I agree with the points that you make to implement patient-specific care. In the reading this week it mentions a scale that can be used to assess the child’s values and feelings towards fertility. This might help providers be more comfortable addressing the topic as it is pre-set questions. I think it is also important to involve the parents and perhaps have them fill out the scale as well (separately). The time of diagnosis is overwhelming and not an appropriate time to delve into details. I think as mentioned in this week’s case study, it’s important to broach the topic and send the family home with some reading about options and agree to circle back. At a later appointment, more in depth discussions can occur and referrals made to start the fertility process. I think bringing an age-appropriate child psychologist into the discussion is also helpful if the child is hesitant to discuss their feelings about the topic.