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Clinical judgement is a crucial part of autism and attention deficit hyperactivity disorder (ADHD) assessments. This study aims to harness insights from psychology and sociology to explore clinical perspectives and assessment practices of autism and attention deficit hyperactivity disorder. Qualitative interviews were conducted with health care professionals (n = 17). Interviews were conducted between January and May 2019. Data were analysed using a thematic approach. Themes were sorted into two interrelated categories (1) approaches to diagnosis (2) elements of diagnosis. Approaches to diagnosis were comprised of the following subthemes: nature of diagnosis, application of diagnosis: natural and pragmatic, revisiting conceptualisations: sub-optimal practice & unhelpful diagnoses, autism and attention deficit hyperactivity disorder. Elements of diagnosis contained three related subthemes: contextualising standardised assessments, triangulating material, organisational factors. There is sometimes a pragmatic as well as nosological dimension to diagnosis. Competing desires for consistency and utility add further complexity to neurodevelopmental assessment. Autism and attention deficit hyperactivity disorder are common behaviourally diagnosed conditions. One of the key aspects of diagnosis is clinical judgement. Yet despite decades of research, it is only in recent times that researchers have started exploring clinicians' perspectives on diagnosing these conditions. We aimed to add to this body of knowledge by conducting interviews with 17 experienced health care professionals in the United Kingdom to hear their perspectives on diagnosing autism and attention deficit hyperactivity disorder. Clinicians reflected that for some children and young people, diagnosis is reasonably straightforward; however, in other situations, decisions are made on more pragmatic grounds (i.e. will this be helpful). We identified some differences of opinion between professionals and organisation which adds to the complexity of applying a diagnosis. We recommend several areas for future research and point to some practical and philosophical implications of the work. [ABSTRACT FROM AUTHOR]

Clinical practitioners are frequently encouraged, through literature, training, and policy, to learn, understand, refer to and use their knowledge of attachment theory and research when working to meet the needs of children and families. However, there has been very little empirical study of how practitioners understand and perceive the relevance of attachment concepts and methods. Q-methodology was used to examine the perceptions of attachment knowledge and its applications for practice among 30 UK clinicians working with children and an international group of 31 attachment researchers. Factor analysis revealed three perspectives, described as: i) pragmatic, developmental, and uncertain, ii) academic, and iii) autodidactic and therapeutic. Participants agreed on core tenants of theory, their aspirations for clinical practice and the inaccessibility of current assessment measures for practitioners. Yet they diverged on their understandings of attachment insecurity, disorganisation, and the implications of both for various aspects of child development. [ABSTRACT FROM AUTHOR]

Background: With the number of children being placed in the care of local authorities increasing, the need to recruit and retain foster carers is essential. Compassion fatigue is recognised as a negative effect for professionals working with adults and children who have experienced trauma. This study aims to confirm the proof of concept within foster carers and to explore the potential risks associated with intent to continue fostering, overall job satisfaction and psychological factors (avoidant coping) that could be targets for interventions. Methods: In total, 131 foster carers completed an online survey including self-report measures of compassion fatigue and associated risk factors. Results: Results confirm the existence of compassion fatigue among foster carers with rates in line with previous studies on other professionals working with children. High compassion fatigue was associated with lower intent to continue fostering and lower job satisfaction. Avoidant cognitive styles of psychological inflexibility and thought suppression were associated with compassion fatigue. Conclusion: The confirmation of compassion fatigue among foster carers and the potential risks to job retention are important findings for social care. The associations with avoidant cognitive styles have clinical implications for potential interventions. Recommendations for further research and the limitations of this study are also discussed. [ABSTRACT FROM AUTHOR]