Wonders of The World: Hope & Resilience Amidst a Pandemic

Camp Klicek, Malejovice, Czech Republic

Playing at a Distance

As a consultant working with the child life team of Sabara Children’s Hospital in Sao Paulo, Brazil, I am so grateful to be in close contact with them during the COVID19 crisis. I meet regularly with the clinicians online to discuss their work with children and families (currently they are working at a distance, as they are sheltering in place). In order to support their challenging work during the pandemic, we have spent the last several sessions together participating in creative arts activities, such as the ones I have been blogging about. Today, we did one of my favorites, Wonders of the World, adapted from Rebecca Carmen’s Helping kids heal: 75 Activities to help children recover from trauma and loss. As we play together via What’sApp, the team benefits from the parallel process of participating in a relaxing, inspiring activity which they can then bring to the children and families in their care.

Shizuoka University, Japan

Activity Instructions

Introduction:

The Wonders of the World activity is meant to instill hope and resilience in children and adults who may have difficulty picturing their lives beyond the walls of sheltering in place. It has been used with hospitalized and traumatized children and teens for the same reasons. Sometimes it is hard to imagine our lives beyond the present situation. It can be a challenge for us to move our bodies when we are leading a more sedentary existence. This activity is a great way to get us up, moving, and interacting physically when we do a life-sized body tracing. More conversation and joy tend to occur when we do it on the larger scale, but it still has therapeutic value and is enjoyable when done on a smaller scale with the outline of a body on drawing paper.

I have conducted this activity with nurses, hospital play specialists, social workers, psychologists, hospital administrators, and children in the Czech Republic and Japan. Thank you to the Czech and Japanese students and professionals in the photos.

Materials

  • Drawing paper with body outline (Links to an external site.) or butcher paper on which to trace your body, should you decide to do this with a friend or relative. Participants can also be invited to draw their own body outline on a piece of paper.
  • Pencil/Pen
  • Crayons/Markers/Watercolor pencils/Paint

Instructions:

You can use the body outline provided, or on large butcher paper, whiteboard (or sidewalk chalk if you want to do it outside!), have someone trace your body. The body tracing can be done lying on the floor/ground or standing against a wall.

Tokyo, Japan

Decorate the body outline with facial features and clothes.

Imagine your life in the future outside the pandemic quarantine. Then draw/paint the following items on the outline or anywhere on the paper that seems appropriate:

  • What you want your eyes to see in the future
  • What you want your ears to hear in the future
  • What you want your nose to smell in the future
  • What you want your mouth to taste in the future
  • What you want your heart to feel in the future
  • What you want your hands to do or make in the future
  • Where you want your feet to take you in the future

Activity Tip

  • Consider playing music in the background to accompany drawing (kid’s choice), maybe a childhood favorite.
  • If a participant is reluctant because they feel they cannot draw, encourage them to pretend they are an artist.
Jess in Sao Paulo, Brazil

Reflections

The sharing out is one of the best parts of this activity, both during the artwork and after.

Today, Jess shared: “When I imagine what could happen, I think of my friends all at the bar – so here we all are hanging out at the bar. I am missing my muay thai. The classes were in the middle of the process of my self perfection. I want to go to the beach and the sand and to smell the smell of the beach. The wave represents things coming and going.”

Dora in Sao Paulo, Brazil

Dora shared: “I put different colors for different feelings and senses. I want to be in nature, because when we go out now, it is just buildings and concrete. I want to hear the wind in the palm tree. I am listening to music a lot. It helps make the days more light. Here is a bird singing. I would like to hear news about a cure for COVID, so I put medicine here. I want to see landscapes, the Christ the Redeemer in Rio, because my best friend lives there and I won’t be able to be there now.

I want to smell the wet ground after rain. I would like to eat the cheesy bread of my grandma, a very special recipe. I would like to feel myself with all things that make me feel safe. We aren’t in a safe context right now. I want to touch things and people and hugs, touching things without fear. My feet want to go to the sea and the sand, and I also put paths to different routes and ways to walk without fear and with freedom.”

