Preparing infant and toddler patients for telehealth
Preparation is important, both for the parents and caregivers as well as for members of your health care team.
On this page:
Before the visit
The following steps are helpful to prepare the patient’s caregiver for the telehealth visit:
- Instructions. Before the visit, provide the caregiver with instructions on how to access the telehealth visit. This includes directions on any software or apps that need to be downloaded in advance. Instructions should include information such as ensuring good lighting, finding a quiet space, and minimizing background noise. Resources and tutorials on how to use the technology platform, prepare for a virtual visit, and assist in the remote examination will increase the likelihood of a successful visit.
- Overview. For parents or caregivers new to telehealth, a short list or video describing the visit and what the patient will need to have may be helpful. This can be used to inform parents what the child should wear (loose fitting clothes), whether the parent should have anything on hand (like a thermometer), what activities the child will be asked to do (for example, a toddler may be asked to hold a crayon and draw a line to assess fine motor skills), and the types of questions you are likely to ask the adult (for example, the child’s eating habits).
- Test run. It is always a good idea to have a member of the care team do a quick test run with the adult to make sure that they are comfortable using the technology and know how to operate features such as speaker, camera, and volume.
- Health history. Caregivers should have relevant medical records about the child that they can reference during the visit. This may include vaccinations and any side effects, current and past medications, and information about the child’s birth (such as whether it was full term, the birth weight, and size).
- Current status. If possible, you may want to have caregivers measure the height, weight, and temperature of the child before the start of the visit.
- List of questions. Caregivers should be instructed to write down any questions, concerns, or observations about the child in advance of the visit.
- Notetaking. Caregivers should also have either a paper and pencil or an electronic device to write down guidance from the provider during the visit.
Tip: Screen for technology skills and communication preferences before the virtual visit.
During the visit
Following these recommendations will contribute to a more productive visit:
- Calm demeanor. The parent or caregiver may be new to telehealth or dealing with a fussy toddler or infant. Like an in-office visit, it is important to help reduce the parent’s stress and ensure they feel comfortable and not rushed. The young child will react better if their guardian is more relaxed.
- Visual stimulation. Children may be uncomfortable sitting in front of a camera, or they may be distracted and unable to sit still. Encourage parents to select a toy or comfort item to have at hand. Consider engaging approaches to help attract the child’s attention.
- Flexibility. It may be helpful to allocate extra time to ensure you can observe the child and interact with the caregiver.
- Next steps. Let caregivers know what to expect after the session, including potential follow-up appointments, electronic prescriptions, lab tests, or any recommended next steps.
After the visit
After the visit ends, you should continue to engage the patient’s caregiver:
- Follow-up. Parents and guardians may have questions after the visit. A quick message through a patient portal or follow-up phone call can help ensure that all their questions are addressed and allows them to review the provider’s guidance.
Telehealth challenges specific to infants and toddlers
Providing telehealth services to infants and toddlers introduces unique challenges:
- Appropriateness. Telehealth services that are appropriate for adults or even school-age children may not be well-suited for younger children. While telehealth services may be great for urgent care and behavioral observations, the provider may need to be in the same room with the infant or toddler for certain types of visits.
- Attention span. Infants and toddlers may not cooperate or stay still during virtual assessments, making it difficult to obtain clear visual or auditory data.
- Using technology. Even if caregivers are very comfortable with technology, it may be difficult to position the video camera while handling a fussy child.
Protecting patient confidentiality
Telehealth is subject to the same privacy protections as visits that take place in a clinical setting. However, parents may have concerns and seek your reassurance that all information from the visit is confidential. Here are a few steps you can take:
- Confirm legal guardian(s). At the start of the visit with a new patient, make sure you document the individual(s) who are the legal guardian(s) of the child.
- Patient privacy. At the start of the visit, make sure the caregiver is in a private space where they feel comfortable talking. You can ask if they are in a space where they can close the door so that they and the child are alone during the visit.
- Provider location. The caregiver may want reassurance that there is no one else in the room with you at the time of the telehealth visit. You can reassure parents by moving the video camera around the room to show that you are alone and the door is closed.
- Privacy protections. Online resources can help reassure caregivers that telehealth visits are private and confidential.
More information
How do I protect my data and privacy? — Health Resources and Services Administration
Telehealth privacy tips for patients (PDF) — Health Resources and Services Administration
Cultural and linguistic responsiveness and health equity
Anytime you are interacting with a patient, whether in-person or virtually, it is important to respect cultural differences and establish a trusting relationship. Consider the following steps to make sure that the care you provide respects the caregiver’s cultural background and preferences.
- Training. Equip health care providers with training on cultural norms, beliefs, and values that can impact health behaviors and perceptions.
- Translation services. Offer interpretation services or multilingual platforms to cater to non-English speaking caregivers.
- Tailored educational material. Provide caregivers with educational materials and resources that are culturally tailored.
- Community engagement. Collaborate with leaders or influencers from various cultural communities to gain insights, build trust, and promote the telehealth program in a culturally relevant manner.
- Accommodations. Caregivers and young patients with disabilities or special health care needs should have tailored telehealth services that cater to their unique challenges, ensuring inclusivity.
- Digital literacy. Your practice should offer digital literacy and telehealth navigation resources. This can empower caregivers, especially those from marginalized communities.
More information:
Preparing patients for telehealth — Health Resources and Services Administration
Talking to families: telehealth for children with special needs (PDF) — Health Resources and Services Administration
Guidance on non-discrimination in telehealth — Office for Civil Rights