Glue & Ballast

I am wondering how many people out there are feeling a bit broken these days. Whether you are parents, teachers, child life specialists, essential workers, or caregivers, whether you live alone or navigate relationships and conflicting needs at home amidst the pandemic, are there times when you feel — well — certainly not at your best?

Monday was a day like that for me. I was following my typical morning routine that involves prayer online with the Church of the Heavenly Rest. I settled onto my couch and lit a candle while my laptop booted up. I signed into my email and clicked on the Zoom link for the video connection …… and all I got was an ERROR message. Thank God I was quickly able to find a workaround. I dialed in with my phone while I reached out via email to Lucas, the program organizer at the church, and simultaneously tried another browser. I was into the service in a minute or two. You would think that I might feel accomplished at this feat of multitasking, but here is the thing. Even though I was functioning and problem solving in real time, I was also bawling my eyes out, with all the unleashed vigor of a toddler.

And I cried so hard that there was no way I could turn on my video or microphone once I got into the service. I think I scared my dog too.

Since the pandemic began, I have only missed one service, and that was for a medical appointment. Amidst the tears yesterday, I was struck by how dependent I’ve become on the routine and comfort that morning prayer provides me: the reverend Matt’s steady, soothing and cheerful presence, the stalwart group of parishioners, who, like me, show up every day, helping one another carry our collective burdens and celebrate our joys. The predictability of the liturgy.

In that brief moment of disconnect, I felt panic at the thought of not being able to join in the service. The panic was followed by a crushing wave of grief, all out of proportion to the situation, but greatly indicative of the accumulated losses of these past 5 months.

The misery of the moment didn’t dissipate. It sucked and pulled at me like quicksand for most of the day. It wasn’t until late afternoon that the despair began to lift. But I can see the seeds of recovery planted throughout the day, some even in the midst of my emotional tornado. The kindness and speed with which Lucas responded to my distress. A chat with a friend midday. In the early evening, another daily ritual, FaceTiming my parents. Our conversations are as predictable as liturgy – we share the highlights of the day, whether or not my folks went for a drive to their local farm, or my dad went for a walk. We ask one another what we are having for dinner, I ask what wildlife they’ve seen, and my dad tells me a bad joke that he saw on the internet and memorized just for me. My mom busts my dad’s chops for hogging the phone, and then joyously exclaims, “There you are!” when he turns the phone her way so that she can see me.

These conversations are the glue and ballast that hold me together.

But there’s more to it. After I wished my parents a good evening, a friend called me and asked if I could spare some time to listen to her about the hard day she’d had. While I listened, nursing a cup of tea, I remembered what Matt had said earlier that day, that when people are struggling, they don’t always need advice. Sometimes, the listening, the gentle witnessing, and just asking the right questions is the way to go, so that our loved ones can access the answers within themselves.

Later in the evening, the phone rang again. This time, it was a child life colleague seeking some support as she prepared for a radio interview. After we discussed her plan of action, she went on to share some great stories of how she has been using Loose Parts to help hospitalized children make meaning out of their medical experiences. When I hung up the phone from these conversations, the change in my mood was nothing short of remarkable. How could it be, that during such a low day, when I felt so beaten down and miserable, the universe could make such good use of me? If loose parts are what children need to make sense of their suffering, it seems that encounters with others, be they friends, colleagues, family or strangers, can serve as our loose parts. Our mutual conversations and witnessing can bring solace, perhaps a shift in perspective, and sometimes even an answer or two. The amazing part is that we don’t have to be at our best to show up and make a difference.

I have a porcelain angel who has knelt in a state of constant prayer on my bedside table since I was a small girl. She is somewhat worse for wear, battered, stained and the tips of her wings broke off years ago. But she brings me comfort every night.

It’s not just how others shore us up when we stumble. It is how even in our brokenness, we can be the glue and ballast for others, and in doing so, burgeon our own healing and open our hearts to the presence of a love beyond our understanding in the midst of our suffering.

For your listening enjoyment, click on the link below.

Blackbird by the Beatles

Klicek Hospice Summer Camp: Kinderspiel Czech Style

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drawing by Markéta Královcová

A Diverse Community

My second stint as a volunteer at Camp Klicek in Malejovice, Czech Republic was as joyful and soul-filling as my time there last year.  The camp is special in many ways, but there are several unique facets that really stand out in my mind.  First, campers are encouraged to invite family and friends, and most campers have at least one sibling, parent, cousin or grandparent accompanying them. Most participants have been affected by an illness, developmental delay, death of a family member, poverty, racism, or incarceration. The campers range in age from one year to twenty-one (higher if you count the adults!) and come from such diverse backgrounds and situations that they form a very unlikely community of intersectionality.  This two-week summer camp brings together these widely varied individuals to partake in an environment steeped in nature, nutrition, community, and simplicity.

