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Background In Sweden, general practitioners encounter nearly all children in health visits within the Child Health Services, and these visits have a predetermined agenda according to a national health programme. During the visits, the general practitioner assess the child's health and development and promote their participation. Earlier research has shown that pictorial support can help capture the child's attention during health visits, thereby promoting participation. This study aimed to explore general practitioners' experiences of using pictorial support to promote three-year-olds' participation in encounters within the Swedish Child Health Services.Methods The study employed a qualitative design, and data were collected through interviews with 20 general practitioners. Deductive content analysis was used when analysing the data.Results The study conveys that general practitioners experience that the pictorial support is a helpful strategy for listening to the child's views and acting on them. This strategy helps to establish a relationship with the child, promote their participation in the encounter, and conduct an equitable assessment of their health and development in these often complex and challenging encounters.Conclusion The pictorial support used in this study was shown to be a helpful strategy for general practitioners in promoting the child's participation and facilitating an equitable assessment of their health and development. These results suggest that using pictorial support can help general practitioners consider children's views and promote their participation in accordance with the Article 12 of the UN Convention on the Rights of the Child.