Archive for the ‘Child Life’ Category

Five things you may not know about music therapy

Tuesday, April 23rd, 2013

In honor of music therapy week, Erinn Danielson, music therapist, gives us a peek inside her job at Children’s Hospitals and Clinics of Minnesota. 

Stepping onto the Children’s elevators each day, guitars on our backs and instruments in hand, we tend to draw comments from fellow riders. They range from the typical “You must be the entertainment” to “Do you actually play all those instruments?” to “I wish I had your job.”

Although explaining the ins and outs of music therapy isn’t always possible by the time one of us gets off on the fourth floor, we do usually manage to smile and say, “I’m one of the music therapists.” After being in this field for almost seven years, I find that this doesn’t always provide a lot of clarification. So in no particular order, here are five things you might not know about music therapy:

1. Music therapy isn’t just for fun. Don’t get me wrong, music therapy usually is funWhat kid or teen doesn’t enjoy music, especially when they get to play along on a shaker or fancy electronic drum set?  However, a casual observer may not notice that a music therapist has goals for each patient he/she works with, ranging from giving a 3-year-old an effective means of emotional expression when he doesn’t have the words, to giving a 15-year-old relaxation strategies using music during a procedure, to motivating a 10-year-old to get out of bed.  The point of music therapy is that we are using the musical experience as a means of reaching a non-musical goal.

2. A child doesn’t need to be a musician or have musical experience to benefit from music therapy. Our goal as music therapists is not to teach kids how to play an instrument, or sing better, or dazzle everyone with their harmonica stylings. Therefore, the child doesn’t need to be musical to benefit from music therapy. Even patients who are sedated can benefit from music therapy, as music therapy can lower heart rate and blood pressure, as well as increase oxygen saturations. Patients who are able to participate on a more active level can play drums, shakers, xylophones and even a special type of harp with little to no previous musical experience.  A music therapist may use teaching the guitar as a way to improve the child’s fine motor skills, or having a child blow through the harmonica as a way to encourage deep breathing, but learning skills on these instruments is never the goal of the session.

3. We always use patient-preferred music. Music therapists use music from all genres to effect positive changes in the patients we work with.  We wouldn’t use “Old MacDonald” in a session with a 16-year-old (unless he or she requested it!) and we probably wouldn’t use a song from the 1920s with a 5-year-old. One of the first things music therapists ask when getting to know a new patient is what kind of music the he or she prefers.  We then work to accomplish our goals using this or similar music. We can’t promise to know every song, (we’re not human jukeboxes!) but we can always use recorded music or find a similar song if need be.

4. Music therapists are not just musicians waiting to make our big break on “American Idol.” Across the board, the music therapists I know went into the field because they want to use their passion for music to make a difference in people’s lives. We went to school for four or six years to do exactly what we do: music therapy. We spent six full months doing an unpaid music therapy internship and worked hard for the jobs we have. Although some music therapists perform outside of their day jobs, we are not performing when we are working with patients. Just listening to us sing is not likely to accomplish very many therapeutic goals!

5. We don’t just sing and play instruments. We do a lot of singing and instrument play with kids, this is true. However, we also work with kids doing songwriting (for emotional expression, processing, or a way to “tell your story”), lyric discussion (again to process emotions, facilitate coping, or put a new perspective on problems), music-assisted relaxation, procedural support, recording, and CD compilation.

So let’s go back to the elevator, so we can finish those conversations:

“You must be the entertainment!” –No, I’m not a performer. I do get to spend the day making great music with courageous, insightful and amazing kids, though!

“Do you actually play all those instruments?” Yes, I can…but I’d rather have the kids playing them!

“I wish I had your job!” -Yes, it is a wonderful and rewarding profession, and I wouldn’t want to be doing anything else!

 

A night in the ED with a child life specialist

Wednesday, March 27th, 2013

A 3-year-old girl needs her bottom lip sutured. A 2-year-old sibling is bored to tears – literally – while she waits for her brother to be released so they can go home. A 7-year-old needs an IV start for blood draws and medicine.

Who are you going to call? The child life specialist.

