The Role of General Practitioners in ADHD Diagnosis & Management

Included in Training (Knowledge)

• Be aware of the range of factors that impact typical development, including adverse experiences, trauma, physical health conditions and their treatment

Not Included in Training (Knowledge)

• Be aware of the changing development needs of children and young people, such as relationships with peers and adults, education, regular patterns of diet, sleep and exercise
• Be aware of the range of typical developmental stages

Included in Training (Knowledge)

• Be aware that some families, such as those whose child has longterm physical health conditions face additional challenges and complexities which impact on usual patterns of parenting
• Have a good working knowledge of resources available to support families, particularly those who face additional challenges and/or are vulnerable

Not Included in Training (Knowledge)

• Be aware of the components of a healthy parent-infant relationship, and how it develops through childhood
• Be aware of the changes in relationships with parents, authority figures and peers in adolescence
• Have a broad understanding of the factors which promote good parentchild relationships, including an understanding of attachment theory and different parenting styles

Included in Training (Knowledge)

• Be aware that some children will have had few opportunities to play, due to physical health conditions, disability or early adversity

Not Included in Training (Knowledge)

• Be aware of the positive and negative impacts of electronic media on child development

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware of the factors that help child, young people and their families to successfully manage transitions
• Be aware that transitions can be emotionally challenging, even when generally experienced as positive
• Be aware of the importance of understanding the transition from the perspective of the child or young person, and how this might differ from the perspectives of others

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware of the wide range of different family structures, including kinship care and other care provision
• Be aware of the potential impact on families of adversity, such as loss, abuse, social change, socio-economic disadvantage and health inequalities
• Be aware that experience of emotional distress and symptoms of mental health are influenced by culture and background
• Be aware of the range of cultural, social and religious differences in relation to family relationships, and parenting style that are likely to be present in the local population
• Be aware that internal beliefs and expectations may affect a child, young person and their family’s ability to engage with helping agencies

Included in Training (Knowledge)

• Be aware that trauma can cause developmental regression and/ or delays, such as in language development and learning difficulties due to emotional dysregulation (fight, flight, freeze response), preoccupation with danger
• Be aware trauma and adverse experiences can impact a child or young person’s development and the ability to form attachment/ therapeutic relationships

Not Included in Training (Knowledge)

• Be aware that children and young people can be affected by sensory reminders of traumatic experiences
• Be aware that the amount of adversity is related to the likelihood of negative impact for children

Included in Training (Knowledge)

• Be aware that neurodevelopmental conditions occur on a spectrum and presentation will vary depending on factors such as age, developmental stage, gender and setting
• Be aware of how impaired communication can be a marker for common neurodevelopmental conditions and the importance of early intervention
• Be aware that neurodevelopmental diversity can impact wellbeing and mental health

Not Included in Training (Knowledge)

Included in Training (Knowledge)

• Be aware that some groups of children and young people are more at risk of mental ill health, and the barriers they may face in accessing help and support

Not Included in Training (Knowledge)

• Be aware of the common mental health difficulties in children and young people, including anxiety and low mood
• Be aware that sustained change in presentation, distress and impact on daily functioning are key indicators of mental health and wellbeing needs
• Be aware that mental health difficulties can impact on family functioning
• Be aware of the links between mental health and wellbeing and mental ill health
• Be aware of the potential for social media to have adverse and/or protective effects on mental health

Included in Training (Knowledge)

• Be aware that differences in development, not just age can impact how distress and mental health difficulties present
• Be aware that experiences of distress, mental illness and trauma can interrupt the typical building blocks of child development, and that this can have effects throughout development and into adulthood

Not Included in Training (Knowledge)

• Be aware of how common mental health difficulties may present at different ages
• Be aware that a child or young person may experience distress in non-verbal and sensory ways and communicate distress through actions, or experience physical health symptoms
• Be aware that different mental health difficulties are more common at different ages and stages of development

