Kids at Home? Staying Sane Through the Power of Play

School Closings

During this time of the coronavirus, school closings are causing tremendous stress for all parents, especially working parents whose child care options are limited or nonexistent. While your children are at home, providing a wide range of play activities will help ratchet down anxiety, promote healthy expression of feelings, and it might even be a unique opportunity to strengthen your relationship and attachment to one another. As a child life specialist, I have spent my career in hospitals helping children and families play as part of the family-centered care approach to healing. Today, I am going to share some ideas for keeping your children calm, happy, and occupied.

What Am I Good At? Building Self Esteem through Play at Camp Klicek in the Czech Republic

Time to Explore:

The long days of summer, with the sun rising at 6:30 AM and setting close to 10:00 PM, lend themselves to unhurried, lengthy swatches of time. These hours can hold many opportunities for children and adults to engage in unfamiliar activities and discover new skills. Time for free play and exploration is a commodity during our workaday, technology-filled lives, but Camp Klicek in Malejovice, Czech Republic provides exactly this to children and families affected by illness and loss.

In the photo above, two seven-year-old boys get their hands on a saw, as they break down a tree branch in preparation for the campfire that all the campers will enjoy. Besides being fun, the boys are building their muscles and coordination, getting some great proprioceptive feedback, practicing cooperation and self regulation, not to mention problem solving. Their self esteem gets a healthy boost as they accomplish something new and contribute the the camp community. These are some of the attributes of spontaneous play that adults should take note of as we consider the developmental, social and emotional needs of all children

Structured Games

Sometimes structured games can lend themselves to learning through play that is so much fun that kids forget that they are learning. On this day, the campers were divided into three teams, and each team had four tasks to compete. They had to find a way to measure a liter of liquid, a kilo of sand, the length of a meter, and the span of a minute, all without the use of measuring devices. The camp was alive with children gathering sticks, pouring water, scooping sand into sacks and counting out loud and in their heads, as the teams competed to see who could get the closest to the actual measurement.

Group Play

On another day, volunteers from the Accace Corporation brought a day of activities to the campers. In the morning, they set up tables in the summer garden and mess tent, including paper arts and crafts, flower pot decorating, a drink mixing table with great recipes for virgin mojitos, margaritas and pina coladas, and a beauty salon station with face, body, and nail painting. Kids explored their artistic sides and wore their art with pride.

In the afternoon, the company volunteers set up an activity course in the forest, replicating what is entailed in working for a big company. My favorite station was the accounting department, where the employee had to take a fist-full of invoices and chase after the client to whack them with the papers to make them pay their bills!

And the other one I loved was a station where kids were taught the art of communication. They were told that communication is the lynchpin of success, and in order to practice communication skills, they had to stand on one side of an easel and describe a picture to their coworker on the other side, who had to paint of draw what that person was describing. It was a tough but very fun challenge for the kids.

In yet another station, the children ran through the forrest balancing cups of coffee they had made for their boss, trying to get to their boss’s office to sign power of attorney documents without spilling a drop.

Sharing Skills With Others

Many of the campers had their own skills to share and teach. Here are several of them, starting with an 18-year-old who made up a rap song on the spot.

One 14-year-old camper had a lot of skills, including bugle playing, fire breathing (So sad I didn’t get that on film!!), and archery. Here he is teaching another teen how to shoot a bow and arrow.

This young magician taught us all how to get a 100 Crown bill out from under a beer bottle without touching the money or the beer.

This artist created a virtual masterpiece depicting several scenes on one ceramic pot.

And even the youngest of the campers showed their talents. Whether it was my lunch-mate practicing his English, or a shy kid joining in on a new ly introduced American game of “Happy Salmon”, the kids never ceased to amaze me with their willingness to take risks, learn and share. I watched with admiration as this 6-year-old moved with the utmost patience and precision in a game of pick up sticks.

Nothing raises kids up to their potential the way play does. You can see the pride glowing as their self esteem grows by the second. And I feel so blessed to witness and participate in this play at Camp Klicek! Happy Summer!

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.

Children Ponder Good & Evil at Camp Klicek

 

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We are all capable of good and evil.  People do bad things – sometimes they make mistakes that cause harm unwittingly. Sometimes they hurt others purposefully. Sometimes, doing nothing causes more pain for others than we can possibly imagine. At Camp Klicek in Malejovice, Czech Republic, founders Jiri and Marketa Královcovi make room for children to discuss and think about tough issues. They want kids in their care to be more than followers and simplistic thinkers, to see the humanity in everyone and the possibility that although conflict might be inevitable when a large group of people gather, people can make mistakes and still not be bad people.