Mindy Teele, child life specialist

On a recent weekday night in the Emergency Department, Mindy Teele, a certified child life specialist at Children’s Hospitals and Clinics of Minnesota, is in demand. A patient is about to have an IV start, so an RN asks Teele to explain the procedure ahead of time. In another exam room, a patient is waiting for results, so Teele brings toys. A few minutes later, she returns to the patient with the IV start to distract the patient during the procedure.

“Child life specialists focus on the psychosocial and developmental needs of children to minimize their fears, clarify misconceptions, build coping abilities and enhance understanding when kids are in the hospital,” said child life manager, Sheila Palm. “Being better prepared improves long-term adjustment to medical conditions, increases cooperation and reduces pain during procedures.”

Children’s deploys certified child life specialists throughout the hospital – to the medical-surgical, pre-surgery, critical care, and cancer and blood disorders units. Child life specialists work in home care and hospice, too. Children’s also has child life associates who help on some of the units and in the Sibling Play Area. Philanthropy helps support child life specialist services; their work is not reimbursable.

In the ED, Teele helps reduce the stress of what can be a traumatic visit by providing age-appropriate information, coping strategies and parent coaching, Palm said. Gaining cooperation from the patient and family can reduce the time of the procedure, need for sedation and need for an extended ED stay.

A 2008 Children’s study in the ED compared parental satisfaction with their child’s experience during a laceration repair in the presence and absence of child life services. Overall, there was greater satisfaction when a child life specialist was involved.

Patients experienced less anxiety when they left the ED when a child life specialist was involved in their care. Child life specialists received a significantly higher rating than other providers in their efforts to relieve anxiety. Children’s also received a rating of excellent from families more often when a child life specialist was present.

“I find the presence of child life services in our ER to be a tremendous asset. The care that they provide in alleviating the apprehension and pain of the sick and injured children we care for on a daily basis is wonderful. I appreciate working alongside such caring individuals and see their effect in many of the patients I come across during my shifts,” said Dr. Mark Schnellinger.

Teele has worked at Children’s for 13 years, 12 of which she’s spent in the ED. “I feel like my personality fits this environment,” she said. “I like the instant gratification.”

In the ED, time is not on Teele’s side. She often only has minutes to explain and prepare patients and families for a procedure. So she relies on analogies to explain them. Instead of calling herself a child life specialist, she tells patients she’s a teacher – a term kids can understand.

“Anyone can go into a room and tell a child what’s about to happen,” Teele said.

But, a child life specialist is able to assess the child and take him or her through the experience on their terms, she said. If a child needs a CT and loves princesses, Teele might develop a scenario from “Snow White.” If the child is obsessed with video games, Teele explains the procedure like it’s a video game with various levels for advancing.

On this recent weekday night, a little boy is minutes away from having a needle inserted into his hand for an IV and blood draws. Teele explains that the RN will use a J-tip, which helps minimize pain with needles, to make the area feel soft. An RN will then use “soap” to clean the skin. Using the same tools for the procedure, she shows him what everything is supposed to feel like. She shows him the “straw” and explains that, unlike a juice box straw, it will give him medicine to make him feel better.

A night in the Emergency Department with a Child Life Specialist (Part I) from Children’s of Minnesota on Vimeo.

Later in the evening, she’s called in to help during an IV start with another patient. The ED has run out of J-tips. Armed with a Disney book, Teele holds it up for him and together they identify the characters while the RN inserts the needle, draws blood and then gives the boy medication. Distraction works. The patient remains calm the entire time.

A night in the Emergency Department with a Child Life Specialist (Part II) from Children’s of Minnesota on Vimeo.

“I think I have a very rewarding job,” Mindy said.

Learn more about child life services.

You can lead kids to water, but can you get them to drink?

Tuesday, January 29th, 2013

By Jeri Kayser

We all know drinking water is important. After air, it is pretty much what we need to survive. We mostly consist of water and everything in our bodies work better with an adequate amount of water in them. Try explaining this to a toddler. Try explaining this to a toddler who is sick or has just had their tonsils out. Now try explaining this to a toddler who has discovered they can clamp their mouth shut and no one can make them drink, not even Mom. And whoa, this is so cool to have power over Mom!

