Waiting Room Chaos in Pediatric Therapy

Waiting Room Chaos

Ah yes, the waiting room: The very bane of my existence.

Parents? Kids? Therapists? Are we all in agreement here? It’s just the worst.

The concept itself is crazy- Here kids, sit in this chair, be quiet, and wait patiently for your turn. Ha!
It gets loud, it gets busy, and it gets challenging to walk around without knocking someone over. And that’s just at 10AM… wait until the afternoon rush hits!

The waiting room has been an issue everywhere I’ve ever worked- whether the clinic was tiny or huge. However, one clinic had the unique opportunity to move into a bigger facility. There was much debate about arranging the waiting room in the new place. Should there be more space? Perhaps an “L” shape for extra nooks and crannies? We could stagger the therapists’ schedules so that everyone isn’t in the waiting room at the same time. Or, how about no waiting room at all?

The consensus was that the waiting room is horrible regardless. More space = kids literally running around. Less space = louder noises. More toys = more of a mess, kids fighting, and germs spread. It’s a lose/lose situation.

Within the first week at the new facility, a parent looked at me as the tornado of children and parents surrounded us, hands over her ears, exclaiming… “I thought this was going to be better!?” Or at least that’s what I think she said… It was awfully loud in there.

So what exactly makes the waiting room such a stressful experience? Here are just a few things I’ve noticed…

-Lack of proper adult supervision.  

Of all the places in the world, a therapy clinic should be a safe place for parents of children with special needs. I completely understand that and want people to be comfortable with their children.

However, there have to be some rules or expectations in order to keep the situation from getting out of hand or causing other children to meltdown in a horrific domino effect.

I often see parents allowing their children to knock the chairs over, rip books apart, or throw things from one side of the waiting room to the other. (And most of the time it’s the sibling that is the guilty party here as they wait for their brother or sister to be done with therapy.)
These kids can get out of control, and will even get into fights or scream at each other as a parent sits silently on their smartphone. I even had one parent that was so sick of other kids being out of control that she yelled at them from across the room. Awkward.

Now, I hate when parents feel overwhelmed in the waiting room, so if their child is having a particularly hard time, I tell them to take the child back to my office immediately upon arrival, or to arrive right at their scheduled time so they don’t have to wait around.

– Getting a little too cozy in the waiting room.

Hey, therapy is a big time suck for a lot of families. They have to drive there, wait around, and then drive back home. They have things to do, and I totally get that. However, there is a point when the activity you’ve chosen to complete is inappropriate in the waiting room setting.

One parent dragged an end table in front of her chair, set up a laminator and large paper cutter (you know, with the giant blade that chops large stacks of paper) and seemed annoyed when I had to step over her.

There are other instances when siblings bring bags full of toys, Legos, or whatever, and spread them all out on the floor, only to be upset when others come to play and check out the fun. Just know that if you have something cool, other kids are going to be interested. If you don’t think your child will be able to share, you might want to think of another activity to bring along. (Oh, and if you bring a video game or some electronic device, make sure to bring headphones or keep the volume waaaay down.)

I’ve also witnessed several parents attempting to home-school in the waiting room, and I have to say, some can pull it off well. Others? Well, it seems to end up to be a bit counterproductive and they get frustrated by other people making noise in the waiting room.

 -A complete loss of “inside voices.”

Wow, the noise of a waiting room. It’s a therapist, child, siblings, and parent, all talking over each other, times ten. Most of the time I can’t even process what I’m saying to a parent due to the noise level, so how can I expect them to understand what I’m telling them? The worst part is trying to move to a new location, only to be bombarded by other therapists attempting to do the same thing.

 -Judgement and stares from other parents.   

Remember how I said a waiting room should be a safe place for a parent of a child with special needs? I really dislike when some parents sit and openly stare or gawk at another child with autism as they make a strange sound, or possibly hand-flap or “stim” off of something. I can get really defensive when I see this happening, as if they are comparing their children’s challenges. We’re all here for the same reasons, people, so please calm down the judgmental stares.

-Finding a new client in the crowd.

Why does this hardly ever seem to go smoothly with me? You can either walk around to every group of people you don’t recognize and creepily ask if they are there for an OT evaluation, or call out a first name to a crowd that just stares back at you. Sometimes another therapist can describe the child or parent right beforehand, or maybe the receptionist can point me in the right direction if she has a spare moment. Regardless, I apologize if this is a strange situation.

-The transfer of the child from parent to therapist, or back again.

Here’s a fun situation. Maybe it’s only me, but when I take a child back out to the waiting room, as soon as the mom or dad is in view, I assume that the child is back in their care. If your child runs out the door into the parking lot, runs into an adjacent office building, or starts hitting the child next to them in the waiting room, please step in. I’ve chased my share of kids out the front door before, and will continue to do so in order to keep them safe; however, I do appreciate it when the parent steps in to try to help.
Now, if you have your hands full with other children or are trying to load everyone in the car, that’s a different situation all together, and I am more than glad to help. This is mostly an issue when the parent seems to ignore a situation that calls for their attention.

-Attempting to have a meaningful conversation with a parent.

There is this little thing called HIPPA that all therapists and medical professionals must abide by. These laws protect you and your child’s private health information. So ideally, you wouldn’t be talking about a child’s therapy in a crowded waiting room. While most parents give consent to talk openly in the waiting room, it can still be challenging to do so in a meaningful way when there is a circus surrounding you. I feel so terrible when a parent is trying to tell me something important, and my next client is literally tugging on my arm. Or perhaps I am so excited to tell them what their child did in therapy, but the sibling is having a meltdown. In these situations I try my best to find a quiet place to talk in the back or at the car, or I’ll ask to call the parent at another time.

