Death may be stupid, but kids aren’t.

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This week, Shani Thornton (aka Child Life Mommy) and I brought Child Life services beyond hospital walls into our community. Via a referral from Jen Holahan, CCLS, a parent invited Shani to do some bereavement work at a girls and boys club.  A staff member and former member of the club had recently died unexpectedly, and the kids and staff  needed support. Shani reached out to me and asked if I would join her. How could I say no?

We armed ourselves with Anastasia Higginbotham’s book Death is Stupid, 3 rolls of toilet paper and Shani’s years of experience volunteering with bereaved children at Center for Hope. Our plan of action included a read aloud, followed by a group mural where  the school-aged children could express any of their many feelings about their beloved mentor’s death. The club supplied a huge roll of white butcher paper, paint, crayons, markers, glue, yarn, glitter, pompons, and googly eyes. The kids supplied their hearts.

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In addition to the mural, we set up a toilet paper target station in a corner away from the art activity.  Kids could draw what was making them sad, angry or afraid, and then wail away at the target with sopping wads of water-logged toilet paper.

What did we discover? Well, first, the children joined us in a circle of chairs for the reading of the book. Some teared up while others got silly. We staid our course and refrained from redirecting any of it. We were surprised when almost all of them raised their hands when asked if they knew others who had died. Many relatives and pets had already paved the way for this loss.

Then we set them loose on the mural. They dug deep quickly, drawing and writing about their feelings and memories about the young man who had died at the tender age of 21. They told us stories of things they had done with him, what he enjoyed, how he had helped them with their homework. They talked openly about feeling sad and angry. One tween drew a heart, wrote “Death is Stupid” in the middle of the heart, and then crossed out ‘Stupid’ and added the words scary, mean, weird, confusing and heartbreaking.

Those who weren’t quite ready to join in the mural found solace in the target game, something that allowed for a more physical, visceral release of emotions. “I hate death” they wrote on the target. “Come Back!” One child drew a picture of himself crying, and then decided to cut the drawing off of the target, so that it would not be ruined by the wet toilet paper. Their bodies danced in anticipation as they lined up to take their turns spooling toilet paper around their fists. The toilet paper flew, splatting with satisfying force again and again, as emotion propelled major league-worthy arms.

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When the smoke cleared, every child had contributed to both the mural and the target practice. We regathered in the circle, where Shani reminded them who they can speak to about their feelings as time goes on. The kids named their parents, counsellors, teachers and one another. We held hands and shouted their friend’s name as a final ritual.

Kids know what they need. When adults provide them with space, time, materials and a listening ear, kids know exactly what to do. They need to talk about the person they lost. They need to know that the adults in their lives can hear them without turning away or handing out platitudes. They need to know that they are normal, that their thoughts and feelings aren’t bad or wrong. And they need to know that the feelings will come and go, and that it’s okay to play and have fun anyway, even amidst the sadness.

After the room had emptied, as we scraped wet toilet paper off the cinder block walls, Shani said, “Isn’t this exactly where child life belongs?!”

Yes, my dear friend. This is exactly where it belongs, in the community where the children live day in and day out, and where death is stupid, scary, mean, weird, confusing and heartbreaking.

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Paper Tigers

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What are paper tigers? Well, they refer to a byproduct of trauma. When kids grow up in environments where toxic stress is an everyday occurrence, their brains wire to keep them in a constant state of fight or flight. They are perpetually on edge, vigilant in assessing their surroundings for dangers, real or imagined. The imagined dangers are paper tigers, not real but emanating from traumatic experiences and just as threatening as a raised fist or an unwanted touch.

The documentary Paper Tigers depicts a school in Walla Walla Washington where teachers and leaders have found a new way to reach and teach kids who see paper tigers around every corner. Instead of responding to acting out teens with punishing discipline, they seek to understand the adverse childhood experiences or ACEs that effect their students and get in the way of their learning.