This daunting task is universal throughout time and cultures and is more easily dealt with when you plan ahead rather than try to persuade your child to drink when they’re at risk of getting dehydrated. Also, dehydration can cause irritability and a killer headache, which brings out the best in absolutely no one. So, I’ve prepared a few tips for parents:

Drink water: Your child watches you closely. They’re going to be more inclined to drink if they see you drink, and they will be more inclined to drink water if they see you drink water. Plus, your body will appreciate it!

Serve it up cold: Water tastes better cold. Add some ice cubes because they’re fun. You can also add a little juice to the water in the ice cube tray to make the cubes even more fun with a splash of color.

Add slices of fruit: if it’s age appropriate, fruit adds just a touch of freshness and may also encourage more exploration of different fruits.

Find a fun water bottle: There are tons of water containers to choose from. Letting your child pick out a water bottle will help encourage their water intake. They might be inclined to pick one with a fun character, something “pretty,” or, if they’re older, something that fits best in their backpack or clips easiest on their sports bag.

Start early: Habits are best developed and maintained when started early. Have your child’s first beverages be milk or water so they begin to associate water with the way to quench thirst.

If your physician has directed you to encourage your child to drink because they are at risk of being dehydrated, here are some additional tips:

Encourage them to talk: When you say a few words, you swallow your saliva without thinking about it to be better understood. This is especially helpful if they are choosing not to swallow because of pain from a sore throat.

Licking feels less overwhelming than drinking: This is partially why Popsicles work so well. Frozen Popsicles are frozen liquids.

Use sibling rivalry: If there are other children in the household, let them have the popsicles as well. No kid wants a sibling to get something they aren’t getting.

Blenders are a giant toy: They have buttons, smash stuff and make a lot of noise—a really awesome toy! Experiment with smoothies.

Schedule tea party time: Drink out of novel containers, tea party dishes, syringes–whatever is appropriate and fun.

Use sticker charts: For kids, it is hard to understand why they need to drink, especially when they don’t feel well, so sticker charts can work great. We are all well motivated when we can easily see how we will benefit from our choices. Make a chart with your child and give them a sticker for whatever amount a fluid swallowed seems reasonable. Create a “sticker store” where they can “buy” things with various amounts of stickers. These items could be something like a coloring book or maybe an activity like choosing a book to be read to, whatever works best in your family.

Communicate with your doctor: They need to know how much your child is drinking so they can best care for your child. They will also be helpful on letting you know what the goals should be for the amount of fluids your child needs.

Communicate with your child: Don’t underestimate your child’s capacity to understand that drinking is important. Even at a very young age children are actively involved in taking care of their bodies: baths and brushing teeth are good examples. They are able to understand that drinking is one more thing they can do for themselves to feel their best.

Jeri Kayser has been a Child Life Specialist at Children’s Hospitals and Clinics of Minnesota since 1985. Her educational background is in child development and psychology. She has three children who have been a great source of anecdotes to help illustrate developmental perspective. They’re good sports about it.

Getting and giving parenting advice

Thursday, December 20th, 2012

By Jeri Kayser 

The holiday season is upon us, full of celebrations and gatherings with family and friends. There are plenty of cookies, leftover turkey and fortunately (or unfortunately) unlimited parenting advice.

  • The advice can be fun when Grandma recounts the temper tantrum your mother threw in the grocery store when she was little and how it was handled.
  • The advice can be helpful when your sister-in-law tells you about a website with deeply discounted baby supplies.
  • The advice can feel judgmental, overwhelming or misinformed when a bunch of aunts declare your baby must be cold because they are. “Why don’t you put a sweater on that child? He’s going to catch pneumonia!”

On the flip side, when you’ve lived life and raised kids, you do have some worthwhile advice to share. It’s hard to watch others struggle when you have good parenting tricks up your sleeve. So, how do we maintain family harmony and actually make this advice business work?  Some thoughts….

Unsolicited advice is rarely valuable. To be motivated to follow advice, it’s best if we actually sought it. As a Child Life Specialist, my day is filled with offering advice to parents on how they can help their child cope with their medical care experience. If the advice is going to be valuable, it has to be given with respect to the individual child and families’ needs, as well as their ability and desire to hear the information. Letting someone know what you have to offer and then respecting their decision as to whether they’d like the advice will encourage a dialogue that’s supportive.

