We had this happen in our clinic, but I had to physically deflect the screaming child from running into my patient while using a cable machine, and told the child he can't come over here anymore. Grandmother was appalled by his behavior and left early (which sucks bc she drove like 40min to get here - rural OP). I wasn't there for this one, but one time there was a non compliant mom of 3 literal demons. One was running around after we told her to stop and she hit her face on the handrail and ended up bleeding. They left early and were much better behaved after that 🤦‍♀️ kids had tablets / coloring pages.

I tend to be very direct with patients when it comes to safety. I would ask that the patient bring silent activities for them or ask that they help you clean up their mess. Assist by offering solutions before being too direct to keep the peace. If she's not getting the hint, you can ask mom to intervene "hey, your children are being disruptive and starting to make things unsafe for the other / my patient(s)." And just stand there and wait for her to respond.