What I learned today is that cranky children can be soothed by continuing with their familiar routines. A crying toddler while obtaining an H&P from his mother may be crying simply because he missed his breakfast, not necessarily because I'm in the room. The same child was a blissed out cuddly monkey, patiently cooperating with this 3rd year medical student haphazardly conducting my first pediatric physical exam; all because I excused myself from the room so he could have breakfast before I proceeded.
A slightly older child required some teasing about having a dragon in his ear, and pretending to look in my ear, before he let me proceed with the otoscope. There is lots of goofing around, taking time to explain things to parents and then again to the child on a level they understand, and time outs to clean up pee or vomit that were projected across the room. It is all about the children when on peds: their schedules, their cooperation, their level of understanding. So far, and not surprisingly, I LOVE it!
What are your tricks for working with the little tykes in both in & out-patient settings?