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware that long-term conditions can impact wellbeing and mental health and that children and young people may need additional supports to manage this

Included in Training (Knowledge)

• Be aware that there are recognised diagnostic criteria for mental health difficulties and disorders in children and young people

Not Included in Training (Knowledge)

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware of how self-esteem, selfworth, self-identity and confidence impact mental health and wellbeing
• Know that the ability of children to regulate their emotions arises from multiple experiences of co-regulation with attuned adults/others
• Be aware of services in the community that can support children, young people and their families in these areas

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware of the importance of good parental mental health for the parent-child relationship and child development
• Be aware that parental mental health difficulties can impact on a child or young person’s wellbeing
• Know about local services and organisations that can support adults with their mental health

Included in Training (Knowledge)

• Understand how stigma is framed and reinforced by myths and language

Not Included in Training (Knowledge)

• Be aware that stigma can lead to discrimination
• Understand that children, young people and their families may be reluctant to disclose difficulties or seek help for fear of being stigmatised
• Be aware that stereotypes and negativity surrounding mental ill health may mean that many children and young people feel that they have no one to talk with

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware of the importance of having a good relationship with a child or young person based on trust and openness while also maintaining professional boundaries
• Be aware that professional boundaries can be challenged by an urge to be overly involved with and/or avoidant of a child or young person

Included in Training (Knowledge)

• Be flexible and allow the child or young person to discuss issues which are important to them being respectful, warm, friendly and affirming
• Incorporate an awareness of issues relating to stigma surrounding mental health concerns into sensitive and respectful communication
• Demonstrate responsibility by challenging unhelpful language and myths

Not Included in Training (Knowledge)

• Be open and trustworthy demonstrating honesty through selfreflection
• Demonstrate genuine interest in the child or young person’s activities and friendships, including the sense they are making of their identity, sexuality and cultural/spiritual beliefs
• Assess how differences in language, literacy, culture and disability may affect the relationship with the practitioner and consider how to manage this, and be able to arrange appropriate support, for example, interpreting services, where appropriate
• Be able to help children and young people who may struggle to disclose their difficulties within their community, taking this into account when accessing interpreting services or groups which provide support to people from a particular cultural, ethnic, religious or disability background
• Provide support that accepts each person for who they are regardless of age, disability, gender identity, race, ethnic or national origin, religion or belief, sexual orientation or socioeconomic background

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be able to discuss different emotions and communicate with children and young people that having these emotions is OK and typical
• Know that emotions can be ‘projected’ into other people if they are too painful to be tolerated, for example, in situations of bullying

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be able to encourage the expression of all emotions, including those which may be strong/negative emotions by using OARs model (open ended questions, affirmations and reflections)
• Be able to talk to children when they are distressed, and help them cope with their feelings using emotion coaching strategies
• Be able to teach and model emotional self-regulation techniques

Included in Training (Knowledge)

• Understand that developmental stage, neurodiversity and trauma history may impact how children and young people communicate their mental health needs

Not Included in Training (Knowledge)

• Be aware of the impact of development on a child or young person’s understanding

Included in Training (Knowledge)

• Be able to check that the child or young person has understood a question or piece of information
• Be able to seek guidance on further adapting communication as required

Not Included in Training (Knowledge)

• Be able to provide developmentally appropriate information and activities to help children and young people express their views
• Be able to adapt communication using a range of methodologies for communicating with and listening to children and young people

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware that withholding information could place a person at risk of significant harm
• Know the legal definitions of consent to an intervention, for example that consent must be freely given, the young person must be suitably informed, and that consent can be withdrawn at any time
• Understand capacity, for example, that young people age 16 or over are presumed to have capacity to give or withhold consent, and unless there is evidence to the contrary, that a child under 16, who can understand and make their own decisions, can give or refuse consent
• Know that capacity and competence are functional (not dependent on age) such that a child with sufficient capacity and intelligence to understand the nature and consequences of what is proposed is deemed competent to give consent
• Be aware of parental rights and responsibilities, including the right to consent to an intervention on behalf of a child who does not have capacity
• Know that the safety needs of a child or young person take precedence over issues of consent and confidentiality for example if a young person is at risk of self-harm or any other harm

