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.
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Study tools
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
- Set the environment and match communication register to developmental stage. [1]
- Engage a preschooler through play and drawing without leading questions. [1]
- Use a professional interpreter and never a child for clinical content. [3]
- Open confidential adolescent time and state limits of confidentiality before sensitive questions. [1] [2]
- Confirm understanding with teach-back and give a concrete, age-appropriate safety-net. [5]
References18ShowHide
- [1]Svetaz MV Adolescent Health: Communication With Adolescent Patients FP Essent, 2021.PMID 34410092
- [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]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]Gutman CK Professional Interpreter Use and Discharge Communication in the Pediatric Emergency Department Acad Pediatr, 2018.PMID 30048713
- [5]Samuels-Kalow M Like a dialogue: Teach-back in the emergency department Patient Educ Couns, 2016.PMID 26597382
- [6]Forkey H Trauma-Informed Care Pediatrics, 2021.PMID 34312292
- [7]Duffee J Trauma-Informed Care in Child Health Systems Pediatrics, 2021.PMID 34312294
- [8]Forkey H Trauma-Informed Strategies in Pediatric Primary Care Pediatr Clin North Am, 2024.PMID 39433381
- [9]Davidson JE Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU Crit Care Med, 2017.PMID 27984278
- [10]Katz AL Informed Consent in Decision-Making in Pediatric Practice Pediatrics, 2016.PMID 27456510
- [11]COMMITTEE ON BIOETHICS Informed Consent in Decision-Making in Pediatric Practice Pediatrics, 2016.PMID 27456514
- [12]Simmons P Characterization of Communication-Related Safety Events in a Pediatric Quaternary Care Hospital J Patient Saf, 2026.PMID 42008794
- [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]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]Therrien MCS A Systematic review of AAC interventions using speech generating devices for autistic preschoolers Augment Altern Commun, 2025.PMID 40164143
- [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]Milton D The 'double empathy problem': Ten years on Autism, 2022.PMID 36263746
- [18]White PH, Cooley WC Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home Pediatrics, 2018.PMID 30348754