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Telehealth for pediatric well visits: Sometimes the best option

The pandemic highlighted how effective telemedicine can be for providing care at well visits.

During the early part of the COVID-19 pandemic, pediatricians realized that to reach families and continue to provide preventive care, including developmental, mental health, and social determinants of health screenings, they needed to embrace telehealth and meet families where they were: at home. What can and can’t be accomplished in a virtual visit? How can health care providers address access to care through the lens of health care disparities and equity? How do payment models affect care delivery?

Whereas technology has not yet allowed us to administer vaccines virtually, many aspects of a preventive visit lend themselves well to a virtual format. The well visit is meant to be part of a continuous conversation with patients and families to anticipate, identify, and address health care needs and promote wellness in a family-centered environment. Anticipatory guidance, screenings, discussion of patient/family priorities, and coordination of care are well suited to a telehealth visit. Telehealth may offer advantages, such as the ability to assess the home environment for issues such as safety, housing, and food insecurity. In addition, physical examination technology is rapidly evolving with the use of smartphones to assess vital signs and visualize key findings.

In the meantime, to make sure patients receive the care they need, starting a visit virtually and then identifying gaps that should be closed via an in-person visit may be used in a hybrid approach. Performing screenings and the “talking” part of a well visit can be accomplished virtually; practices can then choose to use extended hours (early morning and end of day) to allow patients to come in for more accurate growth and blood pressure measurements, targeted exams, and immunizations.

As we innovate for the future, our equity lens should be at the center of our focus. We need to design tools so that the patients who have the most difficulty accessing care are assured of high-quality medical help and improved outcomes. This might include tools that don’t require a high bandwidth or personal data usage, are designed with limited technology and health literacy in mind, and are available in multiple languages. It is often difficult for families to leave essential jobs and pull children out of school or day care for an in-person visit. During the height of the pandemic, some Medicaid managed care plans found that their well visit rates actually improved with the availability of telehealth. In addition, many families expressed that they were more comfortable staying on “their turf” rather than coming to a health care facility, which changes the power paradigm of who drives the visit. We should implement workflows that give families choices to make sure their children get the care they need.

During the pandemic, current fee-for-service models have rapidly exposed the problems with our health care system. If we did not need to focus on which care-delivery sites were adequately paid, we could turn our attention to delivering care in the format best suited for each situation, with consideration for family preferences. Unfortunately, no robust, value-based payment models are designed for pediatric needs. We must advocate for pediatric-specific payment models that address health promotion and illness prevention and show societal value (not simply cost savings in a short time frame, as per chronic disease/adult models). In the meantime, we need to advocate for continued payment parity of telehealth visits, including current procedural terminology codes that include well visits, and determine how to best provide care in an in-person, telehealth, or hybrid format.

Study: Pediatric type 1 diabetes families prefer virtual care and telehealth 

Surveys collected for a study published in the Canadian Journal of Diabetes revealed that desire for telehealth care amid pediatric diabetes families increased from the early onset of the COVID-19 pandemic, to more than 1 year later.

Poll: Majority of parents do not use patient portals for children

According to the report, 34% of parents are using patient portals for advice regarding their child’s illness.

Telemedicine viable method for physical examinations

In a recent study, physical examinations conducted through telemedicine saw consistent results with those from in-person examinations.

Telehealth treatment effective in managing developmental delay

In a recent study, young children with developmental delay saw improvements in behavior after receiving treatment through telehealth.

Telehealth in 2023: What physicians need to know

Answers to some common questions about providing telehealth services in 2023.

Telehealth patients rarely need an in-person follow-up

Trend holds true across almost every specialty.

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Visit guides

Practical guidelines for tele visits

Tele-well-visit guides by age

Well visits conducted via telehealthcan provide a unique opportunity to interact with the patient and family in their home environment and provide anticipatory guidance. The following table has examples to include in a telehealth well visit. The template guides that follow have further detail organized by age group.