The Context of Nature

Children sleep in towering teepees and smaller tents constructed in a field behind the main house, a 100-year-old converted schoolhouse equipped with wheelchair access, hospital beds, and three working kitchens. The field harbors an orchard and several gardens that produce fruit and vegetables for meals and flowers that adorn each table in the mess tent. At breakfast, preserves made from this year’s crop of strawberries smother daily fresh bread from the bakery, accompanying homemade porridge with gingerbread crumble. Every meal is taken outside, and all campers gather several times a day for large group activities.

Real Play

The lengthy summer days, temperate climate, and loose structure of the day leave ample opportunity for the simple kinds of play that seem to be disappearing in today’s wave of technology. Campers are asked to turn in their cellphones each day, and are encouraged to find what they enjoy and make the most of each day. Whenever I offered to help out in the kitchen, I was instead encouraged to “Go play with the children. That is a better use of your time.” And so I too was free to enjoy the spontaneous kind of play that forms the building blocks of childhood.

Here are some examples:

Hand Games

I taught the kids how to play “Butcher Make the Meat Red”, a hand game where one player attempts to slap his opponent’s hands while the other player evades pain. They taught me how to play a finger counting game. Thumb wrestling and criss cross (patty cake) needed no translation.

Rough & Tumble Play

Kids don’t always get a chance to engage in gross motor rough housing play. Here they had plenty of opportunities for this without adult interference.

Feats of endurance:

Kids spontaneously tested their own strength and cheered one another on. Football (Soccer in America) and a Camp Klicek version of baseball (involving knocking over cans and running bases) are also popular.

Loose Parts Play

The children chose names for their teams (there were three teams for chores and competitions), and then found loose parts in nature to depict their team name. The foundation has an ocean theme running through it, which is hard to explain for a land-locked country. But the teams were encouraged to include this theme of being at sea in their chosen names. Here are the results.

“Rats from Below the Deck”

Mussel and Green Psychodogs

Nails on the Sea”

Forrests and Fields

There were many opportunities to walk and play in the neighboring forrest and fields, gathering campfire wood, building fairy houses, and searching for buried treasure.

Imaginative Play

Last but not least, the younger children explored toys, dressed up in princess garb, and played with music.

This smörgåsbord of play is a perfect real world representation of the lovely parting gift I received from Jiri and Marketa Kralovec upon my last day at camp: a print of Pieter Bruegel’s 16th century painting of Kinderspiele.

I came home filled to the brim with fresh air, incredible food, and most of all, play and excellent company. Thank you Camp Klicek!

Stay tuned for my next blog, where I continue to share camp photos and stories.

Cooperative Play in Nature at Camp Klicek, Czech Republic

the volunteers!

Photo credit: Jiří Královec

(Thanks to Jiří Královec for many of the photos! The best ones are his and noted beneath each photo. The rest are my amateur work.)

At Camp Klicek in the Czech Republic, a place where children and adults affected by illness and loss gather, activities run the gamut from a tiddlywinks tournament to bussing campers to a Shakespearean play.  The Accace Corporation provides tax advice to the foundation during the year, but they look forward to visiting the camp in person to have fun with the children and families each summer. This July, a fabulous group of volunteers  arrived with a day full of activities to engage us all. Their choices promoted creativity and cooperation amongst the campers, and nature threaded its way through the day’s activities. The volunteers brought their A game to the endeavor – with wonderful materials and activities – but more than anything, they brought their hearts. Continue reading

Making Hospitals More Hospitable with The Tongue Depressor Challenge

 

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My colleague, child life specialist Jon Luongo, is one of the most playful professionals that I have the pleasure of knowing. He taught me all about the “tongue depressor challenge”, which is described in detail in our co-authored chapter in the Handbook of Medical Play Therapy and Child Life.  Below is a brief introduction to the activity by Jon:

I encourage the doctors to tap into their imaginative playfulness to complete what I call the ‘tongue depressor challenge.’ The task is to co-construct a teaching tool alongside a patient to explain a part of the body, a particular medical condition, or piece of medical hardware. The challenge for doctor and patient is to use at least one tongue depressor in their design; like a single LEGO brick in a set of construction toys, the tongue depressor represents a humble piece of medical paraphernalia with limitless creative building potential.

