OBJECTIVES: In children, utility and health-related quality of life (HRQOL) measurements may be influenced by age, cognitive ability and disease severity. Parents are often proxy respondents. The objectives were to assess the validity and reliability of a parent-child dyad utility and HRQOL assessment wherein children and parents are interviewed together to assess the child's HRQOL. METHODS: The Health Utility Index (HUI), PedsQL Core and Asthma Modules and the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) were administered to 93 asthmatic children aged 8 to 15 years and their parents in a joint dyad interview. All questions were directed at the child to assess the child's utility and HRQOL. Questionnaires were scored normally. A pre-tested structured guide was available to interviewers. To assess construct validity of the dyad approach, Spearman correlations were calculated between HUI attributes and questionnaire domains associated with physical function and with emotional function. Test-retest reliability was assessed with an intra-class correlation coefficient (ICC) in 28 children who remained clinically stable between baseline and follow-up assessments at 5 months. RESULTS: Among the parent-child dyads, the HUI2 Mobility attribute was significantly correlated (p<0.05) with the PedsQL Core Physical (r=0.41) and the PAQLQ Activities (r=0.32) domains. The HUI2 Emotion attribute was significantly correlated (p<0.05) with the PedsQL Core Emotion (r=0.39), the PedsQL Core Social (r=0.34), the PedsQL Asthma Communication (r=0.21) and the PAQLQ Emotion (r=0.25) domains. For clinically stable children, significant ICCs between baseline and follow-up were observed for the HUI2 Total (r=0.53), PedsQL Core Total (r=0.70), PedsQL Asthma Symptoms (r=0.84), PedsQL Asthma Treatment (r=0.51), PAQLQ Activity (r=0.75) and PAQLQ Emotion (r=0.76) domains. CONCLUSIONS: The parent-child dyad demonstrated moderate construct validity and moderate to strong test-retest reliability in generic and disease-specific questionnaires. This approach may be a valid alternative to relying on parent proxies for assessing children's utility and HRQOL.