Please note that certain elements of the physical exam, hearing, vision, growth parameters, and immunizations will require a subsequent office visit.

The following are templates by age to use for telehealth well child checks. These documents do not represent a comprehensive visit and are meant to be a quick reference tool of considerations when approaching these visits.

Infancy (<1 yo)

Toddler (1-3 yo)

Preschool (4-5 yo)

School age (6-10 yo)

Pre adolescent (11-12 yo)

Adolescent (13-17 yo)

Please note that templates are for educational purposes only.

• AAP Bright Futures
• AAP Periodicity Schedule
• AAP Guidance on the Necessary Use of TelehealthDuring the COVID-19 Pandemic

Visits by condition

• Mental Health

This material was designed using the AAP Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents as a reference. Please note that templates are for educational purposes only.

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Clinician Resource Jul | 15 | 2020

What Telemedicine Means for Pediatric Health Care

Key takeaways.

• Virtual visits are an important way for pediatric patients to continue necessary care, allowing more physical distancing to take place in physical health care centers and reducing additional exposures for those who need in-person care
• Many elements of a physical exam, such as heart rate, breathing, blood pressure or weight, can be measured and evaluated through a virtual visit, along with other areas of a child’s life that are not normally visible in a clinic
• Providers should utilize all methods of communication when caring for patients virtually, in addition to the video visit, whether due to privacy concerns or the comfort level of the patient and family when addressing sensitive medical topics

As part of an effort to flatten the curve of COVID-19 and maintain physical distancing, Mass General for Children and many other health care providers shifted their practices towards offering more virtual visits for patients and their families. This method of care allows patients to still be seen and cared for remotely where feasible, while reducing the exposure of patients and providers. With pediatric health care, however, there can also be some unique challenges that providers should keep in mind when meeting with their patients virtually.

Katie Brigham, MD , a pediatrician in the Adolescent and Young Adult Medicine Clinic at Mass General for Children addresses some questions and important differences providers should consider when caring for their pediatric patients via virtual visits.

Q: What are the benefits of virtual visits for pediatric patients?

Brigham: The big benefit is that it allows us to still see patients who need to be seen in a way that’s safe for both the patient and the provider. In some cases, there may be concerns that a family member might be contagious, so it would not be safe for that child to be seen in the office. But with virtual visits we can still provide medical care for these children and adolescents. In addition, having these types of visits also decreases the number of patients seen in the hospital, which decreases everyone’s potential exposure, too.

That said, we’re still taking incredible infection control measures to make sure that if someone needs an in-person visit, we are able to do so safely and effectively. We have spaced out appointments, avoided having large groups together in rooms, separated chairs in waiting rooms, and added barriers between the reception desk and patient checking in.

Q: How might pediatric telemedicine visits differ from adult telemedicine?

Brigham: With pediatric visits, it’s often not just the child or adolescent present, but generally there is also a parent or guardian as well. This can also happen with virtual visits, where in addition to the patient, caregivers or other adults might also be on the Zoom or telephone call.

Another thing that's very interesting is we get to see our patients “at home” in their home environment through these types of visits. It can be scary for children to see a doctor because they're worried about getting a shot or it's just a new environment, but they’re generally quite relaxed when participating in a virtual visit from home. As a result, it can actually be easier to assess children’s developmental milestones—on a video visit you can see them doing things like playing in their own home—so you may get a more accurate picture of their developmental stage than you would have had it be a more typical in-clinic visit.

Q: Are there ever situations where, while it may not be as accurate as what you might get in the hospital, you can ask a caregiver or an older sibling to take someone's pulse, or use a scale at home to get a general weight, for measurements you would normally do in person?