 

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As with many great ideas, I borrowed Jon’s and tweaked it a bit. This past July, I brought the activity with me to the Klicek Foundation Summer Camp in Malejovice, Czech Republic. Camp directors Jiri and Marketa Královcovi graciously allowed me to lead the campers in a slight variation on Jon’s theme. Continue reading

Free Talk: Medical Play Therapy & Child Life

Bank Street College Library

Presents…

Library Salon #15

Friday, March 9, 2018

5:30 to 7:30 pm

A panel discussion with child life practitioners
and alumni contributors to:

Moderated by: Troy Pinkney-Ragsdale, MA, CCLS, has over 25 years of experience in the field of Child Life, including directing several child life programs in the tri-state area. She has served as the director of the Child Life Masters Program at Bank Street College since 2004. She has been a member of the Association of Child Life Professionals, served as the Co-chair of Graduate Accreditation Task Force and member(2012-2014),  served as Director on the Board (2015-2017) and has been a member of the Education and Training Committee for many years.

Panelists:

Lawrence C. Rubin, PhD, the editor of the Handbook of Medical Play Therapy and Child Life, is a professor of counselor education at St. Thomas University in Miami, Florida, and an online lecturer at the University of Massachusetts. Dr. Rubin is a practicing psychologist in Fort Lauderdale, where he specializes with children, teens, and their families.
Jon Luongo, MS, CCLS, is a Bank Street graduate, past adjunct instructor, a delegate with 1199 Healthcare Workers’ Union, and a child life specialist at Maimonides Medical Center in Brooklyn, NY. He began his career in healthcare as a performer in the Big Apple Circus Clown Care Unit in 1997.
Suzanna Paisley, MS, CCLS, is a Bank Street graduate, a parent of two young children, and a child life specialist at Children’s Hospital Colorado. She has lectured on trauma processing with children of all ages at national child life conferences.
Deborah Vilas, MS, CCLS, LMSW, is a Bank Street graduate, a current faculty member, a writer and a public speaker. She has taught play techniques to child life students, hospital play specialists, nursing students, social workers and psychologists in 6 countries around the world.

Patty Weiner, MS, is a mother and grandmother whose career spans over 35 years as a child life specialist and educator. She is the founding director of Bank Street’s Child Life Program and is an educational consultant for The Making Headway Foundation in NYC.

Library Salons are a series of informal lectures, panels, and group discussions
held after hours on Friday evenings.Refreshments Provided#BankStreetLibrarySalon

Copyright © 2018 Bank Street College of Education, All rights reserved.

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Get Well Maps: Road to Recovery

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Please welcome our guest blogger, Christina Connors, who I interviewed after she connected with me on Linked In and sent me samples of her incredible Get Well Maps.

What inspired you to create these maps? My son’s medical experience in 2014, and my desire to help other children and families facing medical challenges, inspired me to create Get Well Maps. Andrew was 5 years old when he was hospitalized with bilateral pneumonia and H1N1 flu, and his condition quickly became life threatening. He was air lifted to our closest pediatric hospital (~2 hours away) and was transferred to the PICU secondary to respiratory failure. I felt completely helpless to care for him. There were so many uncertainties. My “Mama Bear” impulses were raging, and yet my background as an Occupational Therapist was underpinning every effort I made to advocate for my child.

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I felt compelled to have a visual that would depict his “Road Home”, because despite the uncertainty of prognosis, timeline or discharge plan, we needed to SEE our goal of getting home in the midst of adversity. I asked my childhood friend to make a map that had a road, photo of our home and matchbox car to move along as his condition progressed (My son has always loved anything with wheels). She was eager to do anything to help, but found it strange that my request of her was a “craft project” (Child Life Specialists & OTs get it). She graciously obliged, anyways. What began as a desperate mother’s attempt to provide a tool to help her child, began to draw interest from his medical team, and sparked communication that connected us throughout his care (“Is that your house?”, “Do you like to play outside?”, “Buddy, you’ve already rounded that bend”…). It was months after our experience, and after becoming involved in our pediatric hospital’s Family Advisory Committee, that another parent encouraged me to develop this idea in a way that would help other children and families throughout their medical experiences.

