Seeing a minor via telehealth is not the same as seeing an adult patient with a simpler clinical presentation. There are consent requirements to navigate, parent dynamics to manage, age-specific engagement strategies to apply, and documentation considerations that are distinct from adult visits. Getting these right from the start protects the patient, protects your practice, and makes for a better clinical encounter.
Here is what to have in place before a telehealth session with a minor begins.
Consent: Who Needs to Agree, and to What
For patients under 18, a parent or legal guardian must provide consent for the telehealth visit itself. This is separate from the minor’s assent, which is the age-appropriate agreement you seek from the child or adolescent directly. Both matter, but the legal consent authority rests with the parent or guardian.
Send consent forms through SecureVideo’s e-documents feature before the appointment so the parent can review and sign in advance. The consent form should cover:
- Consent to telehealth services generally
- HIPAA notice of privacy practices
- Any specialty-specific consents relevant to the visit type
- Recording consent if applicable
For adolescent patients, some states allow minors to consent to specific types of care independently, including mental health treatment, substance use counseling, and sexual health services. Know your state’s minor consent laws before assuming parental consent is always required for every service type.
Parent Presence: When It Helps and When It Complicates
For younger children, a parent’s presence in the session is necessary and appropriate. They help the child stay focused, provide history the child cannot articulate, and carry out any care instructions after the visit.
For older children and especially adolescents, parent presence during the entire session can limit what the patient is willing to share. A teenager discussing mental health, substance use, or personal relationships is less likely to be candid with a parent on screen. Consider a structure where:
- The parent joins at the start for a brief check-in and history update
- The adolescent has a portion of the session without the parent present
- The parent rejoins at the close if there are care plan items to communicate
Discuss this structure with the parent before the session begins, ideally in the pre-visit paperwork or a brief note with the appointment confirmation. Most parents are receptive when the clinical rationale is explained clearly.
Getting the Right People in the Right Place
Confirm before the session who will be present. For a pediatric medical visit, you typically want the child and at least one parent or guardian on the call. For a behavioral health session with a teenager, you may want only the adolescent for the clinical portion. For a developmental or educational consultation, you may want a parent present throughout with the child visible but not necessarily the primary participant.
Send clear instructions in the pre-visit communication about who should join and how to set up the device so that both parent and child can be seen and heard without one person monopolizing the camera.
Clinical Engagement by Age
Different age groups require different approaches during the session:
For children under 10, keep the clinically active portion brief and use screen sharing to display visual materials, drawings, or simple questionnaires that give the child something to look at and respond to. Speak directly to the child, not just to the parent, even for young children. Brief moments where the child shows you something from their environment, a toy, a drawing, a pet, build rapport quickly and provide behavioral observation at the same time.
For pre-teens and adolescents, be direct and avoid performative attempts to connect. Acknowledge that video sessions can feel awkward. Give them a moment to settle before diving into clinical content. SecureVideo’s clinical chat is a useful option for teens who are more comfortable typing a response than speaking it, particularly for sensitive topics.
Documentation for Minor Telehealth Visits
Document the following for every telehealth session with a minor:
- Who was present during the session and in what capacity
- That parental or guardian consent was obtained and how
- The patient’s assent if applicable
- The patient’s location at the time of the visit
- Any limitations on the visit due to the telehealth format
Note what you observed clinically through video, affect, activity level, parent-child interaction, and engagement quality. These observations are as valid and documentable in a virtual setting as they are in person.
SecureVideo supports pediatric providers with one-click patient access that parents can navigate easily, a virtual waiting room that holds the family until the provider is ready, and the full suite of session tools that make virtual pediatric visits run smoothly. Learn more about SecureVideo or start a free trial today.