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Leeds Early Attachment Observation Tool Training

Training Aims and Objectives

• Implement the Tool: To familiarise practitioners with the LEAO tool and to embed it in everyday practice.
• Help to hear the infant voice : To provide techniques for 2-minute observation, allowing practitioners to "see" the relationship, hear the infant voice and understand the baby's experience.
• Strengthen Relationship Focus: To shift the focus toward the "relationship as the client," focusing on parent-infant interactions rather than just child development milestones.
• Improve Attachment Security: To support families in establishing positive, safe relationships by fostering secure attachment.
• Identify Emerging Difficulties: To train practitioners to spot signs of attachment difficulties or relationship distress between caregivers and infants (0-5 years).
• Provide Pathway Access: To help practitioners know when and how to refer families to the specialised Parent Infant Relationship Service (PaIRS). 

The training is designed to build on practitioners' pre-existing skills, fostering reflective practice in their work with families.

Background and course content –

In March 2024, the Department of Health and Social Care, as part of the Best Start in Life Healthy Babies programme, published guidance that provides 3 conversation prompts for frontline practitioners to explore a parent or carer’s relationship with their baby.

It also sets out a 3-step framework and questions for using them to help identify parent-infant relationship difficulties. The 3 questions came from the Leeds Early Attachment Observation (LEAO) Tool. The LEAO tool was developed by the Leeds Infant Mental Health Service (Leeds Community Healthcare NHS Trust) in collaboration with Leeds Health Visiting Service. It was used to identify emerging attachment difficulties.

As part of our Blackpool Parent-Infant and Early Years Relationship Strategy we are committed to support our workforce to feel confident and skilled in having conversations with parents and carers to help them think about their relationship with their baby. Blackpool have trained a small cohort of LEAO champions and during 2026 they are offering a three-hour training session in the Leeds Early Attachment Observation Tool.

Please see the guidance here Reflecting on parent-infant relationships: A practitioner’s guide to starting conversations

The Leeds Early Attachment Observation (LEAO) training will enable practitioners to identify early caregiver-infant relationship difficulties. The training focuses on utilising the 3-question screening tool and 2-minute observation to foster secure attachments, improve parent-infant interaction, and support early intervention. 

Who is this training for?

Do you work with families with children under 5?
Parents tell us they want to be asked about their relationship with their baby, so they can access support early, without stigma or delay.

This training is for practitioners who have everyday conversations with parents and carers and want greater confidence in opening up safe, supportive discussions about bonding and early relationships.

Target audience

The prompts have been designed to be used by a range of practitioners including but not limited to:

• health visitors
• midwives
• early years practitioners
• family support workers
• social workers
• mental health practitioners

More information about how the LEOA tool/prompts can be used in different roles:

Health visitors: making every interaction count with parents and carers is something that you will already be doing as skilled practitioners. You might find the prompts are useful for you and colleagues in the skill-mix team when talking to parents about bonding and early attachment relationships as part of delivering the healthy child programme. For example, the prompts could lend themselves well to conversations during visits/reviews when exploring the parent-infant relationship

Midwives: some women and birthing people experience difficulties in bonding with their baby during pregnancy. Being asked about this can be a relief for parents and carers who may feel embarrassed or shame for not being as connected with their baby as they believe they ‘should’. For example, at 36 weeks you can have conversations with parents and carers about caring for their newborn baby and their mental health both before and after birth

Early years practitioners: as practitioners who work with families every day, the prompts can support you to have conversations with parents and carers about their relationship with their baby. They have been designed to be used within your existing interactions with families once you have built a positive and trusting relationship

Service managers: you may wish to consider how the prompts fit into your local systems and pathways to ensure local practitioners build relationships across teams  and understand local procedures. You may also want to consider how an understanding of parent-infant relationships becomes part of your service through training and awareness raising

Dates