Parent-child relationships: are health visitors' judgements reliable?

The quality of the parent-child relationship is a strong predictor of outcomes for children, and its assessment is a key element of the work of health visitors. The Glasgow Parenting Support Framework emphasises the importance of relationship assessment, and a feasibility study using a semi-structured approach is being carried out in one area of the city. This paper explores how well health visitors agree in observational assessments of problems in video-recorded mother-child interactions and considers the impact of specific training in observational skills. Variable levels of agreement in judgement were demonstrated by 25 health visitors attending a training day. With little negative interaction between parent and child, agreement was high whether rates of positive interaction were high or low. Less agreement was found where high frequencies of negative behaviours were seen alongside positive behaviours. Assessment training may increase the abilities of health visitors to identify these problems, but more research is required into how this might be done most effectively.