No two situations are the same.  We’re unique individuals. A parenting technique that worked with one child might not work with another. Plus, every parent has their own set of skills and challenges that they work with when parenting. My mother-in-law gave me one of the greatest gifts possible (not counting her incredible, perfect son!). She told me when we had our first child that she wouldn’t tell me how to raise him if I didn’t tell her how to raise her kids. She recognized and respected the fact that we would each have our own style and would be more supportive of each other when we removed judgment.

Is now the right moment? In the midst of a huge toddler meltdown, no one is going to hear anything clearly. During the middle of a challenge is when you feel the most vulnerable as a parent. If you’re the advice giver, find a time later to reflect on what happened. If you’re the recipient of advice at an inopportune moment, be ready to redirect, “I would love to hear your perspective later Aunt Bertha, but I need to deal with this right now.”

Be open to the possibilities of great ideas in the sea of advice. When you’re pregnant, you’re a magnet for advice. People feel compelled to give it. During each of my pregnancies, parents at the hospital would offer me advice. Some of the hints I politely listened to and discarded because it wasn’t right for me, but most of the advice proved to be phenomenally helpful.

When people love us they want to help. They want to know the knowledge they have acquired in life is valuable. We also want to forge our own unique paths. When we are respectful in giving and getting advice, it can be priceless in the tremendous challenge of parenting.

This is a post by Jeri Kayser, who’s been a Child Life Specialist at Children’s Hospitals and Clinics of Minnesota since 1985. Her educational background is in child development and psychology. She has three children who have been a great source of anecdotes to help illustrate developmental perspective. They’re wonderful at being good sports about it.

Preparing kids (for things that weren’t their idea!)

Wednesday, September 26th, 2012

This is a post by Jeri Kayser, who’s been a Child Life Specialist at Children’s Hospitals and Clinics of Minnesota since 1985. Her educational background is in child development and psychology. She has three children who have been a great source of anecdotes to help illustrate developmental perspective. They’re wonderful at being good sports about it.

Something needs to happen; something that was not your child’s choice, and it’s going to require some cooperation on their part. Maybe it’s a trip to the dentist, a haircut, a move to a new school or dinner with some overbearing relative at a restaurant with cloth napkins. Like all successful endeavors, a little planning can go a long way.

Working with children about to have surgery gives me a pretty unique vantage point as to what helps when preparing a child for something new and challenging. The following are some thoughts to consider when faced with this daunting task.

Self–exploration

How do you feel about what’s coming up? What have been your experiences doing this event and what have you found helped or did not help? Personal confession: Going to the dentist is not on my top million list of things to do. I know this about myself so when it came time for my kids’ first visits to the dentist, I was honest about my feelings. I knew that anything I said about the upcoming visit to the dentist was going to contain some of my bias. While explaining what would be the sequence of events, I included where I felt challenged and what I did to make it better. Your emotional context of the event is going to be different from your child’s because you are unique individuals with unique perspectives.

Respect your knowledge of your child

How does your child best take in information? Do they need time to process or does time make them more anxious as they imagine every worse case scenario? Do they learn better hands-on or are they a better visual learner and like to read about a new event before they participate? Every child, at each stage of their development, is going to have their own way of approaching new information.

Find out what your child already knows

Often, when a parent has just confessed to me that they haven’t told their child anything about surgery, the child will be able to go into immense detail about what is going to happen. They know. They listen. They pay attention. The information is just so much more meaningful when there has been a direct conversation with opportunities to ask questions. When you ask your child what they already know, their response can give you helpful guidance in how they understand the event and what, if any, misconceptions they might have.

What to expect and what is expected of them

Not knowing what is going to happen is usually the source of anxiety, not what is actually happening. We as adults can think through all of the possibilities of what to expect and have more life experiences from which to draw. Kids tend to get more anxious about stepping into the great unknown and fear that loss of control. Explaining what will be happening in a step-by-step approach is comforting in its sense of predictability. Be sure about your facts. Shorter descriptions tend to be more accurate and easier to listen to. End the timeline of the event with something you will be doing when you are done and back home. This helps reinforce that the event won’t last forever and normalcy will return. Kids also need to know what is expected of them, when will they be required to be cooperative and what the repercussions for misbehavior are.