Leandro in Sao Paulo, Brazil

Leandro shared: “I think like a kid. At first I was doing philosophy, and it was too hard to think of big ways to change the world because I am so tired. But then, I tried smaller concrete things, and it was easier. I would like to be in nature now and to eat vegan cheese bread and good coffee.

My feet are on the beach between the water and the sand. My hands hold an electric guitar because that is what I want to hear. My eyes want to see the forrest and to smell the forrest – the trees and the green.

My heart is a yin yang because I want to feel good things, but I understand that it doesn’t happen every time. I understand the balance of the good and the bad. “

Thank you, Team Sabara, for doing such great work all the time. You inspire me.

Everyone Poops: Family Play Activity for Sheltering In Place

Humor as a Coping Mechanism

How many of us are feeding our souls with hilarious made-at-home videos about the coronavirus? There is some pretty amazing creativity happening out there, individuals and families who are using humor to cope and sharing their art with the rest of us through social media. I have several favorites, the Sound of Music one, and a family remake of Les Miserable’s One More Day. If I could figure out how to copy one from FaceBook, I would have included a video Yigal Azaria that has made me laugh loudly, something that is not so easy to these days.

Materials

  • Bran cereal – the kind that looks like twigs (but any cereal will do, and so will other ingredients like dry dog food).
  • Two zip lock bags, quart sized (because the first one may break as you pound and crumble the cereal)
  • pitcher/glass/cup of warm water
  • loose parts digestive tract made from items you might find around the house, plastic bags/umbrella bags, string, cardboard…..
  • tape, glue, staples (whatever way works best to make digestive tract)
  • Scissors

With humor in mind, I am stepping out on a limb to introduce a family activity that we have used in hospitals to help kids play and laugh about bowel issues that are usually a cause for shame and embarrassment. Many kids with chronic illness, disabilities, cancer, or trauma suffer from intestinal difficulties, toileting issues and discomfort. Playing about it can break through the shame and silence, teach children about how their bodies work and how healthy diets, hydration, and exercise can keep things running smoothly. Perhaps in this time of sheltering in place, we aren’t getting the exercise or diet we need to stay regular. So, bare with me and I will lead you through a fun, gross, and silly activity for the whole family.

Family Connection in Hard Times: Play Maps

Sheltering in Place

Welcome to the new normal, at least for now. In this time of forced seclusion due to COVID19, nuclear families are spending more time together than ever before. Parents are juggling so much – keeping their family safe from infection, their own work, profound stress if they aren’t working, their children’s schooling, their worries about vulnerable and elderly family members, and everyone’s myriad of coping mechanisms – some functional, some less so. We are all doing the best that we can, and sometimes it just doesn’t feel like we are doing a great job. But, hopefully, we have compassion for ourselves and one another, and we forgive ourselves when we lose it. Then we regather, and keep putting one foot in front of the other.

There may be some silver lining for many families though. Perhaps there are moments of unexpected joy and closeness. Maybe we are putting down our devices and grabbing moments to play games, read aloud, enjoy nature, watch movies, cook together, or just to snuggle. In this vein, I want to share some of my all time favorite family activities over my next several blogs , They were designed for child life specialists to do with hospitalized children and families, but they are perfect for family fun at home. They are all affordable, need minimal supplies, are simple and guaranteed to spark fun and connection. The one I will focus on today is called Play Maps.

This Little Light of Mine

To Look or not to Look: That is the Question

In times of uncertainty, when there is so much out of our control, one of the things that is within our control is how we show up for others. And how we show up for others often has a lot to do with how we show up for ourselves. Since my posting last week, my self care regimen has taken on a whole new look — prayer and yoga are now online rather than in person. Each day I have decisions to make about how I spend my time, who I am in contact with via phone and video conference, and how I interact with others.

Child life specialists are trained to acknowledge and respect the many and varied coping mechanisms of children and families in hospitals. We are trained to assess, respond to, and expand these coping skills. For example, some children like to watch when they are undergoing an iv insertion. Others would prefer to close their eyes, blow bubbles, or search for items in an I Spy book. Some children want to know every detail about their diagnosis and treatment, while others prefer to skip the details.