And so, on one bright summer morning, following a hearty breakfast of porridge, bread, tomatoes, peppers, tea and hot carob with milk, the adults at camp led the children in an activity that reverberated throughout the week. The children gathered in small groups by age bracket. Some sat in the meadow, some under the mess tent, others in the courtyard. With adult guidance, they contemplated these questions:

  • What are bad or evils things?
  • Why do people do them?
  • What can be done about it?

The children took the assignment seriously, taking notes and including the voices of all. I moved amongst the groups, catching a snippet here and there from a kind translator. The children mentioned everything from the past and present atrocities of the world to the more mundane, including genocide, torture, terrorism and bullying on their lists. The youngest camper, when asked why people do bad things, answered, “Because they don’t love each other.”

At the end of the small group conversations, each group reported out to the whole camp, as we sat in the shade of the mess tent and processed together. The discussions were the scaffolding for the real fun. The next step of this activity involved each group choosing one of their examples, writing a play script to demonstrate the concept, and videotaping the enactment. The kids were deeply involved in this process throughout the day, and that night, they set up an outdoor theater in the courtyard, complete with a movie screen, the moon shining down upon us, and homemade apple strudel made from the summer apples, the Klicek version of popcorn. We smacked our lips and licked our fingers as we watched the completed movies, along with some movies created in past years.

My favorite play depicted two different families heading off to summer camp.  One family had no luggage or sleeping bags, just the clothes on their backs. The mother handed her children 10 crowns apiece and kissed them goodbye. The other family stood in front of a Mercedes Benz with their fancy clothes, belongings, cell phones, and the mother dolling out hundreds of crowns to each child. The scenario played out with the rich kids arriving at camp, immediately making fun of the poor kids, an act of kindness when one of them falls down and the other helps them up, and all of the kids ending up playing a game of football (soccer in the US) together.

A simple message, but one not lost on any of us. The campers did indeed come from a variety of backgrounds, and would probably not be interacting at school or in social circles outside of this camp environment. When I think of acts of evil, I think about how we create separation by dehumanizing people who we label as “other.” It is harder to keep these stereotypes and misconceptions in place when we wake, sing, break bread, play, and rest our heads together in the same teepee. I saw many acts of kindness each day between campers, whether it was an older child helping another child navigate steep steps, the hard work of the volunteers in our kitchen, or folks pitching in to help a teen search for her lost eyeglasses.

The thoughtful planning applied to activities that built community astounded me. Along with a mess kit and clothes, the camp packing list asked each child and adult to bring a glass jar with a lid to camp. The campers decorated these jars with their names and artwork, and hung them by ribbons on the branch of a low tree in the meadow behind the house. They left messages of appreciation in each jar, to adults and kids alike throughout the weeks. At the end of camp, they each took their jar with them, with strict instructions to hold off on opening it until they had arrived home. Marketa said that this is a concrete way to further the bonds created at camp. “Some of these children are isolated because of their illnesses. These jars and their notes are a lifeline for them throughout the year.”

My jar sits on my desk at home and reminds me of the generosity of spirit that children share so willingly. I can see why these campers return year after year to the meadow, the tree and the love.

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Camp Klicek: A Dose of Nature and the Universal Language of Play

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I remember the endless swath of time that summer brought when I was a young child. Unstructured free time in nature, with neighborhood kids, and my family. I also played alone, exploring the back roads on my bike and the woods on foot. At the age of seven, I would be gone for hours, playing in brooks, creating forts under the shelter of giant boulders, climbing trees, making up stories in my head, and writing poetry.

These days, we are hard put to find children at play in this kind of open-ended, unsupervised milieu. Their play is planned, highly structured by adults, and often close-ended. When left to their own devices, kids often choose tablets, smart phones and video games as their go to. Child life specialists and hospital play specialists know the value of deep, open-ended play that encourages self-expression, exploration, self-regulation, social development, and problem solving. My friends at the Klicek Foundation in the Czech Republic provide these play opportunities at their summer camp for children and families affected by illness and loss. This year, they invited me to partake in a unique camp experience, and I immersed myself in the healing environment of Camp Klicek, which has been in operation since 1992.

 

Children after a long-term therapy (and sometimes even patients under treatment, if their health allows it) take part in the camp, as well as their friends, siblings, parents and pets. Several bereaved families come too.

