Development and use of the Early Attachment Observation tool for infant mental health

Abstract

The Early Attachment Observation (EAO) is a simple assessment tool that has been developed by the Leeds Infant Mental Health service in collaboration with Leeds Health Visiting Service for use by health visitors to identify emerging attachment difficulties. The EAO is delivered as part of the universal offer at the routine 6–8-week health visitor contact. The EAO protocol requires the health visitor to ask the primary caregiver three questions about the emerging relationship between themselves and their infant: Describe your relationship with your baby in three words; What is the best thing about your relationship with your baby?; and What is your biggest fear about your relationship with your baby? The health visitor completes a 2-minute observation of the interactions between the infant and parent. The purpose of the EAO is to screen for emerging attachment difficulties, in line with the WAVE report Conception to Age 2: The Age of Opportunity. The EAO is now a crucial element of the Leeds Early Start infant mental health pathway. The purpose of this article is to outline the development, pilot, implementation and evaluation of the use of the EAO in Leeds.