Child Life Services

At CHEO, we recognize that children and youth need to have opportunities to play, develop, and socialize during their hospitalization. Child life specialists are professionals trained in areas of child development, play and the psychosocial needs of children and families and are certified through the Child Life Council (www.childlife.org).

Child life specialists provide opportunities for therapeutic and diversional play. Play is recognized as a tool for coping with stressful situations and as a basis for learning. Child life programs at CHEO strive to promote optimum development of children and youth, maintain normal living patterns, and help patients and families adjust to and understand their health care experience. Child life specialists prepare and support children and youth during medical tests and procedures through health care play, teaching and coping skill development.

Child Life Services:

• Offer age appropriate preparation and support for medical tests and surgery.
• Help patients and families learn coping skills that can assist them during stressful experiences.
• Facilitate playroom activities in a therapeutic environment to promote adaptation to illness and hospitalization.
• Provide psychosocial support for patients, siblings and families.
• Adapt activities for patients who are immobilized, have multiple injuries, and repeated or extended hospital stays.
• Provide normal and specialized play activities to strengthen self-esteem and independence in playrooms and at the bedside.
• Offer child life programs such as Mollypenny-CHEO’s therapeutic clown, pet visitation, CLICK (Child Life Interactive Computers for Kids), Upopolis (a private social network that connects hospital patients to their family, friends, schools, etc.)

The Therapeutic Clown Program at CHEO

A member of the Child Life Specialists’ team, Mollypenny works as a Therapeutic Clown to assist children, youth and their families cope with the stress of illness, injury and having to stay in the hospital.

This program has been in existence since September 2001, and was originally funded by Therapeutic Clowns of Canada, but is now funded by anonymous donors.

Laughter and play are important aspects of physical, social and emotional development and recovery. Children who face health altering challenges respond to opportunities that create an environment of playfulness and moments that alter their sterile view of the hospital.

Therefore, Mollypenny’s primary goals are to:

1. Empower the child and create an atmosphere of fun for patients, family and staff.
2. Offer moral support.
3. Normalize the hospital environment.
4. Assist in distraction and offer procedural support, when appropriate.
5. Find humour in a situation and encourage it.
6. Recruit new trainees for Kid Clown School (KCS), where she takes a child along with her to do her rounds and train him or her to be a clown for a day, costume and all. (Note: CHEO is the only hospital in Canada to have a “Kid Clown School”).

Room to room, visits provide healing laughter, a caring attitude, respect, encouragement, comedy, a little magic and red nose transplants! It is not necessarily about the traditional tricks of the trade such as fancy magic tools, but rather the energies that we all possess inside us like listening, intuition, sensitivity, emotional creativity, and more.

In her previous career, Mollypenny was a nurse who worked in the operating room (OR). She now works as a Therapeutic Clown, every Tuesday, Wednesday and Thursday.

For more information, please visit: The Canadian Association of Therapeutic Clowns

Contact information:

Preparing Your Child for Hospital Experiences

How and when your child is prepared for medical experiences will depend on his/her age and how you think your child will react. The ages listed below are guidelines. These suggestions will help you prepare your child before or after a medical experience or procedure.

Infants and toddlers (birth – 3 years):

Infants and toddlers may react to changes in routine and after 8 months of age, may have difficulty separating from caregivers. Tell the staff how you think your infant will react.

Consider:

• Comforting by rocking, holding, and talking gently.
• Providing toys for distraction.
• Keeping explanations for your toddler very simple.

Preschool Children (3–6 years):

Preschool children may believe that hospitalization is punishment and may not fully understand why the procedure or surgery is needed.

• Talk to your child about the procedure 2–3 days prior to the operation.
• Be honest. This will help your child to trust you and the medical staff. The truth is often less scary than what they are thinking.
• Explain only those things that they will see and experience. Too much detail can be confusing.
• Use play and familiar objects to help your child understand his procedure or operation (toys, books).
• Explain what is going to happen, why it needs to be done, and how it may feel.
• Ask your child “what do you think is going to happen?” This is a good way to find out what your child is thinking and gives you a chance to correct misunderstandings.

School-age Children (6–12 years):

School-age children have a basic understanding of how their body works. They need time to ask questions and talk about their feelings.

• Let your child lead the conversation by asking simple questions and allowing him/her to tell you what he/she knows. This is a good way to find out what your child is thinking and gives you a chance to correct misunderstandings.
• Prepare your child by telling him/her why it needs to be done, how it will be done, and how it may feel.
• It is normal for children to feel angry or frightened. Encourage your child to express his or her feelings.
• Do not offer choices that cannot be granted.

Adolescents (12–18 years):

Adolescents are more independent and can become more involved in their own medical care. They may ask for detailed explanations. Privacy is a concern for this age group.

• Be honest with your adolescent. Your adolescent has a right to know about everything that will happen to him/her.
• Encourage your adolescent to ask questions of you or the medical staff.
• Your adolescent may prefer to speak to the medical staff alone.
• Your adolescent may wish to bring written questions with him/her for the medical staff.
• Reassure your adolescent that fear, anger, and tears are normal.

Reactions post-hospitalization:

Children may show changes in their behaviour after hospitalization. These may include:

• sleep disturbances
• eating disturbances
• regression (bed wetting, thumb sucking)
• separation anxiety
• night time crying

These reactions are considered normal but it is still important to address your child’s concerns through play and conversation. If these behaviours persist and prevent your child’s participation in regular routines and activities consult your family physician.

The importance of play:

Play is an essential, natural part of childhood. Play is an important aspect of child life practice with infants, children and youth. For children in hospital or undergoing medical treatments, play facilitates:

• healing
• growth and development
• coping
• mastery/achievement
• self expression/self discovery
• creativity
• learning

Play offers reassurance against fear and anxiety. When children are too sick or injured to play for themselves it can be a positive experience to have someone ‘play for them’.

Coping strategies:

Coping strategies can help a child deal better with medical procedures or pain. Children need an opportunity to select and practice a coping method. Learning and practicing these skills beforehand can increase your child’s comfort level. These can include:

• sitting on a parent’s lap
• choosing to turn away or watch the procedure
• concentrating on a diversional activity (light up toys, book, electronic game, music)
• crying (a natural response to stress)
• thinking games
• relaxation and gentle breathing: have children breathe with you
• imagery: ask your child to think of a favourite place

Child life specialists provide opportunities for medical play to familiarize patients and families with medical procedures and to improve coping. Child life specialists can provide support during medical procedures to help you and your child cope.

You can contact a child life specialist by getting in touch with someone from your health care team.

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