1) yes |
| Multiple housing moves (2+) | (0) no | unknown | (+1) yes |
| Parental arrest | (0) no | unknown | (+1) yes |
| Parental incarceration (or return from incarceration) | (0) no | unknown | (+1) yes |
| PRE-NATAL/PREGNANCY | |||
| Domestic violence | (0) no | unknown | (+1) yes |
| Alcohol use | (0) no | unknown | (+1) yes |
| Cannabis use | (0) no | unknown | (+1) yes |
| Crack/cocaine use | (0) no | unknown | (+1) yes |
| Heroin use | (0) no | unknown | (+1) yes |
| Methadone use | (0) no | unknown | (+1) yes |
| Other opiates use | (0) no | unknown | (+1) yes |
| Nicotine use | (0) no | unknown | (+1) yes |
| Prescription drug use | (0) no | unknown | (+1) yes |
| Other drug use (eg., amphetamines, hallucinogens, barbiturates/sleeping pills, sedatives/hyponotics/tranquilizers, inhalants | (0) no | unknown | (+1) yes |
| Poly-substance exposure versus single substance exposure during pregnancy | (0) no | unknown | (+1) yes |
| Continuous exposure over all three trimesters during pregnancy | (0) no | unknown | (+1) yes |
| Transiency | (0) no | unknown | (+1) yes |
| Low maternal weight gain | (0) no | unknown | (+1) yes |
| High blood pressure/ pre-eclampsia | (0) no | unknown | (+1) yes |
| Mother overweight pre-pregnancy | (0) no | unknown | (+1) yes |
| Poor pre-natal nutrition | (0) no | unknown | (+1) yes |
| Mom >35 years | (0) no | unknown | (+1) yes |
| Teenage pregnancy | (0) no | unknown | (+1) yes |
| Minimal prenatal care | (0) no | unknown | (+1) yes |
| History of miscarriages or terminations | (0) no | unknown | (+1) yes |
| Diabetes during pregnancy | (0) no | unknown | (+1) yes |
| Infections/Sexually Transmitted Disease | (0) no | unknown | (+1) yes |
| Anemia | (0) no | unknown | (+1) yes |
| Placenta Previa | (0) no | unknown | (+1) yes |
| Multiple fetuses | (0) no | unknown | (+1) yes |
| Vaginal bleeding (2nd or 3rd trimester) | (0) no | unknown | (+1) yes |
| BIRTH/POST-NATAL | |||
| Mom >35 years | (0) no | unknown | (+1) yes |
| Teenage pregnancy | (0) no | unknown | (+1) yes |
| Caesarean delivery | (0) no | unknown | (+1) yes |
| Premature delivery | (0) no | unknown | (+1) yes |
| Birth complications | (0) no | unknown | (+1) yes |
| Post-partum depression | (0) no | unknown | (+1) yes |
| Apprehension at birth | (0) no | unknown | (+1) yes |
| Post-natal Medical Diagnoses: | |||
| Fetal Alcohol Spectrum Disorder | (0) no | unknown | (+1) yes |
| Drug withdrawal | (0) no | unknown | (+1) yes |
| Genetic disorder | (0) no | unknown | (+1) yes |
| Seizure/tremors | (0) no | unknown | (+1) yes |
| Heart complications | (0) no | unknown | (+1) yes |
| Birth injuries | (0) no | unknown | (+1) yes |
| Birth defects | (0) no | unknown | (+1) yes |
| Breathing difficulty | (0) no | unknown | (+1) yes |
| Low birth weight | (0) no | unknown | (+1) yes |
| Meconium in placenta | (0) no | unknown | (+1) yes |
| Post-natal Interventions: | |||
| Incubator | (0) no | unknown | (+1) yes |
| Tube feeding | (0) no | unknown | (+1) yes |
| Apnea monitor | (0) no | unknown | (+1) yes |
| Respirator (required ventilation) | (0) no | unknown | (+1) yes |
| Medication requires | (0) no | unknown | (+1) yes |
| CHILD | |||
| Hospitalization of child | (0) no | unknown | (+1) yes |
| Child medical illness | (0) no | unknown | (+1) yes |
| Presence of a diagnosed DSM-IV-Ra/DSM-5b mental illness | (0) no | unknown | (+1) yes |
| Presence of Fetal Alcohol Spectrum Disorder diagnosis | (0) no | unknown | (+1) yes |
| Child in foster care or kin care/Change in primary caregiver | (0) no | unknown | (+1) yes |
| Child neglect (physical, emotional) | (0) no | unknown | (+1) yes |