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be able to explain and discuss information sharing, confidentially and its limits, with a child or young person
• Be able to explain and discuss information sharing, confidentiality and its limits with parents
• Be able to gain informed consent from a child or young person to conduct an intervention
• Be able to seek specialist advice to make information accessible
• Be able to explain the benefits and risks of a proposed intervention to a child or young person using adapted communication as required
• Be able to maintain confidentiality appropriately, for example be able to respond to requests for information that are inappropriate, such as estranged family members

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware that the initial assessment and plan should be regularly updated in response to progress, and being responsive to new information, and all stakeholders kept informed
• Know of the role of services and agencies in the assessment and development of a child’s plan

Included in Training (Knowledge)

• Be able to draw together different strands of information to contribute to the child’s assessment and plan
• Be able to identify people, services and agencies who need to be included in the assessment and development of a child’s plan and involve children and young people in all aspects of their care
• Work collaboratively with children and young people, using strength-based communication skills to promote their participation in gathering information and making decisions
• Document decisions that have been taken and ensure the evidence for taking these decisions is recorded

Not Included in Training (Knowledge)

• Be able to identify risk and protective factors
• Be able to use and apply the GIRFEC tools for a single agency wellbeing assessment and child’s plan
• Be able to share information across agencies within the constraints of consent and confidentiality, on a ‘need to know’ basis and in a proportionate, relevant, accurate, timely and secure manner with the aim of supporting children and young people and preventing the need for them to re-tell painful life-stories over and over again

Included in Training (Knowledge)

• Be aware of standardised questionnaires and assessments that help to gather information on strengths and difficulties of a child

Not Included in Training (Knowledge)

Included in Training (Knowledge)

• Using knowledge of developmental stages, including physical, emotional, interpersonal, cognitive, language and social milestones, identify if a child or young person’s development is broadly typical for their age
• Be able to notice when a child or young person has regressed, or not made the progress expected of them
• Be able to observe and describe the interactions between a child or young person, and their family
• Be able to gather information from speaking to a child or young person and their family about their history
• Be able to use facilitation, empathy, clarification, and summary statements to gather information
• Be able to gather the views of all the members of the family
• Be able to elicit specific, detailed and concrete examples of behaviour when assessing and exploring the concerns of family members
• Recognise the signs that a child may have experienced trauma through their behaviour, emotions and ability to relate to others
• Recognise when further assessment of the impact of trauma on a child’s development is required and make requests for assistance as necessary
• Be able to describe features of possible neurodiversity and where to seek advice about diagnosis and supports

Not Included in Training (Knowledge)

• Be able to gather the views of the child on their wellbeing using developmentally appropriate means and the SHANARRI wellbeing indicators within the GIRFEC framework

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware of and understand the role partnership plays in safeguarding and have knowledge of the procedures adopted by partner agencies
• Be aware that an element of risktaking behaviour is typical and necessary part of development
• Be aware that bullying can become a formal child protection issue
• Be aware of risk and protective factors for different forms of harm

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Identify families at risk of multiple adversities and refer to appropriate services in a timely manner
• Work with other professionals to manage and mitigate risk and to boost protective factors
• Contribute to the development of a risk plan by attending and contributing to multi-agency meetings including case conferences, and core group meetings
• Practice in a non-discriminatory manner to respect and support parental autonomy, while always prioritising safety and welfare
• Be able to support children who have experienced adversity through child protection processes, advocacy and relationship-based approaches designed to create external and internal safety and reduce risk

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware of the ongoing need to reflect on your own practice while working with children and young people at risk of harm

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Seek support to enhance both your practice and for you to manage your emotional response to working with children and young people at risk of harm

Included in Training (Knowledge)