Brigham: Yes, we often ask patients or caregivers to check the patient’s vital signs. One of the things I treat is eating disorders, so for virtual visits, we will ask the patient or parent to weigh the patient prior to the virtual visit. I’ve also discovered that many families have blood pressure cuffs at home, perhaps used for taking care of a grandparent or because a parent is in a medical field. This has been very helpful for adolescents, but most families probably don’t have the right cuff size for an infant or a small child. I’ve taught patients how to check their own pulses, and I often will watch them breathing to count their respiratory rate. We are getting creative in ways that I think none of us anticipated doing, but it's been really rewarding.

Another thing that’s surprised us all is how much of a physical exam we can do without physically touching a patient. While I’m not able to use my stethoscope to listen to someone's lungs or heart, but I can observe the way they're breathing while they're talking to me, and I can look at their chest and see if they're working harder to breathe. For patients who are acutely sick, virtual visits can act as an initial triage step to figure out which patients really need to be seen in person, and where is the safest place for this patient to then be seen. We can keep treating most children at home but for the ones who do need to be seen, we are then able to facilitate arranging an in person evaluation.

Q: Some patients or caregivers may feel more comfortable answering some personal health questions in writing versus speaking to another person. Do you have any suggestions for techniques to address this and get patients in virtual visits feeling more comfortable with the video calls?

Brigham: Over Patient Gateway we are able to assign patients the questionnaires that we would normally have them fill out either on an iPad or on paper in the clinic before seeing their provider. I have also had patients message me over Patient Gateway ahead of virtual visits to give me a “heads up” about issues that they want to make sure we address, which is incredibly helpful if they’re hesitant to initiate these conversations.

In March 2020, when quarantine started, virtual visits felt very new for a lot of people—for both providers and patients. I think for people who have tried the technology and have been using it for a few months, it’s not as big of a deal now. Once you get over the initial difference of being on a zoom call versus being in the office, most are quite comfortable with it. I think what worries us a lot more is that there are some patients who don’t have enough data on their plan to video call in with us, or don’t have  WI-FI in their house and aren’t able to participate in a video visit. We do offer telephone visits, but then a lot of the visual cues you can pick up on from a video call are lost. We are concerned about this “digital divide” that we know already exists, and that this is could be worsening outcomes for patients who don’t have access to these technologies.

Q: With pediatric virtual visits, there may often be a guardian or someone else in the room during the call. This can be helpful or prevent the patient from feeling comfortable speaking fully about their health or questions. This can also happen in a clinic room, but you then have a lot more control over who comes in and out. How do you manage this with virtual visits?

Brigham: I will often just ask the patient, “[child’s name], who else is in the room right now?” That way I know who might overhear what we’re discussing. If it’s just the case where there are other people in the room having lunch, for example, and not actively participating in the virtual visit, I might suggest the patient go to their bedroom or another location. However, this sometimes this isn’t doable if for example there is only one spot in their home that gets good  WI-FI, but you can suggest that they use ear buds so that way other people can’t overhear the conversation. You have to be careful that you don’t say anything that breaches their confidentiality.

I have also had patients use the chat function with me to tell me things that they don't want to say out loud, or to warn me to not mention something. However, if you feel that the patient is being supervised in a way that you can’t ask a particular sensitive question, unless it is something you feel absolutely sure you need to address and that is going to significantly change your management of the patient, I wouldn’t ask them at that visit, and would wait for the next one.

Q: In addition to the chat function, is there any other advice you have for patients who may need to signal the need for a more private visit, but can't overtly state it?

Brigham: With Mass General for Children, you can always send a follow up question on Patient Gateway and tell the patient to check their account that evening or the next day. I sometimes send messages like this just to make sure that the patient understood instructions I gave on a call.

Q: When the provider and parent or patient don't share a common language, are there any additional considerations to make with virtual care?

Brigham: At MGfC, we can use interpreter services . If there is an interpreter at Mass General who can translate that language for us, you can add them into the video call. For any languages where we don’t have an available Mass General interpreter, we use a confidential outside interpreter service, and in those cases I will call them on my phone and put them on speaker right next to my computer so the interpreter speaks through my phone and the patient can hear over my computer. We can help patients in every language for virtual visits.

