Investigating question-answer sequences in child mental health assessments: Engaging children and families through declarative question design

In mental health settings, before a child can be diagnosed with a mental health condition, they must initially be assessed. These assessments are characterised by question-answer sequences with the child and family members, and our objective is to explore the function of declarative questions. Video recordings of mental health assessments from 28 families were collected, each being approximately 90 min. Referred children were aged 6–17-years. Data were transcribed using the Jefferson approach and conversation analysis was used. Attention to question-answer sequences identified that one common type was the declarative question. We focus on three identifiable forms: clean language short declaratives, declaratives with extreme case formulations, and reformulation declaratives. The response to these three types of declaratives formed the basis for subsequent question-answer elaboration sequences. The question functioned both to engage the child directly and align with other family members. Implications for practitioners are that these types of declarative questions offer a resource to engage in fact-checking in a way that is non-face-threatening. Conversation analysis provides a methodological tool for practitioners to engage in reflective practice to enhance their clinical skills in relation to question design. •Question-answer sequences are the cornerstone of health communication practices.•Declarative questions are a useful part of the communication toolkit.•Different types of declarative questions perform different functions.•Practitioners benefit from paying attention to the form and function of declarative questions.•Attending to the child’s knowledge domain through declaratives is child centred.