More than two decades ago, two respected researchers, clinical physician Dr. Vincent Felitti and CDC epidemiologist Robert Anda, published the game-changing Adverse Childhood Experiences Study. It revealed a troubling but irrefutable phenomenon: the more traumatic experiences the respondents had as children (such as physical and emotional abuse and neglect), the more likely they were to develop health problems later in life—problems such as cancer, heart disease, and high blood pressure. To complicate matters, there was also a troubling correlation between adverse childhood experiences and prevalence of drug and alcohol abuse, unprotected sex, and poor diet. Combined, the results of the study painted a staggering portrait of the price our children are paying for growing up in unsafe environments, all the while adding fuel to the fire of some of society’s greatest challenges.    (http://kpjrfilms.co/paper-tigers/about-the-film/)

Adverse Childhood Experiences include eight experiences that impact future health and longevity of children. They fall into three categories: Abuse, Neglect and Household Dysfunction. The eight ACEs are physical, emotional or sexual abuse, physical or emotional neglect, and whether mental illness, the incarceration of a relative, domestic violence, substance abuse or divorce are present in the home environment. The more ACEs present, the worse the outcome.

That’s the bad news.

The good news is that something can be done. Trauma informed therapy and emotionally responsive teaching are two interventions that can buld resiliency in children facing traumatic stress.

Last night I had the pleasure of sitting on a panel made up of policy makers and practitioners  who work tirelessly to address the inequities that perpetuate toxic environments for large numbers of our country’s children. The US rates number two in developed countries for  how many children live in poverty, second only to Romania. In my eyes that is nothing short of a crime. Poverty is the single highest variable coralated with ACEs.

We screened the movie for a standing room only audience at the Grace Church School in Cooper Square in lower Manhattan. Moderator Andrew Solomon, the Pulitzer Prize finalist and author of Far From the Tree: Parents, Children, and the Search for Identity, led us in a lively discussion of the film, fielding questions from an audience of parents, teachers and community leaders.The event was sponsored by many schools and community organizations, including The First Presbyterian Church, Go Project, St. Francis Xavier Catholic Church, NIP Professional Association, Academy of St. Joseph, Prevent Child Abuse New York and the Corlears School. The room was filled with caring citizens who want to see change. Teachers spoke about their own trauma in working with troubled children in broken schools with no resources or administrative support.

Joy Farina Foskett, the organizer of this important event, reminded us all that ACEs cross all socioeconomic boundaries and exist in every culture. Some of the panelists themselves spoke to the ACE of divorce in their own families. We listed some valuable resources in the program: community organizations, websites and books. Included in the list are “Divorce is the Worst” and “Death is Stupid”, two great books by Anastasia Higginbotham, that help adults open up important conversations with children who may suffer alone through painful ACEs. Kathleen McCue’s “How to help Children Through a Parent’s serious Illness” is another great resource to assist parents and teachers.

Trauma informed, emotionally responsive teaching seems like a no brainer. It doesn’t cost more money, and it prevents costly medical care, incarceration and strengthens our country’s most valuable asset, our children. If it worked with teens who’d already been labeled as unreachable and no good, how much more could it do within early childhood settings? In Early Intervention?

We were all left with one question on our minds. Why isn’t every school in the country following in the footsteps of Lincoln Alternative High School? What are we waiting for?

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Driving the Camel: Installment #5

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Chapter 4: You Have to Point it Down

Of course not everything revolved around my cancer. Life has a way of constantly unfolding in and around crises, and one of my dearest friends was on the cusp of a wonderful life transition. I’d known Isabel since my days in graduate school when we acted as course assistants for a beloved professor and mentor. When I received the call to teach at the college, I’d invited Isabel to co-teach with me. Our friendship had grown from there. We’d shared many meals deep in conversation about our lives, sipping sake and sharing our mutual adoration of food. She encouraged me to step out of my comfort zone and we’d gone on yearly vacations together, exploring places I had never even thought of visiting.  But all throughout those fun times, she had always wanted to be a mother. As an early childhood educator, she visited the homes of families and performed assessments for infants and toddlers with suspected delays. Isabel loved babies more than anyone I knew, but at the age of 46, had yet to find a mate who shared her dreams of family.  

The year before I got sick, Isabel made the announcement that she would go it alone and began the laborious process of applying to be an adoptive parent. I drove her to the adoption agency located in Pennsylvania, so that she could make a video to be shown to prospective birth parents. It was a sunny spring day and we enjoyed escaping the city as we headed southwest through New Jersey. Continue reading

Is Reblogging like Regifting? Here is Teacher Tom: Eleven Things To Say Instead Of ‘Be Careful’

 

Forgive me for reblogging someone else’s great ideas today. But Teacher Tom’s words and images of children enjoying “risky” outdoor loose parts play moved me. And he has such great suggestions for how caregivers can help kids take good risks and explore their worlds unafraid, even as they learn how to be safe and think through their play. Thank you Tom! Click below for his article.