Questions from the audience

Make sure you leave time for questions right after you’ve finished explaining what will happen or later when your child may have additional thoughts on the topic. If you ask a person if they have any questions, the typical response is no.  A more helpful way to get to their thoughts could be to say, “Think of three questions you might have about (fill in the blank).” If you can’t answer a question, have your child write it down and make a list of questions to bring to whomever is most likely to have the answers.

Was it like what you thought it would be like?

This is a good question to sum up the experience. This is also a good question to encourage conversation about what went well and what they would want to change to make it even better the next time. If things didn’t go well, there is actually much to be learned by that. Success is a good ego booster, but failure is a better teacher. As you process what happened, you are also teaching your child how to face a new challenge, which is an invaluable gift for the rest of their life. Well-prepared kids tend to face any challenge with more skill, confidence and success.

Bonus round

It is very gratifying to watch your kids handle something you weren’t sure they could, and their self-discovery of just how strong they can be is priceless.

My oldest is going to college. How do I make the transition easy for her siblings?

Monday, August 20th, 2012

This is a post by Jeri Kayser, who’s been a Child Life Specialist at Children’s Hospitals and Clinics of Minnesota since 1985. Her educational background is in child development and psychology. She has three children who have been a great source of anecdotes to help illustrate developmental perspective. They’re wonderful at being good sports about it.

If you’re a parent of a college-bound kid, your life has probably been taken over by filling out FAFSA forms, figuring out finances, deciding who’s bringing the fridge and shopping for dorm sheets. They really had to make them some weird size, huh?

You may not have paid attention to how this transition has impacted your younger children still at home. But, it’s not too late to think about what might work best for your family when your oldest leaves for college, especially if your oldest is just entering his or her senior year in high school this year.

There will be big changes and more subtle ones. Sometimes it’s the little changes that feel more disruptive because they have a way of sneaking up on you.

When our oldest left for school, it took our family forever to set the table for four people instead of five. When that fifth place setting was obviously unnecessary, our youngest would always groan, “Oh yeah, Zach’s not here.”

This shift in family life begins to firm up over that heavily ritualistic space of time known as senior year. Every sport or club banquet honoring seniors, every college fair, the ACT test, senior pictures, prom and graduation celebrations all remind us of what’s to come. At a grad party we attended this spring, I found a younger sibling greeting guests. She spied me, sighed and said, “This has been the ‘All Andrea, All Year- year.’ I’m sick of it!”

It can be a bit daunting to achieve balance between giving your kids the attention they need and preparing yourself, your college-bound child and their siblings for this next step. My hope is that the following tips will help your family:

Visit college with the entire family

Take your younger kids on some college visits. It’ll help them understand what college is about and why their big brother is  so excited. Plus, it’s a family trip! Many college visit programs include activities for siblings. Our youngest loved checking out the bookstores. It’s fun to get them a T-shirt from the chosen school because it’s a direct physical connection to their big sibling when they wear the shirt.

Involve siblings in graduation party prep

It’s a ton of work to get ready for a grad party. Assigning a younger child to sort through pictures and make a poster can be a huge help. It’s also a great way for everyone to reflect on all of the shared memories.

Move-in day: Get all hands on deck

Having siblings help on the day your freshman moves into her dorm is another set of legs to run up those three flights of stairs with all of the stuff, but more importantly it’s a great opportunity for them to see where their big sister will be living. They can also make their own imprint on the room by contributing with a picture, stuffed animal or shared item. When you leave, make plans for when your family will next see each other. Even if that isn’t until Thanksgiving, there’s comfort in knowing when you will see each other again.

Use social media

Facebook, Twitter, Skype, texting and emailing can be easy ways to stay in touch. Our kids share an iTunes account and have grown to love the fact that they can listen to each others’ current interests. When my daughter is missing one of her brothers, she likes to listen to one of their favorite songs.