Our camp activities began as an attempt to offer a two-week stay in beautiful natural surrounding also to those children who couldn’t participate in a “normal” summer camp. We have always tried to create a friendly, open-hearted and open-minded atmosphere in our camps, and we hope that the camp program gives its participants enough opportunities to have fun, to do some useful work, to talk about things that are important to them, to simply be with friends.

The camp games and plays (mostly non-competitive) follow the make-believe story of a man who decided to spend some time with nature and is thus confronted with new situations and thoughts and starts to meditate on his own life and on the civilization he lives in.

Children live in big Indian “tee-pee” tents which are able to accommodate up to six inhabitants and have a fireplace inside.

Since 2000, we organize our camps on a meadow just behind the respite hospice building at Malejovice – thanks to this, children whose condition requires special attention can also participate in the camp program, backed by the safe environment of our house.

 

    klicek.org

 

Indeed, I found myself amidst a remarkable mix of campers and staff, a combination of people and circumstances that is hard to imagine anywhere else. The youngest camper was seven years of age, the oldest, twenty. The children’s diagnoses differed significantly, as did their abilities, disabilities, ethnic and socio-economic backgrounds. There were children undergoing treatment, survivors of serious illness, siblings, friends, parents, and bereaved parents who had lost a child. The camp leaders, Jiri and Marketa, are purposeful in their choice to bring children and adults together where they might not otherwise interact in larger society. Watching connections form between the campers and staff of varied backgrounds was a blessing on so many levels.

The focus of our days involved living in nature, eating good, healthy food, exploring tough topics such as “What is evil?” and “How can we make the hospital experience more pleasant?”, and above all, building community. The virtual lack of technology at camp was so refreshing. I felt myself detoxing from my smartphone addiction as I wrapped myself in nature, old fashioned, simple play, and grand company.

Many friends have asked me what it was like for me to be surrounded by children who spoke Czech. Did I learn any Czech? How did I communicate with them? Well, I was immersed in a foreign language – of that there is no doubt. Most children spoke no more than a few words or phrases in English, and my Czech is abysmal. But the children understand more English than they speak, and play is a universal language.  The children’s welcoming of me was profound, inviting me into play, making me feel immediately part of the group. “Frisbee?” “Will you play?” “Come play football.” “Ping pong?” “Draw.” Once engaged in a game or project, there was much good will and laughter as we all tried our best to communicate.

I too, grew my Czech vocabulary one word and gesture at a time. I made it my goal over the week to learn everyone’s name – a challenging feat with names that were not familiar to me.  But with each name and greeting, I could see the rapport growing, the shy kids responding, the teens warming. Some of my favorite moments were when I would board the 1970’s retro bus for a field trip, and a kid would smile at me and pat the seat beside them to show they’d been saving it for me. Or that wonderful moment, when the quietest camper, one who spent much time alone and looked down or sideways rather than meeting your gaze, took my hand as I stepped off the bus and walked quietly with me to our destination.

It’s the small stuff, really.

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Children berry picking on a picnic in Czech countryside

 

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Klicek Foundation cofounder Marketa leading us in a trivia game in the camp’s mess tent, where we ate all of our meals.

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Handgames

In my next several posts, I will dive deeper into some of the activities we did, the games we played, the lessons I learned.

 

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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Click Here and Scroll down to Register and for access to live stream link

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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Child Life & Art Therapy in Disaster Shelters: The Humanity Factor

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During these recent days of hurricanes, tornados, fires and violence, it is hard to know in which direction to turn – what to focus on – where to put our energies. Fred Rogers taught us all to “look for the helpers”, and I always find that calming and inspiring, so I have decided to republish a piece that I cowrote with Tara Lynch Horan after we coordinated services at a shelter in NYC following Hurricane Sandy in 2012. It gives a taste of what child life specialists and art therapists can do to ease the suffering of children in times of upheaval.

In addition, tapping into our ability to BE the helpers can also assist us in making sense of tragedy. In this vain, I attended a training this past weekend given by  Children’s Disaster Services  in coordination with the Child Life Disaster Relief organization. It was empowering, and I highly recommend the training to anyone who wishes to volunteer to provide safe play opportunities for children following disasters. You can do this locally or be deployed to other states in the USA. And if you can’t lend a hand, donations to organizations like these can still make a difference and impact quality of life for children.

Here is the article reprinted from Vilas, D. & Lynch Horan, T. (2013). Trees, Houses and Sidewalk Cities: Child Life and Creative Arts Interventions at a Post-Sandy Shelter.  New York Association for Play Therapy Newsletter, January 2013, 16 (2).