Q: Despite the safety initiatives the hospital has in place to ensure a safe environment for everyone, many parents and children may be hesitant to come for care that cannot be done virtually. How do you have conversations about the importance of in-person care when that’s needed?

Brigham: I usually review the screening process before a patient comes in and reassure them that everyone who comes to the hospital gets the same screening. I explain that we screen for symptoms, such as asking if anyone has a fever or a sore throat, and if they do, we don't have them come into the regular care areas of the clinic. The hospital has designated sites for patients who need to be evaluated for COVID-type illnesses or who may have COVID-19 but need care for a non-COVID related illness. These sites are separate from where typical clinic patients are seen. I also explain that everyone is given a mask and sanitizes their hands upon entering. I feel very confident when I ask my patients to come in that we are taking effective precautions to keep everyone safe.

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Translations

• Clinician Resource

Centers and Departments

• COVID-19 (Coronavirus)
• Pediatric Care

Tips & Tools

Can telehealth "video visits" be a good option for my child how do they work.

Alison Curfman, MD, FAAP

​A child's medical care is best provided face-to-face. In certain situations, however, video visits and other telehealth tools used by your pediatrician's office (also known as your "medical home") can be a good option. For some families, it can provide access to high-quality pediatric services they could not otherwise get.

Telehealth is being used in a variety of places and settings, including:

If your child needs a pediatric service but it's not available in your area, telehealth can connect you with a specialist remotely.

Emergency situations. Many areas, like rural communities, do not have doctors onsite who are trained to treat children in an emergency. When this happens, telehealth services give immediate access to pediatric specialists in other communities who can help the medical staff stabilize and treat children before they are transported to a pediatric center or children's hospital.

Outpatient visits. If your child has a health issue but you live far away from their specialist, you may be able to visit a local hospital and connect remotely with the doctor to receive care without having to travel long distances.

Special services. In some areas, video visits are being used for physical therapy, speech therapy, hearing screenings, nutrition counseling and other special services that might otherwise require long trips by children and their parents.

Some communities offer telehealth services in their schools. These programs have tools for the school nurse to have a video visit with a doctor or nurse practitioner to diagnose and treat issues like ear infections, strep throat , sprained ankles , and common colds . Parents can be included on the visit as well. These virtual visits help the school nurse know when children need to be seen in person by their pediatrician or in the emergency room.

This type of telehealth is being used more often as a way to see your pediatrician for certain exams that don't require an in-person visit. You can use your own device such as a smartphone, tablet or computer to connect to your pediatrician to diagnose and treat common, non-urgent conditions. There are many companies that offer these services, but not all of them are certified in pediatrics. Ask your pediatrician's office if they offer telehealth services.

How does a video visit work?

During a video visit, the doctor can see your child and ask you about their symptoms, just like in a face-to-face visit. Your child can be examined via video, using tools such as:

Smartphones, tablets and computers. Any device with a camera and internet or WiFi connection can be used for telehealth. Hospitals and schools usually have high-quality cameras to ensure the most accurate exam. For home-based telehealth, you can use the camera on your own device.

Stethoscopes. Hospital-based and school-based telehealth programs will have stethoscopes for your doctor to listen to your child's heart and lungs remotely. These types of tools may be available soon for home use as well.

Otoscope. This tool is used to look inside your child's ears and help diagnose ear infections.

Ultrasound and other imaging. Hospital-based programs can even transmit images such as ultrasound for a pediatric specialist to see remotely.

Video visits also make it possible for the doctor to look at your child's activity level, breathing, interaction and general state of health. If the doctor thinks the video visit is not giving them enough information to diagnose your child, they may recommend you come into the office or go to urgent care or the emergency room.

Telehealth video visits can be good for children. To be sure you are getting good care, avoid telehealth providers that are not trained to treat children. Choose a provider who has the training and tools necessary to diagnose and treat your child, and who has an established relationship with your family. Your pediatrician should always be your first choice when seeking telehealth services.

