The clinical assessment of a child's social and physical environment during health visits

Patrick H. Casey, Robert H. Bradley, Joann Y. Nelson, Steven A. Whaley

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


The quality of a child's home environment plays a critical role in long-term developmental status. The Pediatric Review and Observation of Children's Environmental Support and Stimulation (PROCESS) Inventory was developed to clinically assess aspects of the child's physical environment and the parent-child interaction during a health supervision visit. The final version was used with 76 mother-child pairs by two pediatricians. The Home Observation for Measurement of the Environment (HOME) Inventory was performed within 3 weeks on all pairs, and a laboratory observation of parent-child interaction was completed with 30 of the pairs. Correlations of the PROCESS with the HOME Inventory and parent-child interaction were 0.84 and 0.86 (<0.001), respectively. These significant correlations persisted while controlling for family income and education. When high and low scores of the HOME Inventory known to correlate with positive and negative developmental outcomes were cross-tabulated with PROCESS scores, low scores on the PROCESS identified 77% of low HOME Inventory scores and high scores on the PROCESS identified 95% of the high HOME Inventory scores. The PROCESS provides pediatricians a brief, easy-to-score, clinically useful, reliable, and valid method to measure children's home environments.

Original languageEnglish (US)
Pages (from-to)333-338
Number of pages6
JournalJournal of Developmental and Behavioral Pediatrics
Issue number6
StatePublished - Dec 1988
Externally publishedYes


  • Home environment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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