For Jonas the most important thing still is to get tracheal suctioning over and done with as quickly as possible as he often loses courage as soon as he gets in to the consultation room. 
He likes to bike in the long corridor outside the room and he has found out this is his best way to cope with the tracheal suctioning is to stay on the bike. He can race into the consultation room, get his mum on the backseat and keep holding really tight on the handlebars instead of being fixated. He concentrates on breathing and visualizing and he needs support to focus to divert his anxiety. 
Before entering the consultation room, he has tested which nostril the nurse is going to use and is asked to plan what he is going to visualise. Jonas’ mum gets on the backseat ready to support and hold his head and hands if necessary. 
The nurse is “talking him through” the procedure with short orders: “Now you get mum on the backseat”, “then hold really tight onto the handlebars, like last time”, “remember to breathe” and so on. 
The procedure is quickly over and done and Jonas can draw a deep breath when “the butterflies in his stomach have disappeared”. 
Immediately after the videotaping he is eating fruit gum and telling stories about his last birthday.

Comments/considerations:

Jonas and his mum have been working hard towards Jonas’ “tracheal suctioning on bike”. 
The video shows how hard Jonas is working on cooperating! 
If he had not managed so well, it would still be very important to praise and encourage him and have a talk about what was working and what we could work on for the next time. 
It is crucial to “catch up” and make sure that the experience is never felt as a failure – even if the child is crying or was not able to cope as expected. 
Some children will sit on their parents’ lap until they are very old – others prefer to lie on the couch with their head on a pillow while the mum/dad caresses their feet. Another child will stand on his scooter and divert his anxiety by concentrating to keep his balance. The challenge is to support and help the child until he/she has found a way to cope.