Lynne Ramsay, the eye-catching director of Ratcatcher and Morvern Callar, delivers her most accomplished work to date with We Need to Talk About Kevin: a modern horror tale based on Lionel Shriver’s best-selling novel. Suggestive of other chillers (Rosemary’s Baby, Village of the Damned) it carves its own path, using sound, vision and an evocative soundtrack to build to an unnerving and touching finale.

Anchored by an astounding performance from Tilda Swinton (a sure thing for an Oscar nomination) as the mother of Kevin, there is also strong support from John C Reilly as her unseeing husband and Ezra Miller as her smirking, bad seed boy (kudos too to Jasper Newell as the younger Kevin). And if it burns slow in the early, motif-laden, sections, the knock-out finale will leave you on the floor.

Just like the novel, the film teases out age-old chestnut of nature versus nurture. At the narrative’s infernal centre is a boy called Kevin - a kid who’s not so much a bad apple as a bad seed. But this is not a film about a sociopath, more a tale of how a mother copes with his terrible legacy: one that is painted into the movie in blood red swathes. So at the heart is a mother, Eva, trying to cope with the sins of her son and the guilt of whether she should, or could, have done anything differently. With her Ziggy Stardust looks, now pinched and haunted, Swinton’s face betrays someone caught in an eddy of emotions – guilt, pain, remorse and a whole damn thing. Abused on the street, ignored in her workplace, Eva accepts it all with the weariness of someone condemned to purgatory.

But it begins in love and hope: with her soon-to-be-husband (John C Reilly) and their first born. This is Kevin, the baby that will not stop bawling. She tries everything, most memorably pushing the pram alongside a pneumatic drill on the street, to smother the caterwauling. But it is to no effect – and the audience feel her frustration even as her husband shrugs that crying, and being stroppy, is just what baby boys do and a litany of medical experts can diagnose nothing unusual.

Ramsay’s movie is driven by an evocative and subtly powerful soundtrack – a route 66 of country classics and golden oldies that work both as counterpoint to the images on the screen. Two stand out: a Hallowe’en drive through the neighbourhood with kids dressed as ghosts and ghouls plays out to Buddy Holly’s Every Day. It is sinister if overlong. Much more effective is the piercing and poignant wielding of Nobody’s Child.

Towards the end, Ramsay expertly turns the screw on what we’ve known for some time has been a dance of death (if you haven’t read the book I’m saying nothing) and the killer punches knock you senseless. But there is a touching coda, one that rewires some of what has gone before and gives a terribly human heart to the film. How appropriate then that the screen closes to a blank white canvas - just as it began.

Donal O'Donoghue