Wonder

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“Doctors have come from distant cities just to see me. Stand over my bed disbelieving what they’re seeing. They say I must be one of the wonders of God’s own creation. And as far as they see they can offer no explanation… Oh I believe Fate smiled at Destiny. Laughed as she came to my cradle. Know this child will be able. Laughed as my body she lifted. Know this child will be gifted. With love, with patience and with faith she’ll make her way.”

–Natalie Merchant

I am not sure of when it was that I first heard Natalie Merchant’s song “Wonder”, but each time I do hear it, it resonates deeply with me and I feel incredibly witnessed and uplifted.

In the early morning hours of my birth, the doctor gravely informed my parents that he had little hope for my survival. He actually discouraged my mother from naming me, in a misguided effort to help her accept the inevitable. I was born with a rare genetic skin disorder, Congenital Ichthyosiform Erythroderma (CIE). I made my first appearance on earth encased in a collodian membrane  – a tight outer layer resembling plastic wrap, looking as my father loves to say, like a “shiny red sausage”. The doctors didn’t know what to make of me. They had no name for my symptoms, no explanation for my appearance. But their worry about my skin’s ability to provide a sufficiently protective barrier led them to believe that I would not survive.

 

I spent one month alone in the hospital, as doctors searched high and low for a diagnosis. Parental visits were discouraged. They finally suggested that my parents seek an answer at a larger children’s hospital. My parents held me for the very first time in the back seat of the car, as their friends drove them the hour and a half to New York City. Another month passed before I was discharged, still without a diagnosis. The hospital cautioned my parents that the road ahead would be a rough one, and they highly recommended that my family employ a full-time nurse to see to my complicated needs. My mother balked at this. “I’m her mother,” she said. “I am the only nurse she needs.”

 

My diagnosis came soon after, when Dr. Charles Sheard, a dermatologist in Stamford, CT, observed that I appeared to have the same symptoms as one other patient he had read about in some obscure medical journal. Dr. Sheard took me on as a regular patient, seeing me once a week for the first year of my life, then monthly, and as I continued to grow and develop, annually throughout my teen years. He never charged my parents a dime. Although I suffered some complications and hospitalizations during childhood, my health stabilized and I have grown to live a full and rich life with few limitations. When dermatologists examine me, they remark at the seemingly mild case of ichthyosis I have, compared to other patients whose condition hugely impacted their development, mobility, and appearance.

 

I did, however, struggle with post-hospital trauma in the form of sleep disturbances, sensory issues, and severe separation anxiety. Then came the bullying in school. But I had several resilience factors at play in my life. I grew up listening to my parents tell me stories of my early health challenges, referring to me as a survivor and a fighter. My mother too was a fighter and fierce advocate for my medical and emotional needs throughout my growing years.  It should come as no surprise that I became a child life specialist as an adult, advocating for the emotional and developmental needs of children facing illness in hospitals and their communities.  Natalie Merchant’s song “Wonder” reminds me of the miracle of my birth and life, how I surprised the naysayers, and how my mother saw the possibilities and joy in my birth and life more than the dire prognosis.
To learn more about the many forms of icthyosis, check out the Foundation for Icthyosis and Related Skin Types.

Frightened Teens: Supporting Your Adolescent in Scary Times

Abused teen with stop hand jesture

Another Shooting.

It takes all of our strength as grown-ups to not give in to despair, anxiety, and fear in the face of yet another young person accessing an assault rifle and murdering his peers. School is supposed to be a safe place for all children — teens included.

As the political debates about gun control make our brains feel like exploding, we have to remember to reach out to the adolescents in our care. If it is that tough for us to wrap our heads around, how much harder is it for teens? We must be proactive in engaging teens in conversation every day, about life, about what is important to them, and about the awful things that happen in the world. When something truly terrible happens, it is even more important to take the time to listen, witness, and validate their struggles. And this often means admitting that we don’t have the answers.

Teens have the capacity to reason, to wrestle with abstract concepts, and to articulate their feelings. But their brains are still developing, as is their self-concept, their ideas about who they are in the world. A random act of extreme violence will shake their new identities and burgeoning belief systems to the core, and they need calm, kind adults to prop them up as they try to make sense of their new reality. They need to know what to expect as much as possible, who they can count on. We know it isn’t always easy, so here are a few tips from the experts.