-Keeping things clean.

Please don’t judge a clinic by the cleanliness of the waiting room. I promise, it’s really the hardest place in the world to keep clean. People throw trash on the ground, leave toilet paper all over the floor, spill drinks, vomit, you name it. Again, I know it is a challenging place to keep everyone happy and on their best behavior, but man, I’ve seen some gross stuff left behind.
The worst part is that typically many small or private clinics can’t afford to hire someone specifically to clean. It’s usually a duty that is spread between therapists and other support staff. And throughout the day it’s hard to keep things clean and well stocked when you have a full caseload. However, I will always stop what I’m doing to make sure you have toilet paper. That’s kind of like life’s necessity.

-Finding a waiting room alternative.

So when the waiting room is just too much to handle, what else can we do? For many parents, I recommend taking the child to the car and talking there. The downside to that plan is that I often end up sweating in the heat, or freezing in the cold or rain.

Also, without the watchful eye of the next parent staring you down, people can get lost in the 5 minutes or so allotted to talk before the next session starts. I’ve been stranded in the parking lot on more than one occasion, looking for a pause in the conversation to say, “I gotta go!”
I admit, there’s a point when I stop listening and start thinking, I’m late, I’m late, please stop talking, I’m late… But that’s hard to say when a parent is opening up about something personal or difficult for them, or even just chatting about their day. I would advise bringing up big problems before the last few minutes of the session because you’re more likely to have the full attention of the therapist. Or, if time is running out, suggest having the therapist call you later when they have more time to talk.

And yes, I’ve been yelled at for being late because a parent kept talking to me. (Probably why I’m so paranoid about being late to my next appointment.) One parent literally watched the clock to make sure I wasn’t “stealing” any of her child’s session. Or, how about watching one parent yell at another parent for making their therapist late to their child’s session. Yikes. I have to say, never a dull moment in this job!

So to parents that hate the waiting room, just know that a lot of therapists are right there with you. And if anyone has come up with an amazing solution, please feel free to send it my way.


About TheAnonymousOT

Pediatric Occupational Therapist
This entry was posted in Insider Information, Lessons Learned, Occupational Therapy and tagged , , , . Bookmark the permalink.

5 Responses to Waiting Room Chaos in Pediatric Therapy

  1. pk says:

    Good heavens! This could easily have been written by any one of our therapists or myself, the office manager of a 10-therapist clinic. Having just survived a tornado in our waiting area and wondering what I can do to avoid it next time, I found this blog! Love it! Thanks for saying everything I wish I had… except that I am still too shellshocked after today’s appointments to speak. Best to you!

  2. Siobhan says:

    Love your site here! I have a question about therapy wait rooms and I’d love any help! Do you have any suggestions for how to manage strong cigarette smells in a waiting room? Some parents smoke so heavily and they must smoke in closed spaces (their home, car ride on the way over) that they reek of smoke in addition to their coats, stroller, child, etc. It makes the other parents uncomfortable and the waiting room then smells like smoke for hours afterwards. I bring a change of cloths and have to change right after treating those kids or otherwise I will also then smell of smoke during following sessions. Our clinic windows don’t open and the winter is here which means lots of coats, hats and gloves that all smell smoky! Thanks in advance!

  3. Laura says:

    Play spaces for siblings that aren’t the waiting room are great. The Guild School in Spokane has 4 sibling options. That’s right, FOUR! I’m struggling now as we moved and starting therapies at a new place that has nothing for siblings. The 4 spaces are: sibling boxes in the therapy rooms when you need to be back with your child receiving therapy. (These didn’t work well for us, my 2 yr old only wanted to play with her brother’s things… But great for a lot of people, esp ones with older sibs). A gym that is occasionally used for therapies, but is otherwise open for families with sibs. My 2 yr old loved running the ramps, jumping on the trampoline, and driving the cozy coupe. 3rd is a family room with a play kitchen, vehicles and other toys as well as reading material related to a lot of disability issues for parents to read and checkout. The 4th and final I recognize as not realistic for a lot of centers, but nice… An outdoor playground. We used it quite a bit in the summer, never in the winter. The guild school doesn’t really have a waiting room. It has about 6 chairs in the entry area with a penny well stocked with pennies. It keeps the kids occupied for those few min before appts. The therapy rooms all have one way viewing so you can watch your kid in therapy without interupting, and you pick your kid up in the classroom where you can talk with the therapist without lots of others around. The place we go now is a lot less family friendly and I don’t feel as connected to the therapy or therapists… And my 2 yr old gets very restless in the waiting room for an hour… And is bouncing off the walls by the time the therapist comes out and is trying to talk with me.

  4. Melissa says:

    I know this post is old… but I wanted to comment. I’ve not encountered this problem (well at least not to the level you’re describing). The biggest reason is that parents are required to join in on sessions with their children (except for in certain circumstances). The reason for this is that if we expect parents to have any involvement with their child’s therapy (eg – continue activities at home… see their progress… discuss their child in privacy…etc.) it just makes more sense to have them join in the session. Yes this often includes siblings -which we try to include if they are willing/able – but can also be a distraction. This might be one of those situations where the parent is absolutely unable to book a time without the sibling, and having them in session was creating major issues, so the parent will wait in the waiting room with the sibling. Otherwise, no one was ever waiting for more than a few minutes for their appointment – hence no crazy waiting room.
    I don’t know how I would be able to deal with trying to talk to a parent in a busy waiting room – or in their car! – you are a better woman than I lol! 🙂


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