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What was the process like from your idea to creating the product and your company? I would be lying if I said I wasn’t scared! I was exposing a time in our family’s life that held much vulnerability. But I was also excited about the possibility of having a creative outlet that helped me process our experience in a way that helped others. My faith was strengthened by our experience, and I felt like I was being called into this work. I felt that this was a unique opportunity to combine my experience as a parent and healthcare professional (& my husband is an educator) to make a positive impact in the healthcare experiences of other children and families. I began slowly. Brainstorming, then drafting prototypes, researching materials, production options, searching for the right illustrator, and learning the basics of establishing a business. I use the analogy of a foggy road when I think about the process of transforming an idea into a company, and even now as I continue to navigate and evolve. I can’t always see where I am headed because the road is foggy, but when I have faith enough to move forward, the fog lifts briefly and becomes a little clearer just in front of me, which in turn gives me the confidence to keep going. (Just can’t seem to get away from the road/car analogies!)

Can you tell us a bit about your work as an OT and your experience as a mom? I graduated from the Occupational Therapy program at Towson University in 2002, and have been practicing as an Occupational Therapist for 15 years. I became interested in Occupational Therapy after my Aunt was in a car accident and sustained a C4-C5 spinal cord injury. It was the 1st time my family was truly impacted by disability and I was inspired to learn more about the professionals that were helping her. Since beginning my career as an OT, I have always had an equal love of pediatric and adult rehabilitation. I have experience in hospital, inpatient rehabilitation, home healthcare and school settings. I have always found my work as an OT very rewarding, and am very passionate about working with individuals with neurological disorders and sensory needs. My greatest loves… my hubbie, Mike, and my 2 children are at the center of my world. There was a lot we experienced emotionally as a family during and following my son’s hospitalization that changed my perspective as a mom. I don’t worry as much about small decisions and details, don’t take as much for granted, and really value the importance of finding moments of “calm” in our hectic day-to-day routines. Their love, support, and boundless energy are driving forces behind Child Inspired.

What do you want parents and medical staff to know about children in hospitals? I think many already know, but I think ALL medical professionals need to know that (many, if not most) children and families are not processing auditory information effectively during stressful medical events. Children and families want (and need) medical teams to disclose accurate and honest medical information, but it needs to be delivered with a compassionate, child-centered approach. Don’t be scared of informing children and parents of setbacks or regressions in progress. They know setbacks occur. They just need consistent, jargon-free language that helps them understand what is happening and supports them through the disappointment. Families and medical professionals also need to know that emotional healing will often take much longer than physical healing, and need to be educated on resources that the family can access if emotional or behavioral concerns arise after discharge.

 

What are your hopes for your company? My hope for Child Inspired is that our Get Well Maps will become a model for child-centered discharge planning, and that our tools will also help children and families visualize their progress as they re-integrate back into school and community activities after medical events. In this fast-paced, digital age where much of what our children encounter is instant gratification, many children need support and encouragement as they work towards goals that require time and perseverance. It is my hope that our Maps facilitate positive, encouraging language and communication between children and the adults providing their care.

 

Do you have any tips for how parents and child life specialists might use these maps? I love your profession and the amazing work that you do with children, siblings and families, as well as the work you do to model and advocate for child-centered care among your other medical colleagues. I think that Child Life Specialists can play a pivotal role in daily medical rounding and discharge planning, and that Get Well Maps provide a method for facilitating child-centered communication and visually tracking medical progress. A Get Well Map is fun, and individualized to the child’s interests and goal, therefore, it reduces anxiety by helping you relay and reinforce information discussed in medical rounding (often laden with medical jargon) in a way that is developmentally appropriate and child-centered. Contact us to learn more about how a CCLS is using Get Well Maps with children after bone marrow transplants, and how her unit now has a physician order and pathway to initiate Child Life assessment and intervention (including Get Well Maps) from diagnosis to discharge.
Anything else you want us to know? Thank you for all that you do! As always, I would love to collaborate with you and your teams to develop solutions for your patient populations and healthcare organizations.

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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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Less anesthesia – More play for MRIs

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Erik Ranschaert and Ben Taragin

Dr. Benjamin Taragin knows a lot about what kids need when facing radiology scans. He has spearheaded the production of a miniature MRI model using toy building blocks, so that children can play about their experiences before and after scans. When I asked Dr. Ben about how this all came about, he shared the following narrative. We hope you will be inspired by his story and jump on board to help make his I Love MRI kits available to any child in need of an MRI.  Continue reading

Driving the Camel: Installment #8

 

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Homesick

 

Once the conference began, I was surrounded by like-minded professionals, everyone eager to learn and share.  In order to earn my keep, I was slotted to present three times on three topics, the first a workshop on play techniques to use with angry or withdrawn children. The audience was receptive and participants volunteered readily to assist me in demonstrating several activities. They shared what made them angry, hurled wet toilet paper at a paper target, and erupted a play dough volcano with glee.  Continue reading