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Christy Kimpo, PhD, MHP, CMHS
Navos Community Strategies Meeting Handout
Axis II PIRGAS – Parent infant relationship global assessment scale
1 – 10 Documented maltreatment and/or neglect, physical and/or sexual abuse that affects the child’s
physical and emotional development.
11 – 20 Grossly impaired – relationships are dangerously disorganized. Frequent serious disturbance of
relationships.
21 – 30 Severely disordered – relationships in this range are compromised. Both parent and child are
significantly distressed by the relationship. Maladaptive patterns are entrenched, have been in place for
a long time, and are likely to be conflicted. Developmental progress has been influenced.
31 – 40 Disordered – Rigid, maladaptive interaction patterns, often displaying distress in one partner or
the other. Interactions are typically conflicted or grossly inappropriate for child’s developmental stage.
Developmental progress is disturbed or impacted.
41 – 50 Disturbed – Adaptive qualities of a disturbed relationship are overshadowed by problems. Not
entrenched (occasional good moments) but more than transient. Developmental progress proceeds,
but may be interrupted.
51 – 60 Distressed – Relationships are transiently affected, one or both partners experience distress in
the relationships. Some flexibility and adaptive qualities in the relationship, conflict may spread across
multiple domains of functioning. No interference to normal developmental trajectories.
61 – 70 Significantly Perturbed – Relationships are strained but still adequate and satisfying. Conflicts
limited to one or two problem areas. Adaptive flexibility exists and problems are generally short-lived.
Normal developmental trajectories.
71 – 80 Perturbed – Some aspects less than optimal, some transient distress but relationship remains
adaptive, flexible and satisfying. Normal developmental trajectories.
81 – 90 Adapted – Relationships functioning well, and are reciprocal, synchronous, show no distress,
and are adaptive. Normal developmental trajectories.
91 – 100 Well adapted – exceptionally well functioning relationships are satisfying and mutually
enjoyable to both partners. Significant adaptation to new circumstances and little conflict beyond minor
disturbances. Normal developmental trajectories.
Axis V Functional Emotional Assessment Scales –FEAS – From Greenspan, DeGangi, & Wieder (2001)
The Functional Emotional Assessment Scale (FEAS), Bethesda, MD: ICDL
Attention & regulation /is infant aware of surroundings– interested, looking around, responding to
environment
Mutual engagement /does relationship w/CG provide comfort, does infant look to adult for security &
pleasure, does infant attempt to engage adult, does adult respond?
Intentional 2-way /does infant uses gestures that get responded to, develop means to communicate
Complex gestures & prob solving / can infant master using motor skills & language to get needs met
Use of symbols /does infant use imaginative play and language to express thoughts, ideas, feelings
Connecting symbols/ connect sequences of ideas logically 30 - 48
Levels of Organizing and/or representing Emotions and Experiences (Table 3-1)
Developmental Level Level of Organizing and Representing
Shared attention and regulation Affective interest in sights, sounds, touch, movement, and
other sensory experiences. Also, initial experiences of
(By 3 months) modulating affects, e.g., calming down.
Engagement and Relating Pleasurable affects characterize relationships. Growing
feelings of intimacy.
(By 5 months)
Two way intentional communication A range of affects become used in back-and-forth affective
signaling to convey intentions (e.g., reading and responding
(By 9 months) to affective signals)
Complex problem solving gestures. Affective interactions organized into action or behavioral
Organization of Pre-symbolic self patterns to express wishes and needs and solve problems
(showing someone what you want with a pattern of actions
(By 14-18 months) rather than words or pictures)
a. Fragmented level (little islands of intentional problem-
solving behavior)
b. Polarized level (organized patterns of behavior
expressing only one or another feeling state, e.g.,
organized aggression and impulsivity or organized
clinging, needy, dependent behavior, or organized
fearful patterns.
c. Integrated level (different emotional patterns –
dependency, assertiveness, pleasure, etc – organized
into integrated problem-solving affective interactions
such as flirting, seeking closeness, and then getting
help to find a needed object.
Creating representations 1. Words and actions used together (ideas are acted out
in action, but words are also used to signify the
(By 24-30 months)
actions)
2. Somatic or physical words to convey feeling state (“my
muscles are exploding; “head is aching”)
3. Putting desires or feelings into actions (hugging,
hitting, biting)
4. Using actions words instead of actions to convey intent
(“hit you”)
5. Conveying feeling as real rather than as signals (“I’m
mad” or “hungry” or “need a hug” or “I feel hungry” or
“I feel like I need a hug”)
6. Global feeling states (“I feel awful” or “I feel OK”
7. Polarized feeling states (feelings tend to be
characterized as all good or all bad)
Representational differentiation and 1. Differentiated feelings (gradually there are more and
emotional thinking more subtle descriptions of feeling states – loneliness,
sadness, annoyance, anger, delight, happiness)
(By 36-48 months)
2. Creating connections between differentiated feeling
states (“I feel angry when you are mad at me”)
Triangular thinking Triadic interactions among feeling states (“I feel left out
when {name} likes {other name} better than me”)
(Between 4 – 7 years)