More Information

• Telehealth 101: Get Plugged in to Your Child's Health
• Telehealth Services for Children
• Ask the Pediatrician: Is it really that important to see my pediatrician right now?
• 10 Common Childhood Illnesses and Their Treatments

Other languages available

• Brazilian Portuguese
• Simplified Chinese
• Traditional Chinese

​Alison Curfman, MD, FAAP, is an executive committee member of the American Academy of Pediatrics Section on Telehealth Care. Dr. Curfman is also a pediatric emergency medicine physician at Mercy Clinic in St. Louis and serves as Medical Director for pediatric virtual care within the Mercy Hospital system. She is co-founder and Vice-Chair of SPROUT, a multi-center research network dedicated to high quality pediatric telehealth research. She is co-author of the chapter “Pediatric Emergency and Critical Care Telemedicine” within the textbook Understanding Telehealth.

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Can I use telehealth for my child with special health care needs?

Telehealth can be used to support children and families with unique health care needs.

On this page:

What should i know about telehealth if my child has special health care needs, how can telehealth help with family-centered care, what can i expect during my child’s telehealth exam, how can i support my child during a virtual visit.

When your child has special medical needs, you want the best care for them. Telehealth may be able to help.

• Same care, more comfort. Even though telehealth is virtual, your child will get the same care as in a provider’s office. But your child can have the visit in the place where they feel most comfortable.
• Less stress . With telehealth you may not need to travel to the health care appointment. You may not need to wait in an office. This means less worries for both you and your child.
• No germs. Other patients at your provider’s office may have germs. With telehealth, your child will have less exposure.

Tip: Read more about telehealth visits for your child with special health care needs (PDF).

When your child has special health care needs, getting good health care is a team effort. That is what family-centered care is all about — teamwork between you, your child, and health care providers. Telehealth can help with family-centered care.

• Safe at home.  Telehealth visits from home are often more relaxed. Health care settings can be overwhelming for your child and make them scared or have problems focusing.
• Quality time. With telehealth, you can have more one-on-one time with your child’s health care provider. You can also have a private conversation with the provider before your child joins the visit. This is a time to discuss any sensitive topics or your child’s emotional needs without them overhearing.
• Flexible schedule.  Families often have a busy schedule with lots of appointments. Telehealth means less time traveling and away from home.

Getting ready for a telehealth visit with your child’s health care provider is important. Here is how to make it a smooth experience:

• Share information. Before the visit, tell the provider about any behaviors, special assistive devices, or sensitive topics that you want to discuss. This helps them prepare and provide better care.
• Dress comfortably. Dress your child in loose clothing that makes it easy for them to move. This is especially important if the provider asks you to show a part of the body.
• Prepare information. Be ready to discuss your child’s health, medications, diagnoses, allergies, recent illnesses or surgeries, and their social and emotional well-being.
• Be equal partners.  Remember, you are an equal partner in your child’s health care. You should share your opinions, concerns, and questions during the visit.
• Engage your child. Your child should be a part of their health care, even if they have challenges with verbal communication. The provider should address your child directly, make eye contact, and include them in the conversation.
• Ask questions . Do not hesitate to ask the provider to explain anything that you don't fully understand.
• Take notes. Keep a pen and paper near you. Write down important thoughts before and during the visit.
• Discuss next steps. Before ending the telehealth visit, the provider should talk about what comes next. This could involve scheduling follow-up visits, tests, referrals, medication changes, or plans to address behavior or emotions.

With these steps, your child’s telehealth visit can be a productive and comfortable experience for both you and your child.

