Advice

Keeping It Kid-Friendly

By Jennifer E. Davis, OD, Waynesboro, Va.

WITH ALL OF THE different patients we see, it's difficult to relate to all of them. Older patients typically require more of your time, middle-aged patients are often busy and want the quick and dirty rundown, and kids … well kids can be less predictable.

As a rule, every exam will run more smoothly if you can put yourself in the patient's shoes and try to see things from his perspective. Below are some ideas to help you win over the child in your exam chair.

■ A smile goes a long way. Even if you're uncomfortable, it's important to relay otherwise. The law of attraction tells us that we can expect positive responses when we give off positive vibes.

■ Take off the white coat. Perception is everything and a child might be intimidated just by the doctor's office. The absence of a white coat can allow a nervous child to feel more relaxed. (Consider countering that idea by actually wearing a white coat if you are examining a more disobedient child.)

■ Try to relate. I often find myself commenting on something a child is wearing to get the conversation started. Kids are expressive and enjoy wearing clothes and accessories that are of interest to them. If you're not already familiar with them, make efforts to become acquainted with some of the Disney characters to keep the conversation going. Modern day animated films are surprisingly funny and engaging for adults.

■ Talk their talk. Simplify, stay flexible and avoid technical talk. Automated screening visual fields are like a computer game, and color vision testing can become a tracing game for those who don't yet know their numbers. Stereoscopic eyeglasses can become magic glasses; the picture of the car on your pediatric acuity slide can be a “tricycle” as long as patients consistently call it a tricycle. Holding your transilluminator against a young patient's finger can create an awesome red laser finger; the BIO can be a cool hat and so on. Using goofy finger puppets for fixation targets is also fun.

■ Be punctual and work swiftly. By virtue of being children, their attention span is limited. You don't need to hurry, but you certainly need to be conscious of using your time wisely. Before you start the exam, consider a kind explanation to mom and/or dad that you would like to reserve time at the end of the exam for explanations and questions.

■ Provide encouragement. Share positive feedback, even if they aren't doing perfectly, because this will give them the courage to continue.

■ Keep it fun, but remain in charge. It can be helpful to have an encouraging parent in the room, but overbearing parents can make it difficult for you to run your exam and may cause the child some performance anxiety. You should never hesitate to ask a distracting parent to wait outside the exam room.

As time goes on, giving a child-friendly exam will become easier for you. Until then, think about what it was like to be a kid, and remember, we were all kids once! nOD