Source: Teacher Tom: Eleven Things To Say Instead Of ‘Be Careful’

What Kids Need During Holidays

 

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No matter what holiday you celebrate, kids have certain needs that adults should consider during the holiday season (and all year round!).

Here is my round up of reminders for adults who are rushing and stressed with the many tasks and obligations of important holidays.

Kids Need:

Routine – Kids feel safer and calmer when following daily life routines. Holidays throw routines up into the air like confetti, and the result can be unpleasant for everyone. Whenever possible, keep sleeping/eating/napping/family-time routines in place.  If you can’t, talk to your children about what to expect. Where are they going or who will visit? What will they do and see? What is expected of them? Consider making a family calendar together depicting special events, and have children place a sticker on each day at they count down the days leading up to and including the holiday.

Play time – All children need time to play and unwind, and I am talking about  open-ended play, as well as games, art and cooking activities and physical play where they can run , jump and climb and get their sillies out. Make sure they put down their electronic devices and get away from screen time.

Permission to not perform – Sometimes when we get together with family and friends over the holidays, kids are expected to be squeezed, pinched, hugged and kissed by relatives who may need this affection a lot more than the child does. If your child has sensory issues or a history of trauma, this kind of touch can feel unbearable. You can talk with your child about this phenomenon prior to gatherings and coach them on how to respond to adults in a way that is polite but helps them maintain their body integrity. You may need to run interference and advocate for your child with well-meaning relatives, letting them know what kind of touch your child can tolerate.

Positive Limit Setting – All children need limits, especially those who are wired from too much holiday sugar or excitement. However, a constant barrage of “No!” “Stop that!” “Behave!” can wear thin and get you nowhere. When setting limits, ask yourself, is this a limit that needs to be set, or am I being arbitrary? If the limit is necessary, take a few deep breaths and try your best to remember these steps.

  1. Name the feeling or desire the child is showing before you set the limit. “Your are so excited.” Or “You really want that toy.” Or “You are so mad at your brother”.
  2. Set the limit  with a calm voice in a concrete way. “The furniture is not for jumping on” or “I am not buying toys today” or “Your brother is not for hitting.”
  3. Offer an alternative.  “Let’s run/play/dance/get your sillies out.” Or “You can play with your toys when you get home.” Or “You can punch a pillow or stamp your feet”
  4. Repeat if necessary, but give the child a chance to reign it in and make a good decision first. They might surprise you. Avoid over-explaining why the limit needs to be set. This tends to escalate negative behavior.

Moderation – The onslaught of media can turn the nicest child into a black hole of greed – commercials are aimed at children and can overstimulate them with desire for toys that may or may not be appropriate or affordable. Try to limit unsupervised screen time. Help children narrow down desires to a few affordable choices by making lists together. More is not always better. It is okay to say “No” to their requests without shaming them for wanting the toy – blame it on the advertisers! And try not to feel guilty if you cannot afford gifts. Your love and attention are the most valuable gifts you can give them.

The video below is a great reminder to us all about what  REALLY matters and what kids really need!

 

 

 

Growing Play Work in the Czech Republic

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The red rooftops of Prague and the Malejovice countryside were a welcome sight this week as I rejoined the Kralovec family in their dream to grow Hospital Play Work in the Czech Republic .

As the Klicek Foundation enters their 25th year, they celebrate not only their anniversary but their entry into a new phase of their mission. In collaboration with Charles University and the Plzen School of Nursing, they are developing a college level program on Play Work, the first of its kind in their country. This is all in addition to the work they do in hospitals for ill children and their families, and the summer camp they run for these families each year. (Click on “summer camp for a beautiful view of the property where they live and work in Malejovice, filmed by Jiri Kralovec, Jiri’s son).

As part of this vision, they invited me to consult with them about curriculum and to teach two seminars on child centered play, a topic that Marketa Kralovec says is much needed in their culture.

“It is such a necessary but unheard of thing here, to follow the child’s lead in play,” she states with feeling.

