For Young Patients, a Hospital Stay is Fun and Games Thanks to Child Life Specialists

LEXINGTON, Ky (March 29, 2018) – When a ten-year-old girl arrived at Kentucky Children's Hospital for a routine appendectomy, she fired off a series of anxious questions. Would she be able to feel the surgery? Will it hurt? What if she woke up in the middle of it?

Then a young lady named Sarah McAlister arrived, and calmly demonstrated everything the little girl could expect before the surgery, from the stickers and leads to the anesthesia mask, and all of the other steps that would occur until she went to sleep on the operating table.

"As we were talking," McAlister said, "she was calmer, happier and engaged again."

McAlister is one of the Child Life specialists at Kentucky Children's Hospital (KCH), a group of professionals dedicated to helping young patients and their families understand and cope with the stresses of illness and injury.

"We prepare, educate, support, distract and play with kids in the hospital", said Ashley Rapske, another Child Life specialist at KCH.  "We help them positively cope with being here, and help them understand what’s happening and why."

Children process the world differently than adults, and traumatic stress or injury can inhibit their ability to cope and heal. Without the intervention of a certified professional,  the pain, confusion, stress and fear can have a lasting effect on their development. Child Life specialists work closely with doctors, nurses, social workers and family members to help implement a child's health plan and help them reach their treatment goals. To a child, this can look and feel like playtime, which helps alleviate stress and assuage fear.

"Play is not just a thing that you do, it's how kids learn, process and understand the world around them," said McAlister. "You may think, oh they're just building something cool with Legos, but we're also working on fine motor skills. Or if they are chasing bubbles down the hall, they're working on gross motor skills and breathing."

"We're helping them reach their treatment goals, but the patient is going look at it as play," said Rapske. "We use the things the patient likes and tie that into their therapy. So if they need to walk, what can we do to help them walk? Can we have a dance party, a bubble-popping party, or get a remote control car? Or if they need to eat or drink, we could have a tea party. Or play Candyland and every time you get a red card you take two bites of your pudding."

The Child Life profession has existed since the 1920s and in 1982, formally drafted standards of practice as an organization that became the Association of Child Life Professionals. Certification is rigorous; a trainee must complete a 600 hundred hour internship before taking an exam. After certification, specialists are required to complete 60 hours of professional development courses every five years. These requirements are in addition to a bachelor's degree; McAlister has a degree in family and child studies with a concentration in child life and Rapske studied human development and family sciences with an emphasis in child development.

The services of a child life specialist can go beyond the hospital setting. Recently, the third grade class of Pikeville Elementary sent a "Flat Stanley" to KCH. The child life specialists and nurses used it as an opportunity to educate children about what happens in a hospital.

"We treated 'Stanley' as though he had a broken leg," said Erin McAnallen, the Expressive Arts Resource Specialist who works with the Child Life staff on art and creative projects for the patients. "We bandaged him up, and took pictures of him interacting with the nurses, playing in the playroom and having fun at the hospital. We really wanted to clear up the misconception that hospitals are scary places, and let kids know that this is a place of help and healing."

In addition helping children understand their treatment, the team works hard to make the patients' hospital stay fun. Throughout the year, they organize events around holidays so that patients don't feel as though they are missing anything. Events include trick or treating at Halloween, a visit with Santa at Christmas and soon, an easter egg hunt around KCH. During the Olympics, staff organized events such as "cart curling" and "snow ball toss".

"Our team is made up of dedicated and passionate specialists and patient activity assistants," said Child Life Coordinator Jennifer Guilliams. "They have the extraordinary ability to give patients and families the tools need to understand, master, and positively cope with the challenges they face during their medical treatments."

The day of a child life specialist isn't always games and crafts. Sometimes they are called upon to help a patient have opportunities and experiences they wouldn't otherwise have. McAlister recalls a terminally ill patient who was sad that she never got to go to the beach. So the staff brought the beach to her.

"We had sand and shells, smells of the beach and a virtual reality set so she could feel like she was really there. Even though it was a really sad experience, we helped that patient reach one of her goals in life."

From the trying to the triumphant, the specialists take great pride in seeing their patients overcome their fear and anxiety and use those coping skills even after they leave the hospital.

"For me, it's the "I did it" moments," said Rapske. "Seeing a child go from hiding in the corner to coping with their treatment. To have a child say 'I understand, I'm not scared. I can do this, look what I did', and getting them from one point to another in their journey is really great."