Effective healthcare communication represents a complex and dynamic process that unfolds over time characterizing the interaction between a myriad of contextual and individual difference factors to promote positive patient health and well-being outcomes Although significant advancements have been made toward the delivery of patient-centered care, studies of healthcare communication to date predominantly consider the adult patient-provider archetype, with substantially less known about communication involving non-dyadic patient-units including pediatric healthcare visits involving a child patient and accompanying parent. Understanding the unique dynamics of communication involving pediatric triads is a crucial step toward evaluating and optimizing the provision of pediatric care healthcare. Thus, two studies are presented below exploring novel complexities of triadic healthcare communication involving pediatric patients receiving asthma and allergy care (Study 1) followed by an investigation of potential mechanisms and antecedents of parental behavior and conversational dynamics during pediatric healthcare visits (Study 2). In Study 1, audio-recorded consultations involving pediatric triads were transcribed and analyzed to reveal distinct patterns in the use of technical language, interruptions, and flow of information exchange between the triad that may create or hinder opportunities for children to participate in their own care visit (i.e., gatekeeping). Study 2 builds upon these findings to investigate how differences in parenting and family dynamics may motivate positive or negative parental gatekeeping behaviors during pediatric care visits (e.g., encouraging their child to share their symptoms experience with the provider versus interrupting their child to volunteer their own opinion). Findings from these studies highlight distinct nuances of triadic communication involving pediatric patients relative to dyadic norms to reveal potential mechanisms underlying effective communication involving pediatric triads.