Paeds · professional-practice-and-evidence
Paediatric consultation with child, young person and family
Also known as Paediatric medical interview · Child and family consultation · Triadic consultation paediatrics · Calgary-Cambridge paediatric consultation · Adolescent interview and HEEADSSS · Paediatric history taking and examination encounter · Communication skills in paediatrics
Fellowship-level approach to the paediatric consultation as a triadic, developmentally-adapted encounter: Calgary-Cambridge structure and the Paediatric Consultation Assessment Tool, age-adapted history and examination, eliciting the child's voice and parental agenda, adolescent confidentiality and HEEADSSS, breaking bad news with SPIKES, family-centred rounds, telehealth, safety-netting and documentation.
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Target exams
Red flags
- A child who is talked about but never talked to — the clinician has lost the patient in the room
- Closing the history before the parental agenda and the hidden fear are exposed
- No time alone, and no confidentiality framing, for an adolescent — the psychosocial screen will fail
- Rapport built too late so a frightened child refuses the examination
- A 'routine' symptom overlaying a safeguarding concern that is never asked about
- A plan with no explicit safety-net and no documented plain-language summary
Life stages
Care settings
Clinical exam formats
Board mappings
- General and Community Paediatrics
- Clinical Skills (history and examination)
- Ethics and Professionalism
- Renewed curriculum for first-year trainees from 2027 — Learning goal 12: Communication with patients, families, and health professionals
- Renewed curriculum for first-year trainees from 2027 — Learning goal 15: Essential general paediatrics
- Renewed curriculum for first-year trainees from 2027 — Learning goal 19: Ethics and professional behaviour
- Renewed curriculum for first-year trainees from 2027 — Learning goal 20: Child safety and maltreatment
- Clinical Skills and Communication
- Long Cases
- Short Cases
- Communication
- 2. Professional skills and knowledge: communication
- 4. Professional skills and knowledge: Patient management
- General Paediatrics: Works in partnership with children, young people and families
- Safeguarding: Recognises and responds to child protection concerns
- Foundation of Practice (FOP)
- Applied Knowledge in Practice (AKP)
- History Taking and Management Planning
- Child Development
- General Pediatrics Content Outline — Universal Task 3: Physical Examination and History
- General Pediatrics Content Outline — Universal Task 4: Management and Treatment
- General Pediatrics Content Outline — Universal Task 5: Communication
- General Pediatrics Content Outline — Domain 1: Professionalism and Ethics
- Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
- Patient Care 1: Patient and Family Interviewing
- Professionalism 1: Professional Behavior and Ethical Principles
- Systems-Based Practice 2: System Navigation for Patient-Centered Care
- Communicator
- Collaborator
- Professional
- Pediatrics: Foundations EPA #8 — Communicating assessment findings and management plans to patients and/or families
Overview & Definition
A child walks into the consulting room carrying more than a symptom. The parent carries the history, the timetable and the fear; the child carries the experience and, increasingly with age, the preference. The clinician carries a hypothesis that can be wrong. The paediatric consultation is the structured meeting of all three, and it does two jobs at once: it gathers information and it builds the relationship that lets a plan succeed. [1] [2]
Unlike the adult dyad, the paediatric interview is triadic. The roles shift across childhood. The infant and toddler are observed through play while the parent gives the history; the school-age child becomes a direct informant who can assent; the adolescent is a patient in their own right who needs confidentiality and time alone. Lose sight of the child and you have met the family but not the patient. [1] [10]
Done well, the consultation is therapeutic in itself. Patients who feel heard disclose more, recall more, adhere more and complain less. Done badly, it is the single most common source of parental complaint and diagnostic error in paediatrics — not a soft skill but a measurable safety intervention. [1] [2]
References11ShowHide
- [1]Levetown M and American Academy of Pediatrics Committee on Bioethics Communicating with children and families: from everyday interactions to skill in conveying distressing information. Pediatrics, 2008.PMID 18450887
- [2]Howells RJ, Davies HA, Silverman JD, Archer JC, Mellon AF Assessment of doctors' consultation skills in the paediatric setting: the Paediatric Consultation Assessment Tool. Archives of disease in childhood, 2010.PMID 19019880
- [3]Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. The oncologist, 2000.PMID 10964998
- [4]Ford CA, Skiles MP, English A, Cai J, Agans RP, Stokley S, Markowitz L, Koumans EH Minor consent and delivery of adolescent vaccines. The Journal of adolescent health, 2014.PMID 24074605
- [5]Waterston T, Yilmaz G Child Rights and Health Care: International Society for Social Pediatrics and Child Health (ISSOP) Position Statement. Child: care, health and development, 2014.PMID 24588351
- [6]Ho J, Fong CK, Iskander A, Towns S, Steinbeck K Digital psychosocial assessment: An efficient and effective screening tool. Journal of paediatrics and child health, 2020.PMID 31883286
- [7]Coyne I, Sleath B, Surdey J, Pembroke S, Hilliard C, Chechalk K, Rafferty S, Rogerson S, Hughes MM, Murphy M, Cody D, Roche E Intervention to promote adolescents' communication and engagement in diabetes clinic encounters: A pilot randomized controlled trial. Patient education and counseling, 2024.PMID 38772095
- [8]Sleath B, Beznos B, Carpenter D, Thomas K, Annis I, Tudor G, Garcia N, Adjei A, Anastopoulos A, Leslie L, Coyne I A pre-visit video/question prompt list intervention to increase youth question-asking about attention deficit hyperactivity disorder during pediatric visits. Patient education and counseling, 2024.PMID 38851012
- [9]Sleath B, Thomas KC, Carpenter DM, Annis IE, Tudor G, Coyne I, Garcia N, Adjei AA, Leslie LK Provider use of a participatory decision-making style with youth with ADHD and their caregivers and visit satisfaction. Patient education and counseling, 2025.PMID 40020479
- [10]COMMITTEE ON HOSPITAL CARE and INSTITUTE FOR PATIENT- AND FAMILY-CENTERED CARE Patient- and family-centered care and the pediatrician's role. Pediatrics, 2012.PMID 22291118
- [11]Moore D, Sheetz J Pediatric palliative care consultation. Pediatric clinics of North America, 2014.PMID 25084721