Children may have different reactions to health care visits, including telehealth appointments. Here is how to make your child more at ease during a virtual visit:

• Practice ahead of time.  Use any video conferencing platform to practice the virtual visit with your child. Role-play and take turns pretending to be the provider. This can help your child become familiar with the process.
• Answer questions. Ask your child if they have any questions before their telehealth visit. Provide answers when you can or take notes to ask the provider later.
• Choose a comfortable place.  Find a place that is familiar to your child This could be their bedroom, the kitchen, a playroom, or a quiet room at school.
• Minimize distractions.  Remove anything that could distract your child during the telehealth visit. This could be other people, pets, or noisy toys and electronics.
• Bring a comfort item.  Some children find comfort when they have a small, quiet item next to them during the telehealth visit. This could be a favorite blanket, stuffed animal, or doll.
• Encourage participation.  Guide your child to actively participate in the virtual visit. Your child should be encouraged to ask questions, discuss their feelings (even with a thumbs up or thumbs down sign), and advocate for themselves.

By following these steps, you can help your child feel more comfortable and engaged during their telehealth visit.

More information:

How do I use telehealth for behavioral health care? — Health Resources and Services Administration

National Survey of Children with Special Health Care Needs Chartbook — Health Resources and Services Administration

Telehealth for Children and Youth with Special Health Care Needs (PDF) — Health Resources and Services Administration

What can be treated through telehealth? — Health Resources and Services Administration

Get tips to help your child participate in virtual visits (PDF) — Family Voices

What is family-centered telehealth? (PDF) — Family Voices

Nuts and bolts of telemedicine: Essential for a family-centered experience — Family Voices

Telehealth for emergency care

Telehealth can be used to get emergency medical care right away.

Telehealth for rural communities

Telehealth makes it easier to get health care from your hometown.

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Telehealth for kids.

What parents need to know about remote mental health treatment

Writer: Katherine Martinelli

Clinical Expert: Joanna Stern, PsyD

What You'll Learn

How does telehealth work.

• What are the pros and cons of telehealth for kids?
• What can parents do to help kids’ telehealth sessions go smoothly?

Many mental health providers now offer the option of virtual or online treatment. This is called telehealth. Video calls are the most common form, but sessions can also happen over the phone or by text. These sessions can be for one person, families or groups, and they are available for most mental health conditions.

Many insurance companies will now cover telehealth therapy for kids.  But you should still check with your insurance company before starting treatment to make sure. Telehealth providers must use secure technology and follow HIPAA guidelines for handling your health information.

There are some advantages to telehealth therapy for children. You won’t have to travel to the appointment and your child may be more comfortable in their own home than in an unfamiliar office. But there are some downsides as well. For example, while you can read some body language on video, you won’t pick up on everything. It could be hard for your child to find private space to have their session. Plus, you may experience tech issues from time to time.

To make telehealth therapy work well, it’s important to do some prep work in advance. Start by explaining telehealth to your child and answering any questions. Then, before the first session, make sure there’s a private place and no distractions. You should also do a software test ahead of time to prevent tech problems. It’s helpful to check in with the provider regularly and make sure telehealth is working for your child.

Whether your child already receives mental health treatment or you’re working on finding them treatment, chances are that the coronavirus crisis has thrown a wrench into your plans. But while in-person sessions aren’t possible right now, many providers are now offering mental health services online.

The crisis has prompted many mental health professionals across the country to begin seeing patients virtually. For patients they were already seeing, it provides support and continuity. “What we’re doing is really trying to keep things as consistent as we can,” says Joanna Stern , PsyD, a clinical psychologist at the Child Mind Institute. “There are so many things that we don’t have control over, that are changing, so let’s keep this touch point.”

But the expansion of telehealth services also means that if you live in an area with few mental health professionals, you may now have much greater access to care for your child.

Here’s a guide to making the most of telehealth for your child’s mental health treatment. To learn more about telehealth, you can also read our 2020 Children’s Mental Health Report , which offers an overview of the latest research.

Telehealth is essentially a session with a health provider that happens via technology instead of in person. In mental health treatment, that could include a diagnostic evaluation or a treatment session. Video calls are the most common medium, but telehealth sessions can also happen over the phone or via text chat. Just like in-person mental health treatment, telehealth can provide sessions for individuals, families or groups. Though the details of treatment may vary, telehealth sessions are generally available for most mental health conditions.

