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SETTING THE TONE

To ensure the best cooperation, especially in the pre­school age, the environment should be child-friendly. Exposure to crying and upset children should be avoided in the waiting room or other areas.

If the fam­ily brings the child's siblings, someone should take care of them during the appointment so that the par­ents can focus on the interview without distraction. The examination room should have a small table and chair with an assortment of toys for different ages to make the child comfortable and relaxed. The examin­er's attire also influences the child. A good rule is to “lose the white coat.” The child is not impressed by it and, in fact, may be intimidated from past medical visits. Pictures of cartoon characters or animals on the wall, small toys, and decals on instruments help to create a playful atmosphere and alleviate the child's fears.

Start the visit by introducing yourself, which should include telling the patient and parents some­thing about yourself, and what will be happening during the visit, and for how long, and then asking the parents to tell in their own words why they came and what specific questions they have for you.

Concerns stated by the referral source should be shared with the parents. Many parents are unsure about what information the visit can provide. This is the opportunity to explain what pediatric rehabil­itation is and what it can offer the child and family. The examiner also should explain that it is part of the examination to watch the child so that the parents will not feel offended by the examiner's wandering gaze. Because observation of spontaneous behavior is one of the most informative aspects of evaluating young­sters with a disability, examination begins from the moment the child is in the physician's view. Questions about history and illnesses should be asked in sim­ple terms so that the family can understand them and provide proper information. It is also important to clarify insurance coverage and whether additional tests can be performed on the same day or must await approval.

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Source: Alexander M.A., Matthews D.J.. Pediatric Rehabilitation: Principles and Practice. 4 th. åd. — New York: Demos Medical Publishing,2010. — 540 ð.. 2010
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