• Be aware the assessment process can be an emotional time for children, young people and their families

Not Included in Training (Knowledge)

• Understand the aim is to reach an agreed description of the strengths and difficulties and to explain the development and maintenance of the child or young person’s strengths and difficulties and provide options for intervention and supports

Included in Training (Knowledge)

• Be able to seek the views of the child, young person and family throughout the process
• Support a child or young person to understand the outcome of any assessment

Not Included in Training (Knowledge)

Included in Training (Knowledge)

• Have a good working knowledge of resources available to support families, particularly those facing additional vulnerability
• Have a broad understanding of evidence-based practice and how this informs the selection of both universal and targeted interventions across settings

Not Included in Training (Knowledge)

• Be aware that while potentially offering support and services to parents, the needs of the children and young people are primary
• Know the difference between universal preventive programmes and targeted interventions

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Use strengths-based approaches, that recognise and build upon a child and family’s own abilities, knowledge skills and potential
• Promote social and emotional development through universal approaches, such as supporting play, positive parenting interventions and personal social education (PSE)
• Work with others in the wider professional network to ensure children and their families are supported when compulsory measures are necessary
• Ensure that support and services are accessible to children, young people and their families who may face barriers in accessing help and support
• Talk with children, young people, and their families about the impact of social media on protective and adverse factors for mental health and wellbeing
• Encourage and scaffold child and young people to engage in valued and meaningful social activities
• Adapt your usual practice to meet the developmental needs of a child or young person
• Create environments that are inclusive and allow children and young people to be understood

Included in Training (Knowledge)

• Be able to talk with children and young people and/or families, about common mental health difficulties
• Share information about typical development with children and young people and colleagues as required
• Reduce and challenge discrimination and stigma against CYP experiencing mental health issues

Not Included in Training (Knowledge)

• Share knowledge about mental health in children and young people with colleagues
• Explain to families the approaches available to support parent – child relationships

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware of the impact of endings and transitions on staff working with children and young people
• Be aware of the importance of clear and timely communication about endings and transitions
• Be aware of any unhelpful avoidance of endings
• Be aware that ending a relationship with a professional in a therapeutic relationship can trigger feelings for a child or young person that relate to previous losses or bereavements that they have experienced

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be able to assist children, young people, and their families with managing transitions in a healthy way
• Prepare children and young people and their families for a planned ending of contact and assess any risk associated during or after this ending

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Know the responsibilities of each agency and discipline
• Be aware of wider support and services that provide services to adults that may be working with parents

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Contribute to multi-professional/ multi-agency intervention
• Support parents to access mental health support as required

Included in Training (Knowledge)

• Be able to complete questionnaires, and other measures to inform the interventions of other agencies and specialist services

Not Included in Training (Knowledge)

Included in Training (Knowledge)

• Where appropriate have basic knowledge of medication that a child or young person is taking, such as ADHD medication

Not Included in Training (Knowledge)

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Be aware of theories of coaching and adult learning theory and how this support using new skills in practice
• Be aware of the range of services and resources available to support selfcare and staff wellbeing

Included in Training (Knowledge)

Not Included in Training (Knowledge)

• Make use of supervision and support from other members of staff to manage your own emotional responses to providing care and protection for children
• Reflect on your practice and use reflective tools to do so
• Use coaching to translate new skills into practice
• Be able to present an honest and open account of work undertaken
• Be able to recognise when your ability to self-regulate is compromised and take steps to seek supports with this, such as supervision/reflective practice/self-care
• Promote the use of self-care and staff wellbeing resources in your workplace

Included in Training (Knowledge)

• Be able to identify where usual practices and/or the environment is impacting on a child or young person’s wellbeing and adjust accordingly
• Be able to use practical strategies, such as technology and adapting communication, to help meet the needs of the individual by facilitating effective communication about supports and interventions

Not Included in Training (Knowledge)

• Able to adjust intervention work in accordance with any additional support needs of children and young people