What are key components of a structured pediatric interview when the child is present with a parent?

• A. Start with parent, then talk to child age-appropriately, obtain assent when possible, maintain child privacy, verify understanding with parent, use developmentally appropriate language
• B. Talk only to the child
• C. Speak only to the parent
• D. Demand immediate assent from the child regardless of age

Answer: (A)

When a pediatric interview happens with the child present, the approach should engage both the parent and the child while using language the child can understand. Begin by talking with the parent to gather history, concerns, and context, then shift to the child with questions tailored to their age and development to hear the child’s perspective directly. Obtain assent from the child when possible, recognizing that willingness to participate depends on their age and ability to understand what is being asked. Protect the child’s privacy as appropriate, so they feel safe sharing information, while still including the parent in discussion of the plan and decisions. Check that both the parent and child understand what was discussed and what will happen next, which helps ensure everyone is on the same page. The language you use should be developmentally appropriate to foster trust and accurate responses.

Focusing only on the child misses important parental context and safety considerations; focusing only on the parent misses the child’s own experiences and autonomy; demanding assent from a child without regard to their developmental level isn’t appropriate or ethical.