Objective: To examine whether the routine health surveillance check for two-year-old children could be satisfactorily conducted with children and their parents in groups, rather than by the traditional one-to-one approach.
Method: Over a period of one year, a total of 160 two-year-old children were seen with their parents at group assessment sessions lasting one hour. The maximum number of two year olds at each session was eight. Children with special needs were excluded. The children's play was supervised and observed by a nursery nurse and health visitor. They recorded when individual children demonstrated activities expected of a two year old as specified in the national parent-held Personal Child Health Record (PCHR). While the children played, another health visitor led a group discussion with the parents on health and safety issues identified by the PCHR as important for two year olds. The parents then had individual interviews with a health visitor to receive feedback about their child's assessment and to discuss any issues in confidence.
Results: Evaluation showed that the overwhelming number of parents were satisfied with the group assessment method of health surveillance for their two year olds. Although offered a choice of group or traditional one-to-one assessments, all opted for group assessment. Of those with previous experience of the traditional method, most preferred the group assessment. Many parents commented that the group discussion was reassuring in showing them that other parents had similar problems and helpful in enabling them to hear other parents' ways of coping. No child needed a follow-up because part of the assessment had not been completed. The group assessments proved a more effective use of scarce professional resources, freeing staff time for other activities.
Conclusion: Group assessment for routine child health and development surveillance at the age of two years appears to be effective and received a high approval rating from parents. It offers a viable alternative to the traditional one-to-one surveillance interviews.