And so we got down on the floor with play dough, Legos, army figurines and plastic monsters, demonstrating child centered play techniques and then practicing them together.  We also drew play maps, shared stories of our childhood memories of play, played hand games and blew lip whistles –  the hours passed quickly

The Caritas School of Social Services hosted our first seminar. The head of the school, Martin Bednar, welcomed us warmly, expressing his gratitude by presenting me with the book Destinies as hard as stone,  about a sculpture in the school courtyard – The Monument of Stories.  A wooden series of towers house stones from around the world on many small shelves.  Students bring stones from their internships to represent a story that affected them deeply in their learning.  The school gathers for each installment to hear and record the student’s narrative. It is an incredible tribute to the work of students and the people who’ve shaped their lives.

“We are like stones in a river. If alone, the water will wash us away. Together, however, we make up a dam.”

 

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Our second  day of teaching took place in a medieval building overlooking Wenceslas Square in the heart of Prague. Throughout our seminar occasional strains of church bells and the hoofbeats of horse-drawn carriages drifted up to the windows from the cobblestones below. I couldn’t take my eyes off the ceiling of the room, which was crossed by beams of ancient wood and hand painted panels depicting whimsical animal scenes.

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Our students in these two venues included  both undergraduates and working play workers. They showed great passion for the children and families in their care, and a willingness to ask tough questions and share painful memories and struggles. Throughout the students’ stories ran a common thread of the childhood desire for self expression, adventure and kind attention from adults. Child-centered practice definitely fits in with this ideal.   The participants truly brought all of themselves to the learning.  I couldn’t have enjoyed a more engaging and thoughtful group. Not to mention Jiri Kralovec, who was a tireless interpreter, translating my every word.

Please enjoy the photos below, and remember the Klicek Foundation during this holiday season. If you wish to make a donation to this humane and critical work, you can contact Jiri & Marketa, the founders, at klicek@klicek.org for more information.

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Thanks to Jiri Kralovec Junior for capturing our seminars with his wonderful photography

 

 

 

 

 

 

 

 

 

Self-Regulation through Play

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I posted a question poll on  Twitter yesterday to try something new.

What kind of play promotes self-regulation – open ended free play or board games?

At first glance, those of us who work with young children will shout out happily: FREE PLAY! Why? Because it allows children  to explore their environment at their own pace and interests. It provides many opportunities for them to problem solve and access their imagination and creativity.  It gives them feed back loops to build vital connections in their developing brains. It helps them make meaning and gain mastery over childhood challenges or traumas. As Lev Vygotsky said:

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No question. It is great stuff.

But my tweet was a trick question. Structured, close-ended games and toys also have their place in a child’s development of self regulation. When a child is in a stressful situation, sometimes a familiar game like CandyLand or Checkers might help them calm down and feel safe. If a child has played about something that made them feel vulnerable in some way, playing a close-ended game, doing a puzzle or coloring in a coloring book after more open-ended play can shore them up and help them get back to baseline. Board games teach turn taking, frustration tolerance, how to be a gracious winner and how to  lose without losing it.

When we think about how to best support a child’s developmental and emotional being, it pays to provide many different types of play. Sensory play with water, sand, shaving cream, oobleck or play dough is wonderful for toddlers and preschoolers. Constructive play with blocks, legos, cardboard boxes, any raw materials, is great for preschoolers on up. Dramatic play with play dress up materials, puppets, dolls, play food, miniature figurines, etc. speaks highly to preschoolers and young school aged kids. All children need to move their bodies, run, jump, balance, climb and take moderate physical risks in order to gain mastery over their body in space. Preschoolers can be introduced to board games, but the rules need to be flexible and adults should know that it is fine for a young child to change the rules so that they win. When children reach the age of 6 and 7, they can begin to learn to play by the rules and practice winning and losing. Games without toys such as tag, hide and seek, Mother may I, Simon says, kick the can,  and capture the flag teach invaluable lessons in social interactions, and teach kids to rely on themselves for entertainment.

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We can learn a lot through observing a child’s play choices. We can see what they are drawn to and comfortable with, what challenges, pleases or frustrates them, and we can introduce new and less familiar activities to scaffold their growth. We can provide play time and attention as caring adults, and we can also make room for them to play on their own and with peers. Children need time to muck around and explore without an adult agenda always steering their play.

