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Paeds Casesprofessional-practice-and-evidence

Paeds Cases · professional-practice-and-evidence

Developmentally appropriate communication OSCE — preschool engagement and adolescent confidentiality

Observed structured encounter testing developmentally appropriate engagement of a preschooler through play, interpreter-supported communication, confidential adolescent interviewing with limits of confidentiality, behavioural pain reading and teach-back.

osce communication station2 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
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Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a febrile preschooler who clings to the caregiver, with language discordance. Station B is an adolescent requesting private time for mixed somatic and psychosocial concerns.

Station objectives

  1. Set the environment and match communication register to developmental stage. [1]
  2. Engage a preschooler through play and drawing without leading questions. [1]
  3. Use a professional interpreter and never a child for clinical content. [3]
  4. Open confidential adolescent time and state limits of confidentiality before sensitive questions. [1] [2]
  5. Confirm understanding with teach-back and give a concrete, age-appropriate safety-net. [5]
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References18ShowHide
  1. [1]Svetaz MV Adolescent Health: Communication With Adolescent Patients FP Essent, 2021.PMID 34410092
  2. [2]Coble C Teaching SSHADESS Versus HEADSS to Medical Students: An Association With Improved Communication Skills and Increased Psychosocial Factor Assessments Acad Pediatr, 2023.PMID 36130691
  3. [3]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review JBI Evid Synth, 2020.PMID 32813387
  4. [4]Gutman CK Professional Interpreter Use and Discharge Communication in the Pediatric Emergency Department Acad Pediatr, 2018.PMID 30048713
  5. [5]Samuels-Kalow M Like a dialogue: Teach-back in the emergency department Patient Educ Couns, 2016.PMID 26597382
  6. [6]Forkey H Trauma-Informed Care Pediatrics, 2021.PMID 34312292
  7. [7]Duffee J Trauma-Informed Care in Child Health Systems Pediatrics, 2021.PMID 34312294
  8. [8]Forkey H Trauma-Informed Strategies in Pediatric Primary Care Pediatr Clin North Am, 2024.PMID 39433381
  9. [9]Davidson JE Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU Crit Care Med, 2017.PMID 27984278
  10. [10]Katz AL Informed Consent in Decision-Making in Pediatric Practice Pediatrics, 2016.PMID 27456510
  11. [11]COMMITTEE ON BIOETHICS Informed Consent in Decision-Making in Pediatric Practice Pediatrics, 2016.PMID 27456514
  12. [12]Simmons P Characterization of Communication-Related Safety Events in a Pediatric Quaternary Care Hospital J Patient Saf, 2026.PMID 42008794
  13. [13]Shaban R Pain assessment in non-verbal children with neurocognitive impairment: a review on current tools, challenges, and clinical perspectives Front Pain Res (Lausanne), 2026.PMID 41987884
  14. [14]Schuck RK Preferences for Identity-First and Person-First Language: A Systematic Review of Research With Autistic Adults/Adults With Autism J Autism Dev Disord, 2025.PMID 41389164
  15. [15]Therrien MCS A Systematic review of AAC interventions using speech generating devices for autistic preschoolers Augment Altern Commun, 2025.PMID 40164143
  16. [16]Weitzman C, Guevara J, Curtin M, et al. Promoting Optimal Development: Screening for Mental Health, Emotional, and Behavioral Problems: Clinical Report Pediatrics, 2025.PMID 40850690
  17. [17]Milton D The 'double empathy problem': Ten years on Autism, 2022.PMID 36263746
  18. [18]White PH, Cooley WC Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home Pediatrics, 2018.PMID 30348754
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