Be mindful that your freshman needs time to establish relationships with new friends at college and most schools recommend that they stay at school for about six weeks without visiting in person. This is a fantastic rule and a tough one to follow, but it’s definitely worth it for their enjoyment of everything the college experience has to offer. Be ready to intervene if your younger children are communicating too much.

Send care packages

Every kid likes to get a care package. And there’s no better time like the present – when back-to-school shopping is in full swing – to start collecting shoe boxes for transporting goodies to your child. As you find items that would be of interest to your freshman, put them in the box and when you fill it up, send it off. Younger siblings can help prepare the care package.

Parents: You’ve got this. Here’s to a great school year!

Talking to your kids about tragedies in the news

Friday, July 20th, 2012

By now, you’ve likely read or heard about the violence that took place at an Aurora, Colo., movie theater during the midnight showing of the new Batman movie, “The Dark Knight Rises.” According to the Denver Post, a gunman entered the theater and allegedly shot 71 people, killing at least 12. Police arrested a suspect, who is in custody.

We at Children’s Hospitals and Clinics of Minnesota are disturbed and saddened by this tragedy, and we extend our thoughts and prayers to everyone affected by it.

Today and over the next several days and weeks, the story around this mass shooting will continue to develop in local, national and world news outlets, as well as on social media. As a parent, you want to protect your children in every way, including sheltering them from this horrific event. Yet they may still be exposed. They may hear about the shooting from friends and other adults, social channels like Facebook and the news. Tragedies can hit home – no matter where they happen.

We reached out to some of our therapists and child life specialists, who offered tips about how to talk to children when there’s a tragedy:

Limit their exposure to media coverage

    • Don’t assume your children won’t pay attention to anything that isn’t “kid” programming. News media often display dramatic images that capture the attention of young children.
    • Be aware that media may break into a children’s program with updates.
    • Choose to watch a DVD or listen to a CD instead of watching TV or listening to the radio.
    • Consider activities away from media sources such as going to the park, reading books or playing board games.

Watch what your child watches and discuss what you see and hear together

    • Ask your children what they think and feel about what they hear and see.
    • Clarify any misconceptions they have about the information presented in the media.
    • Be certain to include information that older children may receive through social media and texting.
    • Monitor adult conversations. Children will often listen when adults are talking and may confuse facts for opinions.

Reassure your child of their own safety

    • Remind your children that you love them and are doing everything you can to keep them safe.
    • Educate them about the role of community service agencies such as police and firefighters that help to keep them safe.
    • Acknowledge a child’s emotions and take them seriously. Don’t try to minimize or talk them out of their fears.
    • Answer their questions directly but don’t give them more information than necessary.

Pay attention to changes in your child that may be a result of what they have seen or heard

    • Younger children are significantly more impacted by the reactions of adults around them as well as the visual images on television. They are more likely to exhibit behavioral changes as a result.
    • Older children may need to talk about what happened and their feelings about the events. They may ask more questions related to the event/attack or make speculations through “what if” questions.
    • Children may exhibit behaviors related to stress such as generalized fear that something might happen, changes in sleep habits or appetites, avoidance of places that are similar to the site of the attack/shooting, poor concentration and separation anxiety.

Be honest with your teenager

  • Be up front and frank. Teens have a higher understanding of the world than young children.
  • Invite them to share their opinions. They have them.
  • Be aware of their reluctance to go to a movie theater or similar environment. Be willing to accompany them until they feel more comfortable.
  • Talk about ways they can protect themselves and create a plan together should they find themselves in a dangerous situation.

For additional information about talking with your children about tragedies and trauma, please visit the American Academy of Pediatrics.

 

 

How do we teach our kids to be sad?

Wednesday, July 18th, 2012

This is a post by Jeri Kayser, a Child Life Specialist at Children’s Hospitals and Clinics of Minnesota.

Yep, you read that right. How do we teach our kids to be sad when every natural inclination tells us that kids need to always be happy? As parents, we tend to measure our self-worth in the reflection of our child’s emotions. As soon as our child cries, we seek a solution to sooth in a sympathetic response. But sympathy can sabotage self-esteem. No one wants others to feel sorry for them.