Tips For talking with Teens

What Mental Health Experts say to Their Kids

Fear and trauma responses can sometimes look like anger and disconnect. The teen who is suffering the most, without the ability to articulate and share their feelings, may be the one who needs your best efforts. Often teens find it easier to talk about tough topics when they are involved in an activity. Consider a cooking project, or gathering some art supplies, maybe magazines for collage. Or how about the ingredients to make a mini volcano? As you create something together, you can talk about how the shooter was a volcano waiting to blow, and how many feelings are often seething underneath. The teen can write down questions they have about life or list things that make them feel like blowing their top, and these items can be folded and put into the volcano before you set off the eruption together.

Volcano!

Introduction

This technique helps release anger through a structured activity providing an opportunity to discuss anger and to problem solve. It works well individually and in groups with preschoolers to teens.

Materials

  • Small paper cup or medicine cup (Dixie brand bathroom cups work great)
  • Plastic cereal bowl
  • One container of Play-Dough (The kind that comes in a 4-pack) or homemade.
  • White vinegar
  • Dishwashing liquid
  • Baking soda
  • Red and yellow food coloring
  • Teaspoon

Activity

  • Place a small paper cup upright on top of an upside-down plastic bowl. Secure it with a few pieces of tape.  Wrap it in play dough to make a volcano, leaving the mouth of the cup open.  Pour ¼ cup white vinegar, two squirts of dishwashing liquid, and several drops of food coloring into the “mouth” of the volcano.
  • If the child wishes, they can write down or dictate things that upset them (make them scared or angry or mad) on tiny pieces of paper and place them in the volcano.
  • Spoon in a heaping teaspoon of baking soda and watch the eruption!
  • For instant replays, alternate adding a little more baking soda and vinegar. A group can make a larger volcano using a large salad bowl and more playdough. Miniature people, animals, and props can be added to add aspects of dramatic play.

 

 

 

 

 

Why Aren’t We Preparing Kids for Disaster

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Beal_Photo_sm Guest Blogger Heather Beal is a military veteran with 23 years of crisis management and operational planning experience that she draws upon daily in her battle to raise two well-prepared, happy, curious, and intelligent children. As a trained emergency manager and parent, she saw the need to provide age-appropriate disaster preparedness information to young children in a way that empowered rather than frightened them. She is currently writing additional books to cover a greater spectrum of potential disasters children may face.

“Generally speaking, we do not prepare our children for disaster. We make them hold our hand in the parking lot and talk about the dangers of getting burned by the stove, but we stop short of this really big “disaster” word. When I think about it, I can come up with a few excuses we call reasons as to why we don’t give this topic the attention that we should.

First, like our children, (but usually without donning the superhero capes and masks), we believe that we are invincible. It (the disaster) can’t happen to ‘us,’ it only happens to ‘others.’ Folks – look at Hurricane Harvey, Superstorm Sandy, Hurricane Katrina, the Indian Ocean Tsunami, and any other number of disasters. With that many people affected – the ‘us’ and the ‘others’ are the same people. We need to look at disaster as a probability, not a possibility.

Second, we think talking about disaster will be too scary. I get it. No one wants to tell children anything bad could happen. We all know our children could get terribly hurt running if hit by a car in the parking lot, but we don’t get into explicit details about injury and death. We do however, talk to them about being safe, making good choices, and not doing things that could more likely result in their getting hurt.

We should approach talking about disaster in the same way we approach other learning topics or the consequences of actions or inaction. We don’t need to focus on the destruction a tornado can cause, how their lives could be uprooted, or what other things could dramatically change. We can however, talk about what children need to do to stay as safe as possible.

There are no guarantees in life for anything. We can’t guarantee that a car in the parking lot won’t do something stupid, just as we can’t guarantee the tornado will miss a child’s house, school, or childcare. But we, as parents, as childcare providers, as educators, as caregivers, as emergency managers, and as community members, can arm our children with the tools to succeed. We owe them that.

Sounds good – but how would I know, right? Fair question. A few years ago I tried to explain to my then 4-year old daughter that she and her brother might be woken up in the middle of the night to go into the basement if there was a tornado warning. Of course, it was already dark and stormy (thunder and lightning and everything). Needless to say, I did a very poor job, ultimately scaring her and beating myself up about my failed attempt to mitigate later fear through a botched explanation. Never again I vowed.