| Child abuse (physical, sexual, emotional) | (0) no | unknown | (+1) yes |
| Child reunification with parent after separation | (0) no | unknown | (+1) yes |
| Multiple changes in childcare provider | (0) no | unknown | (+1) yes |
| Stress surrounding child starting daycare/entered school system | (0) no | unknown | (+1) yes |
| Challenging temperament style | (0) no | unknown | (+1) yes |
| Psychosocial & Health Concerns at Intake: | |||
| Chronic colds | (0) no | unknown | (+1) yes |
| Chronic respiratory problems | (0) no | unknown | (+1) yes |
| Chronic ear infections | (0) no | unknown | (+1) yes |
| Heart problems | (0) no | unknown | (+1) yes |
| Gastroenteritis | (0) no | unknown | (+1) yes |
| Limitation in mobility | (0) no | unknown | (+1) yes |
| Seizures | (0) no | unknown | (+1) yes |
| Psychological/emotional problem | (0) no | unknown | (+1) yes |
| Developmental delays/delays to meet developmental milestones | (0) no | unknown | (+1) yes |
| Injuries | (0) no | unknown | (+1) yes |
| Eating problems | (0) no | unknown | (+1) yes |
| Slow weight gain | (0) no | unknown | (+1) yes |
| Behind in immunization | (0) no | unknown | (+1) yes |
| Visual impairment | (0) no | unknown | (+1) yes |
| Hearing impairment | (0) no | unknown | (+1) yes |
| Speech impairment | (0) no | unknown | (+1) yes |
| Cognitive impairment | (0) no | unknown | (+1) yes |
| Frequent injuries | (0) no | unknown | (+1) yes |
| Behavioural problems | (0) no | unknown | (+1) yes |
| Asthma | (0) no | unknown | (+1) yes |
| PARENT-CHILD INTERACTION | |||
| Low parental efficacy (BaPh) | (0) no | unknown | (+1) yes |
| Low parental satisfaction (BaPh) | (0) no | unknown | (+1) yes |
| High defensive responding (PSIi) | (0) no | unknown | (+1) yes |
| High parental distress (PSIi) | (0) no | unknown | (+1) yes |
| High parent-child dysfunctional interactions (PSIi) | (0) no | unknown | (+1) yes |
| Mother's perception of having a difficult child (PSIi) | (0) no | unknown | (+1) yes |
| Clinical level of stress in parenting role (PSIi) | (0) no | unknown | (+1) yes |
| High parental expectations (AAPIj) | (0) no | unknown | (+1) yes |
| Low parental empathy (AAPIj) | (0) no | unknown | (+1) yes |
| Reversed familial/parent-child roles (AAPIj) | (0) no | unknown | (+1) yes |
| High hostile ineffective parenting (NLSCYk) | (0) no | unknown | (+1) yes |
| High inconsistent parenting (NLSCYk) | (0) no | unknown | (+1) yes |
| Low positive parenting (NLSCYk) | (0) no | unknown | (+1) yes |
| Reporting challenging relationship with child | (0) no | unknown | (+1) yes |
| Child apprehension within first three years of life | (0) no | unknown | (+1) yes |
| SOCIAL NETWORK | |||
| Disadvantaged minority ethnic background | (0) no | unknown | (+1) yes |
| Immigrant status | (0) no | unknown | (+1) yes |
| Acculturation or language conflicts | (0) no | unknown | (+1) yes |
a
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; American Psychiatric Association, 2000
b
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; American Psychiatric Association, 2013
c
Beck Anxiety Inventory; Beck, Epstein, Brown, & Steer, 1988
d
Center for Epidemiologic Studies Depression Scale; Radloff, 1977
e
Perceived Social Support from Friends and Family; Procidano & Heller, 1983
f
Revised Adult Attachment Scale; Collins, 1996
g
Drug-Taking Confidence Questionnaire; Annis & Martin, 1985
h
Being a Parent Scale; Johnston & Mash, 1989
i
Parenting Stress Index; Abidin, 1986
j
Adult Adolescent Parenting Inventory; Bavolek, 1984
k
National Longitudinal Survey of Children and Youth; Statistics Canada, 1994