Until recently, telehealth providers could only provide services to clients in the state in which they were licensed. Most states have loosened their regulations, allowing licensed psychologists and psychiatrists from other states to practice there. But there are still state-by-state limitations. For instance, in some states you’re allowed to do telehealth if you have a preexisting relationship with a client in that state, but you can’t start a new relationship with someone in that state.

As for payment, many insurance companies have recently begun covering telehealth treatment. In some cases, telehealth services may be reimbursed by insurance companies but not covered outright. Before starting telehealth sessions, it’s always best to check with your insurance company directly to make sure the visits will be covered and you won’t incur any unexpected expenses. Some providers might also offer sliding scale payment options for telehealth sessions.

Finally, providers offering telehealth services must follow all the usual regulations for practicing under their license. This means that they must follow HIPAA guidelines and use secure connections for online sessions. However, it is always worth checking in with them to see what cybersecurity measures they have in place to keep your sessions confidential.

What are some pros and cons of telehealth for kids?

Though it might seem strange at first, remote mental health treatment can actually have some advantages over in-person sessions. For instance:

• Flexibility: Without travel time and location to worry about, it can be easier for you and your child to schedule sessions at times that work well for you. What’s more, you’re not limited to seeing only professionals in your immediate geographic area, which can be especially helpful if you’re looking to work with a specialist.
• Comfort: Kids might be more willing to open up when they can talk to a therapist from the comfort of their own home, rather than an unfamiliar office.
• Direct support: Depending on what kind of treatment you’re looking for, it might be helpful to schedule sessions around specific activities that your child struggles with. For instance, telehealth enables eating disorder specialists to offer direct support at mealtimes.

That said, there can still be drawbacks to telehealth sessions. These might include:

• Body language: Video chat can replicate some of the sense of connection that comes from body language, but it’s usually not quite the same. Dr. Stern notes that with videoconferencing, providers and clients are still able to pick up tone of voice and facial expressions, but that “you don’t get as much of the full body language.”
• Lack of privacy: It may be hard to find a quiet, private space at home for your child to meet with a provider. Plus, electronics, toys and other distractions might make it harder for your child to focus on the session.
• Tech issues: As with any online platform, telehealth sessions can have their share of tech challenges. You might find yourself coping with audio glitches or slow video, which can make the session less productive.

How can we make the most of my child’s telehealth sessions?

With a little preparation, you can help your child get as much out of telehealth as they did out of in-person sessions. Here are a few tips to keep in mind:

• Let your child know what to expect. Before beginning, have a conversation with your child about what remote care is and ask if they have any questions or concerns. You can also let your child know that it may feel strange at first, but that within a few sessions it should feel at least somewhat like normal. “One way to get over the initial awkwardness is to just keep going,” advises Dr. Stern.
• Set clear boundaries. If you are usually present during your child’s appointment, then you can be there virtually as well. But if your child usually sees their provider solo, then it’s important to give them that same level of privacy now. Provide a private room if you can, and make sure that siblings and other family members don’t interrupt. This can be tricky if you are confined to a small apartment, but do your best to find fixes. For instance, if your child needs to have a session in a shared space, have the other people present put on headphones and focus on another activity.
• Do a trial run. Before the first session, Dr. Stern urges clients to make sure they can use the designated platform on the device they intend to use. Download the software if necessary and test it out ahead of time if possible. This way you won’t waste precious minutes dealing with technical difficulties.
• Know the ground rules. Your child’s provider will likely use part of the first session to set guidelines for how remote care will work, and it will probably make sense for you to be present for that conversation. If it’s a group session, then the provider should lead a conversation about rules around things like taking screenshots and sharing what others have said.
• Stay focused. Stern says it’s important to approach telehealth the same way you would in-person care. “Anything you wouldn’t do in a doctor’s office, you wouldn’t do over telehealth,” she says. That means kids should avoid things like eating a meal or scrolling through social media during their appointments, and you can help by removing distractions and making sure notifications are muted. Along the same lines, make sure your child knows that they’re expected to start on time and stay for the whole session.
• Provide support. Even if your child is meeting with their provider on their own, they will still need a hand from you at times. In some kinds of therapy, like cognitive behavioral therapy (CBT), completing homework (like diary entries or mental exercises) is crucial. Make sure you know what your child is expected to do between sessions and, if necessary, make a plan with them to figure out when and how they’ll do it. You can also check in with both your child and their provider regularly to see how the remote sessions are going. Remember that you can adapt the sessions if need be — for instance, if your child has trouble focusing at home, you could be present for part of the session to guide them or perhaps switch to shorter sessions.

