Your advance notice is a useful starting point. I’d give staff a consistent process: set expectations, speak privately to the accompanying adult, offer practical help, and involve you if the disruption continues.

- **Before the appointment:** “If children will accompany you, please bring another adult to supervise them while you’re receiving care. Our staff cannot provide childcare.” Include this in appointment reminders so families can plan.
- **Set a reasonable threshold:** Allow ordinary talking and brief crying. Address sustained shouting, running, or behavior that affects care or safety. Apply the same expectations to all visitors.
- **Speak calmly to the parent:** “The sound is carrying into the treatment rooms. Could you help your child lower their voice? We have some coloring materials available.” Avoid saying the child is “interfering with the surgeons,” which can sound accusatory.
- **Offer an outside break when feasible:** “If a short walk would help, we can coordinate with you about when to return.” Confirm that the supervising adult can leave and that the child stays with them. If the parent is receiving treatment, speak with the accompanying caregiver.
- **If it continues:** Have staff bring the situation to you. Assess whether a quieter waiting space, an adjusted appointment time, or rescheduling a nonurgent visit would help. The clinician should assess urgency before care is postponed.

I’d leave hunger and thirst to the parent unless they raise it. **If the child is the patient, staff should check preoperative instructions before offering food or drink.**

For sedation visits, explain supervision and escort arrangements during scheduling. AAOMS guidance requires a responsible adult escort for discharge after surgery and anesthesia; your office should make sure the family’s childcare arrangements also allow that person to fulfill the escort role. [AAOMS patient assessment guidance](https://aaoms.org/wp-content/uploads/2024/08/parcare_patient_assesment.pdf)

Give staff room to respond to individual needs, including sensory distress or disability. A quieter space or shorter wait may help. If you’re in the U.S., disability-related policy adjustments may also be required. [DOJ guidance on reasonable modifications](https://www.ada.gov/resources/title-iii-primer/)

The tone to aim for is: **“We understand waiting can be difficult for children. Please help us keep the office calm so everyone can receive care.”**