However you slice it, the more playtime a child gets, the more opportunities there are for cognitive, emotional, social and motor development. Advocate for play to be included every day in Pre-K and Kindergarten, and for recess to be part of the daily curriculum through grade school. Kids focus better on academics when they’ve had time to play out their sillies. Keep them growing a head taller than themselves at every turn, and you will be on the right track.

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Taming Tantrums

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Parenting is never easy – it may just be the toughest job in the history of the world. As a mother of two young boys, and a pediatric social worker, Randi Goldfarb  has seen a lot of tantrums in and out of hospitals.

I found that tantrum behavior is universal, and no one knows what to do. Then as a parent, I couldn’t control my own child’s tantrum.

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Randi put on her thinking cap, asking herself how do you help a child calm down  and keep calm? Then she put on her creativity cap and rolled up her sleeves. The result is the keep calm kit©. Continue reading

Retraining my Brain

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I had surgery last week to repair a tendon in my right wrist, which happens to be my dominant hand. With my hand wrapped up like a giant cocoon, I am learning a few lessons quickly.

  1. There are many daily tasks that we perform without much attention or awareness.
  2. My non-dominant left hand is slow and clumsy.
  3. I cannot multitask as I did before.
  4. I am slowing down to a methodical plod with each task.
  5. I am compensating by using my left hand a lot.
  6. This may not be such a bad thing.

“The non-dominant hand is actually linked to the non-dominant hemisphere in your brain – the one that isn’t exercised as often. There are studies that show that when you use your dominant hand, one hemisphere of the brain is active. When you use the non-dominant hand, both hemispheres are activated, which may result in thinking differently and becoming more creative.”http://www.goodfinancialcents.com/benefits-of-using-your-opposite-hand-grow-brain-cells-while-brushing-your-teeth/

Continue reading

Reach for It!

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A community of street vendors lines the sidewalk around the corner from where I live. As I run the gauntlet of tourists and fellow New Yorkers, my yellow lab-pit mix lunges at an unsuspecting flock of pigeons. They burst into the air, settling a moment later. Gracie gives it another go, all but yelling “Hiyah!” as the birds flap around us.

One of the vendors calls out, “You just keep on going!”

I turn to him and smile. “Yeah, can you believe she’s 11 years old?”

“No, you,” he grins. “You’re like the energizer bunny, going and going.”

As Gracie pulls me on, I wonder. Why did he say that? I don’t know his name, but he knows something about me. At the end of my 1.6 mile walk around the reservoir, I return to his food cart.

“Hey, excuse me,“ I say. “Can I ask you a question?”

He turns from what he’s doing and steps closer to his cart window, looking down at me.

“Did you know that I’d been sick?” I ask him. “Is that why you said that before?”

He smiles kindly. “Yeah, I talked to the guy who walks your dog. I asked him about you.”

I let that sink in for a moment. I take another risk.

“You were sick a while back too, right? I noticed you’d lost weight, and then you weren’t around for a while.”

“I lost a kidney,” he replies. “But now I’m 100%.” He says this with a big smile, spreading his hands expansively to measure his improvement. “ What were you sick with?”

“Breast cancer,” I say, without hesitation. “Surgery, chemo, radiation, the whole shebang. Now I’m 100% too.”

I reach my hand into his cart. “I’m Debbie. Nice to meet you, neighbor.”

“Jimmy”, he says, shaking my hand.

I see this encounter as a reminder. I survived some pretty daunting medical treatment in 2013. But I had incredible support from some unexpected places. In addition to a community of colleagues and Bank Street College alumni who did everything from walking my dog to accompanying me to chemo appointments, I had my own secret weapon. I reached into my Child Life bag of tricks for coping mechanisms to help me through. I used play, humor, writing and videography to scaffold my journey.

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This week I face a much less frightening surgery, an outpatient procedure to mend a torn tendon in my right wrist. Until this morning, though, I have to admit I was feeling a bit sorry for myself and pretty anxious about being stuck left handed for the duration of my recovery.

But Jimmy’s witnessing was a reminder. It jumpstarted my awareness of the lessons learned during cancer treatment. I have all that I need. It’s all here. I can handle this. All I have to do is reach for it.

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