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Well-Child Visits: Parent and Patient Education

The Bright Futures Parent and Patient Educational Handouts help guide anticipatory guidance and reinforce key messages (organized around the 5 priorities in each visit) for the family. Each educational handout is written in plain language to ensure the information is clear, concise, relevant, and easy to understand. Each educational handout is available in English and Spanish (in HTML and PDF format). Beginning at the 7 year visit , there is both a Parent and Patient education handout (in English and Spanish).

For the Bright Futures Parent Handouts for well-child visits up to 2 years of age , translations of 12 additional languages (PDF format) are made possible thanks to the generous support of members, staff, and businesses who donate to the AAP Friends of Children Fund . The 12 additional languages are Arabic, Bengali, Chinese, French, Haitian Creole, Hmong, Korean, Polish, Portuguese, Russian, Somali, and Vietnamese.

Reminder for Health Care Professionals:  The  Bright Futures Tool and Resource Kit, 2nd Edition ​ is available as an online access product. For more detailed information about the Toolkit, visit  shop.aap.org . To license the Toolkit to use the forms in practice and/or incorporate them into an Electronic Medical Record System, please contact  AAP Sales .

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Parent and patient educational handouts, middle childhood visits.

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9-10 Year Visit - For Patients

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11-14 Year Visit

11-14 Year Visit - For Patients

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Child and Adolescent Well-Care Visits (W30, WCV)

Well-Child Visits in the First 30 Months of Life : Assesses children who turned 15 months old during the measurement year and had at least six well-child visits with a primary care physician during their first 15 months of life. Assesses children who turned 30 months old during the measurement year and had at least two well-child visits with a primary care physician in the last 15 months.

Child and Adolescent Well-Care Visits: Assesses members 3–21 years of age who received one or more well-care visit with a primary care practitioner or an OB/GYN practitioner during the measurement year.

Why It Matters?

Assessing physical, emotional and social development is important at every stage of life, particularly with children and adolescents. 1 Well-care visits provide an opportunity for providers to influence health and development and they are a critical opportunity for screening and counseling. 2

Results – National Averages

Well child visits in the first 15 months, well child visits in the first 30 months of life (15 months – 30 months), well-child visits (ages 3-6 years): 1 or more well-child visits, child and adolescent well-care visits (total):.

This State of Healthcare Quality Report classifies health plans differently than NCQA’s Quality Compass. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. PPO corresponds to PPO and EPO within Quality Compass.

Figures do not account for changes in the underlying measure that could break trending. Contact Information Products via  my.ncqa.org  for analysis that accounts for trend breaks.

• Bright Futures. 2021. https://brightfutures.aap.org/
• Lipkin, Paul H., Michelle M. Macias, Section on Developmental and Behavioral Pediatrics Council on Children with Disabilities, Kenneth W. Norwood Jr, Timothy J. Brei, Lynn F. Davidson, Beth Ellen Davis, et al. 2020. “Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening.” Pediatrics 145 (1): e20193449. https://doi.org/10.1542/peds.2019-3449

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OHCA SoonerCare to allow Well-child visits via telehealth