That was when I discovered that almost no one was having the conversation with young kids (toddler, preschool, or kindergarten) about disaster. At the same time, I realized that disaster was not going to sit by patiently and wait until my children could calmly and rationally discuss everything at a grown up level. I decided I could develop a way to talk with them in a way that didn’t scare them, but instead empowered them by teaching them what to do and giving them back a little control in a typically uncontrollable situation. They might not be able to stop the disaster, but they could do something to increase their safety within it.

I started Train 4 Safety Press to develop picture books that would teach children what to do “if.” As I conducted research, I discovered a few books out there on the science of disaster, but almost none that taught young children what to do when the disaster was happening. Our first book Elephant Wind tackles what to do during a tornado. Tummy Rumble Quake teaches children about the Great ShakeOut™ and earthquake safety.

Children have a great capacity for building their own resilience. Teaching them how to protect themselves can have an exponential effect. Children could not only help themselves, they could help their classmates, their teachers, their family and their community. Isn’t anything that increases the odds we bring our children home after a disaster worth it? Can we afford not to talk about it?”

And here is a great resource: National Child Traumatic Stress Network

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Medical Play: Modeling Empathy for your Child

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Colleague and friend, Teresa Schoell, is a child life specialist in upstate New York. She is featured in  “That’s Child Life!” , a video published by the Child  Life Council. She is also, first and foremost, a mother to Malcolm. She posted this story on FaceBook today, and with her permission (and Malcolm’s), I wanted to share it with all of you.

I just finished performing surgery on one of Malcolm’s beloved stuffies (a gift from the dear Justinn Walker). Apparently, JC the Lobster was quite anxious about the procedure, hiding in Malcolm’s arms while I threaded my needle.

“I’m scared it’s going to hurt,” came JC’s voice (with a marked similarity to Malcolm’s falsetto).

Then I heard Malcolm’s reassuring voice “Don’t worry, JC, we’ll give you sleep medicine so you don’t feel anything. Would a hug help you feel brave?”

A few hugs and and some invisible anesthesia later, the lobster was open on my table (prepped and draped in the usual sterile fashion….which is to say, laying on a couch cushion on my lap) Today’s procedure was to repair the distal fracture to the bendy wire in the patient’s left antenna, which supports movement and pose-ability.

Under general anesthesia I opened and peeled back the fabric, revealing the damaged wire. The sharp wire bits were realigned and repaired use med-surg duct tape, reinserted into the fabric, and sealed with a running subcuticular suture (sewed on the inside for a near-invisible scar). Procedure complete in 15 minutes with minimal stuffing loss. Patient resting comfortably.

 

I commend how Teresa invested in Malcolm’s powers of imagination and attachment by treating JC the Lobster with the respect one would give a live patient. When parents take their child’s attachments and emotional needs seriously, they model empathy, the glue that holds our society together.

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Child Abuse Prevention

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Thank you so much for joining me on my blogging adventure. It may take me some time to find my groove, and you may see me jumping around a bit to different topics. Please comment on which topics are of most interest to you, and I will do my best to give you what you need and enjoy.

Today, I am writing on one of the topics I had in mind when I set up this website – advice for child life specialists, but my hope is that it will be helpful for teachers and caregivers as well. A wise man, Jon Luongo, advised me that I have a great deal of writing material squirreled away in the posts I have been making to the Child Life Forum for a number of years. Today I responded to a request on the Forum for information and resources regarding running a workshop for parents/caregivers on child abuse prevention. Below is the gist of my response. Continue reading

Tilling

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A cluster of school children spill onto the bridle path from an entrance on the upper west side of Manhattan. They emanate pent-up energy and their voices crescendo as they discover the reservoir vista. I register some mild annoyance at their squealing, but it only takes me a moment to recalibrate and appreciate their excitement. They overtake me and I walk for a bit beside the noisy group, eavesdropping on their exuberance and their teacher’s failing attempts to curtail it.

“Stop walking that way. Walk like this. Pick up your feet!” Continue reading