Empathy is more powerful. When you’re empathetic, you let your children know that you understand their distress and are prepared to support them as they develop their coping skills. This is much easier said than done. It’s painful to see your child in pain. Plus, learning to cope with sadness is a skill set that needs to be learned, so how can we help teach our kids how to be sad?

First Step: Embrace your own sadness. Kids learn by example. When you’re feeling overwhelmed, fatigued, frustrated, or generally not pleased with the status quo, do some self-exploration. There is much to be gained from trying to figure out why you aren’t happy. Seeking solutions is a way to gain control and find balance and when your children observe you work through something, they learn the value of the effort. Plus, they’re comforted by the fact that you have some of the same emotions as they do and have learned to deal with them.

Second Step: Remember everybody gets to own their emotion and every emotion is valid. We can go through the same event and have different responses to it, each equally relevant. There’s no “bad” emotion, just the one that’s present. If you can retain a calm presence, it’s easier to be supportive and not have your emotional response get mixed up with your child’s.

Third Step: Help give your child the vocabulary to express their emotion. Teach your child descriptive words that more accurately express their feelings. As they’re learning these words, encourage them to use art as well to express what they’re feeling.

Fourth Step: Help your child discover coping skills that work for them. One of my kids likes to write down her feelings in the privacy of her room (after the door has been slammed!). We know now to wait for the essay to be finished before she is ready to talk.

Last and most important step: Cut yourself and your child some slack. Being emotional is being human. Emotions are how we embrace life and experience it fully. It is not neat or perfect but real and messy and rich.

Setting up child life services in India: Success in the Face of Continued Challenges

Friday, March 30th, 2012

As National Child Life Month draws to a close, we continue our spotlight on Jeanine Clapsaddle. Jeanine is a Child Life specialist from Children’s who is in India for two months to help set up Child Life services at Manipal Hospital.

Jeanine’s trip is in partnership with the Priyanka Foundation, which was established to fulfill the dying wish of a former Children’s patient who wanted other kids around the world to get the same care she received. Jeanine is documenting her experiences through this blog series.

This is the fourth report from her trip:

 

The Child Life office here at Manipal is located just off the waiting room to the vaccination clinic. I am provided with ample opportunity to watch families with children of all ages interact while they wait or recover from their visit. I have been invited to gaze upon babies who, quite frankly, are breathtakingly beautiful with their heads of full, lustrous hair and dark eyes.

On more than one occasion every day, I am treated to games of peek-a-boo with curious toddlers who delight with running in and out of the open office door. Some grab their parents by the hand and drag them to the door to show them what they’ve discovered.

Parents are always gracious and smile, sometimes sharing the child’s name or asking questions about where I come from and what I’m doing at Manipal.

Today, in this same waiting room, I was witness how far my students have come in the short time I have been here, as well as how far we have to go.

I was in the office with my student, Sunitha, when we heard, as we frequently do, the traumatic screams of a child being carried to the vaccination room.  Somehow this girl of about 6 was able to escape her father’s arms and run back out into the waiting room. She was hunkered down in a corner sobbing.

In the blink of an eye, without any prodding from me, Sunitha grabbed a bubble tumbler and took off to approach the girl. Although the girl did not want to blow the bubbles, she was able to watch Sunitha blow them and settle herself some. Sunitha was able to talk with her quietly until the girl’s father could come and sit down next to her.

When the father was able to pick his daughter up, he approached our office door and Sunitha explained that I was here training her and as such we could give him some help with the situation.  I explained the work of Child Life as quickly as I could, shared some strategies such as positioning for comfort and distraction, and walked with him to the vaccination room, hoping that this would be the in-road that I had been longing for with the staff.

No such luck. The nurse was quick to dismiss us and our suggestions to the point of shutting the door in our faces. Sunitha and I walked the 10 steps back to our office to endure the resulting screams. As they left the vaccination room, the father stopped by the office door and thanked us for our help.

Despite the less than optimal outcome, I couldn’t have been more proud of Sunitha’s initiative and genuine attempts to help this child. I have observed the work of my students consistently and know that their skills are progressing. We spend time discussing various aspects of child life practice, dissecting my observations as well as theirs and converting understanding into guided actions.

