In pediatrics, when assent is appropriate but parental permission is required, which approach is appropriate?

• A. Explain the plan only to the parent and not to the child.
• B. Explain the plan in developmentally appropriate terms, check the minor's willingness and encourage questions.
• C. Require assent to be identical to parental permission.
• D. Avoid answering the minor’s questions to prevent confusion.

Answer: (B)

In pediatrics, when assent is appropriate but parental permission is required, the best approach is to explain the plan to the minor in developmentally appropriate terms, check the child’s willingness, and encourage questions. This respects the child’s developing autonomy by giving them a clear understanding of what will happen and an opportunity to express preferences or concerns. It also helps build trust and can reduce anxiety, which supports better cooperation and adherence to the plan.

Explaining only to the parent misses the child’s perspective and can undermine their sense of control. Requiring assent to be identical to parental permission ignores the child’s own understanding and preferences. Avoiding the minor’s questions prevents informed involvement and can erode trust.