The Child Life Maker Movement: Loose Parts Impacting Healthcare

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What happens when you cross a child life specialist with loose parts? Creativity, to say the very least. Specialists have been using loose parts to make the medical world more accessible and friendly for children and families since the beginning of our profession. They combine medical supplies (tubing, gauze, rubber gloves) and household items (paper towel rolls, pipe cleaners, paper clips, felt) to create everything from customized dolls that reflect a child’s medical situation, to a glove-o-phone to help children pass breathing tests. Simple and complex inventions have aided children in making meaning out of their medical experiences.

 

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Now, with the Maker Movement, child life specialists have invaluable opportunities to join brains with other disciplines seeking to improve patient experience and speed recovery.   Bank Street College Child Life alumnae Jon Luongo and Kelly Segar, and children’s book author Anastasia Higginbotham rolled up their sleeves to join the Maker Faire at The New York Hall of Science this past weekend. They joined nurses, doctors, medical technicians and fellow inventors in the Health Maker tent on this brisk and cloudy autumn day.

As children and caregivers meandered through the exhibits, .the specialists shared information about how to make pediatric hospital stays more manageable, less stressful, and more fun. As Jon demonstrated the glove-o-phone, kids jumped at the unexpectedly loud honk it made.

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Exclamations of “Ewww gross!” were followed by attentive curiosity as Jon explained the purpose of the vial of “blood soup” on the table.

 

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Families spontaneously grabbed colorful neon strings and engaged in string play, a simple game that crosses generations, culture and language around the world.

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Kelly demonstrated her Barium Bear, “Barry”, developed to support children receiving barium enemas and scans. She used simple circuitry that she learned from a Hospital Play Specialist in Japan to illuminate the pretend scan.

 

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At nearby tables, radiation techs and doctors showcased how legos can be used to build mini MRI, CT-Scan, and linear accelerator machines. When they are doll sized, they aren’t quite so scary. And when children aren’t as frightened, doctors can administer less anesthesia to their tiny patients, a win-win for everyone.

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Did you know that a A three-D printer can be used to make prosthetic hands for children who have lost theirs to birth defects, disease or accidents? And for a fraction of the cost of traditional prosthetics. And they aren’t just your run of the mill hands either. They are superhero hands! As I observed a three-D printer humming away at one exhibit, I wondered about what kind of mind came up with the idea of this machine. And then who had the amazing idea about the possible application of it in the medical world?

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Wonderful ideas start somewhere, and when we encourage children to explore and create, even in the medical environment, we are investing in their healing and in their future. The Maker Faire was an extraordinary celebration of the possibilities of the human brain. From low-tech to high-tech, creative minds came together in the Health Lab tent to hack medical problems and make the healing process more fun. If you want to get your maker on, I encourage you to find maker spaces near you Challenge your child life staff to a loose parts contest at the next departmental meeting. Jumpstart a health maker group in your hospital and invite staff from throughout the institution to collaborate. And don’t forget your best assets. Find every opportunity to include children in creative problem solving with loose parts. In and out of the healthcare field, children and adults all benefit when we connect with what Eleanor Duckworth called “wonderful ideas.”

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Medical Staff Gotta Play!

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The recent Pokemon Go craze has hospital administrators  flummoxed by their employees’ behavior. Several hospitals have called for a ban on medical staff playing the digital game while at work, claiming that they are ignoring patient needs in pursuit of the free-to-play location-based augmented reality mobile game. There is no question that social media should never come before a patient’s medical needs, but the administrators may be missing an important point.

Adults need to play.

Yup, that’s what I said. Adults need to play.

Articles about burnout in the medical field appear every day on my news feed. Caring professionals exposed to repeated trauma working long hours in tough conditions with impossible patient to staff ratios face compassion fatigue and burnout on a regular basis. There are no easy answers, probably not one thing that can turn this phenomenon around. But if we look at the current Pokemon seeking behavior, it gives us a clue.

Think about recess at school and all the studies that show how increased physical movement and play greatly improve children’s ability to learn, function and lead healthier lives. Why should it be any different for adults? In fact, Alison Tonkin and Julia Whitaker have just published a terrific book Play in Healthcare for Adults: Using Play to Promote Health and Wellbeing Across the Adult Lifespan, that explores the role of play in adults’ health and coping. 

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They show how central play is to our biological makeup and evolutionary history. Play is a crucial ingredient of survival for all mammalian species (Tonkin & Whitaker, 2016). In the forward to the book, Suzanne Zeedyk, a research scientist and founder of connected baby states

We know these truths instinctively. However we relegate them to our private lives and personal relationships. Contemporary culture does not reserve an official role for play in our public, professional lives. Work is serious. Play is not.

That’s why this book is radical. Its editors have been willing to shout loudly about the importance of play in professional contexts.They have been willing to bring theory, empirical evidence, and practical examples to their claim.

Jon Loungo, a child life specialist at Maimonides Hospital Center in Brooklyn, NY, coined the term Tongue Depressor Challenge. It refers to providing medical staff (and often patients) with loose parts , and telling them, “Create something that shows how the hospital experience could be improved, in real or imaginary ways, and include at least one tongue depressor in your project.”  With this 3-D challenge in mind, I allow my imagination free reign in envisioning what the presence of play might contribute to excellent healthcare in hospitals. I picture doctors, nurses, administrators and technicians taking scheduled breaks throughout the work day. I picture play rooms set aside for staff that include expressive art corners, rock climbing walls, trampolines and ping pong tables.  Hey, and what about pet therapy?

Call me crazy.

 

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Rabbit Ray – Helping Kids with Needle Fears

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Esther Wang has a vision. As an entrepreneur, designer and inventor, she has learned first hand what it means to use creative skills to make the world a better place. Esther took up the challenge of “How can we help kids be less afraid of needles?” in Singapore, her native country.  She designed Rabbit Ray, an interactive, virtually unbreakable, washable patient interactive device that empowers even more than it teaches. Continue reading

Get Ready to Play!

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Okay, so call me a nerd. Few things bring me more joy than teaching a subject that I love with a colleague who has even more passion and enthusiasm for the subject than I do. I have had the pleasure over the years of co-teaching with many wonderful and talented colleagues – Betsy Wilford, Elizabeth Laureano, Edna Garces, Karen Marschke-Tobier, Caitlin Koch and Jon Luongo, to name a few. In each of those situations, whether it was Sunday school, a therapeutic nursery school, graduate school, in another country, or at a conference, I became a better teacher within the partnership than I ever would have been alone.

And now, as I prepare for my upcoming gig at the Child Life Council’s 34th Annual Conference in Orlando, Florida next week, I celebrate the colleagues that I will be teaming up with.  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

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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