But in this moment, I was aware that at some point the culmination of teaching is the development of some internal instinct about the work. Sunitha didn’t stop and ask me if she should or how to intervene with this child.  She grabbed the bubbles and took off. And I stood in the doorway to not only to use the opportunity to observe her work, but to also appreciate the intuition that activated her.

Being a good advocate, like in this case, does not always secure the actions or outcomes we strive for, with staff or with families. In the past week, we have done presentations for nearly five hundred of the physicians and nurses in the hospital, introducing them to the work of Child Life. And although I would speculate that this vaccination clinic nurse didn’t attend any of the presentations, I know that new and innovative programs are often met with resistance.

There are lessons to be learned about approaching barriers with subtly and persistence.  There will always be medical providers of all sorts, in hospitals everywhere, who see the work of child life as an intrusion or unnecessary.

But knowing that we gave this child a moment of respite to catch her breath, and her father some tools that he can use in the future, is enough to know that we do make an important difference in the lives of children and their families.

I hope that this is something my students will learn along with the technical aspects of providing care.

Setting up child life services in India: Meeting Nischit

Wednesday, March 14th, 2012

March is National Child Life Month, which honors those in the Child Life profession. It’s the perfect opportunity to continue our spotlight on Jeanine Clapsaddle. Jeanine is a Child Life specialist from Children’s who is in India for two months to help set up Child Life services at Manipal Hospital.

Jeanine’s trip is in partnership with the Priyanka Foundation, which was established to fulfill the dying wish of a former Children’s patient who wanted other kids around the world to get the same care she received. Jeanine is documenting her experiences through this blog series.

This is the third report from her trip:

 

The two students I am training here have been working in the hospital for nearly a year, providing patients with opportunities for normative play.  They have a well-established rapport with patients and families who identify them by that all too familiar title; the play lady. Patients, parents and staff alike have all identified the immense impact these women and their toys have had on the healthcare experience.

On my first day at Manipal, I met a nearly 4 year old boy named Nischit, who is four months into treatment for leukemia. During the initial portion of his visit to the outpatient clinic for labs, and chemotherapy, he clung to his mother, was tearful and apprehensive. He cried through his port accessing, labs and related cares.

Although he was slow to warm up to the toys and chose items that were intended for a much younger child, he was able to quietly engage in play after some time. This was a consistent response for Nischit during subsequent sessions despite attempts to engage him in distraction during his port accessing.

When the new toys I had sent from the U.S. arrived, I had the Child Life Practitioner working with him put a play doctor kit among the toys that he was able to choose from. Although he responded to the cares as he had in the past, Nischit was curious about the medical play kit, and opted to engage in play sooner than he had previously.

Over the next several visits to the hospital, Nischit became captivated by the doctor kit. He was quickly able to develop mastery of the medical toys, generalize the toys to his own experience, compare the play equipment with the real equipment, and not only model how the equipment works, but his role in the process.  He has successfully ‘treated’ his mother, the stuffed duck that tags along with the medical kit, and all the staff that care for him.

When I come to observe the sessions with Nischit now, he actively engages in distraction for his port accessing and is eager to play when the ‘work’ is over. His mood is more stable.  He has become quite talkative and he displays better resilience to unexpected stressors, such as hospital admission due to fever.

Today he was able to tell the student, “I come for chee-bee-chee (CBC) test.” In all honesty, seeing this smiling face with cheeks puffy from steroids try and spit out CBC test, particularly knowing how much he struggled with his cares just a short time ago, is almost too much for me.

Nischit will always stand out as a prime example of why I became a Child Life Specialist and why I came to India. Surviving and thriving can be part of the same experience, and I believe the aim of Child Life is to diminish the gap that exists between them.

The young girl, for whom the Priyanka Foundation is named, knew this. She saw it first hand when she visited India.  Children were surviving, certainly.  Thriving throughout their treatment was less likely.

I continue to feel incredibly honored to be living Priyanka’s vision and helping to spread the work of Child Life through this teaching endeavor.

Jeanine Clapsaddle
Child Life Specialist
Children’s Hospitals and Clinics of Minnesota

 

The first report from her trip can be read here.
The second report from her trip can be read here.