Telehealth has long held promise as a way to increase access to subspecialty care for children and families, including in developmental and behavioral pediatrics (DBP). The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid uptake of telehealth to continue care delivery that was facilitated by "temporary" policy changes related to the pandemic. As a result, the field of DBP has recognized telehealth as a potential model of care for performing home-based diagnostic assessments, providing medication management follow-up, and delivering therapeutic interventions for children with neurodevelopmental disorders. Telehealth has been helpful in mitigating barriers families often face when attending in-person visits (lack of transportation and child care, missed work hours, etc) but has also highlighted additional determinants of health that need to be addressed to provide equitable access to care (broadband connectivity, device access, digital literacy, access to interpretation and sign language services, etc). Anticipating the lifting of pandemic-related emergency declaration and expiration of temporary policies around telehealth, the ability to continue to deliver DBP care by telehealth is uncertain. The purpose of this policy statement is to advocate for legislation and policies that support ongoing, equitable, home-based telehealth care for patients seen by DBP providers while ensuring equitable access to DBP in general. In addition, there is a need to recognize the benefits and challenges of telehealth versus in-person care and to identify clinical scenarios that favor 1 model of care versus the other.

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The health needs of children have evolved over the past century. This chapter reviews biomedical innovations leading to changes in children's health and health care delivery across various medical settings. Special emphasis is placed on the changing epidemiology of children's disease and increasing emphasis on child development, behavior, and mental health. The most significant change in children's health is a decrease in death and an increase in chronic disease. Child health care has evolved in different locations for the care of children each of which are reviewed in this chapter: primary care, emergency care, inpatient medicine, and the neonatal intensive care unit. Finally, implications and changes for the future of the health care of children are presented. Throughout the chapter, examples of disease are presented to provide a clinical context for these changing forces and dynamics.