“A phone call from a Naval Commander stationed at a shelter in  NYC sparked the —-  Shelter Creative Arts Therapy / Child Life Initiative Mission. Commander Moira McGuire headed up a mental health team at the shelter serving many families. As a behavioral health nurse, she saw the need for therapeutic activities for the approximately 50 children facing displacement and uncertainty. In response to her outreach, a consortium of Creative Arts Therapists and Child Life Specialists quickly assembled. Our goal was to provide therapeutic creative arts opportunities to children and families post Hurricane Sandy. We hoped to facilitate psychosocial coping and adjustment to the stress and potential trauma of the Hurricane experience and to the stressors of the shelter environment. The first team of volunteers that responded within 24 hours numbered 14 and included 11 child life specialists who were colleagues, alumni or current students from the Bank Street College of Education, along with two art therapists and one dance and movement therapist.

We would like to share some of the techniques that we employed successfully during the two weeks that the shelter was in operation. Leyla Akca, an art therapist, brought paper shopping bags in on that first day. She led children in an activity that explored the “stuff “we carry with us daily, and the invisible stuff we carry on the inside no matter where we are. It was a powerful metaphor, and the children took to it eagerly, decorating their bags with many open-ended materials. Leyla had previously participated in disaster relief in Turkey following earthquakes there. She had a lot of wisdom to share with us all, and her activity gave us focus and purpose.

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Maryanne Verzosa, a child life specialist from St. Lukes Roosevelt Hospital, supplied found objects from nature, which included sticks and twigs. As she gathered children in a circle sitting on the floor of the shelter, the children spontaneously created three-dimensional houses out of the materials. One child presented his stick house to his uncle, saying, “This is for you because you lost your house.” Commander McGuire had asked us to bring sidewalk chalk with us, as the children had access to an outdoor patio. Her instincts were perfect. A six year-old boy spent all afternoon creating a chalk city of roads, “for the children”, and buildings. We provided the child with miniature buildings and figures for his chalk city, and the play continued and drew other children into its circle.

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One of the final activities took place during the last day when families were moving out of the shelter, many of them to hotels. Tara Lynch Horan, a child life specialist, worked with several art therapists on a community project of building a mural tree and decorating it with leaves representing what families leaned on during Sandy‟s aftermath. The art therapists worked with the children creating the tree, while Tara went from cot to cot, engaging parents in depicting their resiliency factors on precut leaves made from construction paper.

The collaboration of Child Life and Creative Arts Therapists brought about many therapeutic moments for these children and families. The activities employed a variety of directive and open-ended techniques. As we would expect, the children and parents created their own meaning and healing. All they needed was the time, space, materials and gentle encouragement from trained therapeutic agents. Humanity at its best.”

Prescription for Play: How Pediatric Play Promotes Health and Healing

I was honored and so excited to be interviewed by Photographer & Guest Writer, Marj Kleinman for her article at TocaBoca.com. She and I have much in common, including a deep passion for child life and play in hospitals, and the fact that we are both alums from Saint Ann’s School in Brooklyn, NY. She is a talented artist and used her creativity to write a photo journal of child life and play at Maimonides Hospital. I will publish that here next week. The Toca Boca article is reprinted here in full below.

Child life specialists support kids and families in a hospital environment, reducing stress and increasing joy.

Marj Kleinman
BY
Marj Kleinman, Toca Magazine Guest Writer

When I tell someone that I volunteer in pediatric hospitals, I usually spot a sad face across from me. That response is understandable, given that hospitals can be scary and sometimes painful and upsetting. But in fact, there’s no greater place to see joy and resilience on display, all through kids’ natural passion for play.

Whether at their doctor’s office or in the ER, kids find a way to play, particularly with encouragement. Most children’s hospitals today come equipped with a playroom and a bevy of materials and activities, so kids can be kids while hospitalized. Once they see a playroom full of toys, messy finger paints and a silly guy blowing bubbles, they know this place is made for them and they will probably feel safe there. There’s even a team of people whose job is to play with your child: the child life specialists. They become parents’ partners in health and healing.

Meet the child life team: Your play partners

Many parents are surprised to learn that there’s a person solely focused on your child’s emotional health during a hospital stay — and they do it mainly through play. Child life specialists (CLSs) help kids and families adapt to the hospital environment and support them in understanding what’s taking place, thereby reducing the stress of a hospitalization. CLSs are trained in child development and play theory, as well anatomy, research methodology, sociocultural issues, ethics, family systems and bereavement, among other things. They also act as a bridge and advocate with your medical team. Child life departments often include art and music therapists, and are visited by yoga and mindfulness teachers, clowns and other practitioners.

Language of play

Play is the universal language of childhood — in fact, when CLSs assess their patients, they’re watching how kids communicate via play. I spoke to Deborah B. Vilas, a CLS and social worker who teaches child life graduate students at Bank Street College of Education. Vilas says, “Young children won’t sit down and say, ‘I felt sad today and I think I’m anxious about the medical treatment I’m getting.’ When children are playing, they act out scenarios and show us what they’re feeling; they show us what they understand, what they’re capable of and what their coping mechanisms are.” This may seem obvious, but in some hospitals, there’s a misconception that play is frivolous or low on the priority totem pole.

Young children won’t sit down and say, ‘I felt sad today and I think I’m anxious about the medical treatment I’m getting.’

Vilas reminds us, “It’s been proven that when children have play opportunities that they need less medicine, less anesthesia, are more compliant and get better faster. The benefits of play reach beyond the child to assist medical personnel and influence the hospital’s bottom line.”

Benefits of play

According to the American Academy of Pediatrics (AAP), “Play is essential to development because it contributes to the cognitive, physical, social, and emotional well-being of children and youth. Play also offers an ideal opportunity for parents to engage fully with their children.” Why would all that stop at the hospital? The AAP goes on to state that hospital play is a necessity that helps kids cope with treatment and stay on track, developmentally. The uses and benefits of play in medical settings are varied and significant.

At its essence, play provides a safe space for kids to experiment with unfamiliar and often scary experiences. Through open-ended play, kids can take in new information at their own pace, re-create situations and play out fears until they are familiar enough to gain a sense of mastery over the situation. When supported by an empathetic parent or CLS, this process is deepened and they can better process and release feelings.

At its essence, play provides a safe space for kids to experiment with unfamiliar and often scary experiences.

Open-ended and child-centered play, in particular, are highly beneficial, as they provide opportunities for kids to immerse themselves more deeply in play and lead from a sense of agency. Unfortunately, free play has been on the decline due to our hurried and jam-packed, overscheduled and tech-filled lifestyles, yet it is necessary for skill development, self-regulation, independent thinking and creative problem solving. In the hospital, where kids lack choices, it’s even more crucial to let kids be in charge.

Medical play

One of the roles of the CLS is to normalize the hospital experience through play. They might do familiarization activities, for example, building a robot using a bedpan, tongue depressors and IV tubing, all taped together with bandages. Suddenly medical supplies aren’t scary, cold, weird objects that only doctors and nurses use, and kids can “hack” the hospital.

Going a step further, medical play with a toy doctor’s kit and/or real medical supplies can 1.) educate children about an upcoming procedure, 2.) let them process their experience, before, during or after a procedure, and 3.) put the child back in the driver’s seat.

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Meghan Amorosa, CLS, engages Jan, age 4, in medical play at Brooklyn Hospital Center, Brooklyn, N.Y. Photo by Marj Kleinman.
 

Children experience a strong sense of helplessness, vulnerability and anxiety when faced with uncertainty and misconceptions (let’s face it, so do grownups). Procedural support helps educate, greatly reducing feelings of unpredictability, and increases a level of mastery.

Meghan Amorosa, child life specialist at Brooklyn Hospital Center in Brooklyn, N.Y., says, “A really big part of medical play is about giving patients choice and control over their own hospital experience. Instead of being the patient, they become the doctor and play on their own little patient.” She observed that Jan (pictured above) gave the doll a lot of shots, which is typical in patients who’ve been poked a lot. In fact, “If a kid gives a doll a million shots, they’re showing you how painful that was for him,” says Vilas.

A really big part of medical play is about giving patients choice and control over their own hospital experience.

Movement plays a key role in healing.

Movement also plays a key role in healing, which is why doctors want patients up and walking almost right after surgery. If kids can get out of bed and step on bubble wrap or a floor piano, ride a hospital wagon around the unit, or skate down the hallway on their IV pole, they get the blood circulating, feel more energized and also empowered at the same time.

Play is powerful and can be tailored towards your child’s individual age, temperament and tastes. Read on to find out 10 ways to support kids going to the hospital, as patients or visitors.

Marj Kleinman is a Brooklyn based photographer and children’s media producer with a master’s in educational psychology.

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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