Recreational Therapy and Child Life

Melanie Cole (Host): Hospitalization can be so stressful for children and their families, but there are ways that you can get your children involved and make it a less stressful situation. My guests today, are Amanda Hogle — she’s a Recreational Therapist, and Allison Goldstein – she’s a Certified Child Life Specialist with Shriner’s Hospitals for Children Chicago. Welcome to the show, ladies. Amanda, I would like to start with you. When we think of recreation and activities, why are they more particularly important for children with special needs or physical disabilities or children who have to be hospitalized?

Amanda Hogle (Guest): Yeah, so our kids here at Shriner’s, a lot of times they don’t have the same opportunities or don’t know about all of the opportunities that they have to participate in many of the same recreational activities that their able-bodied peers are participating in. I take my role here at the hospital both while they're in the hospital with us and for those that live close by, to help them explore different leisure interests and give them that confidence to participate in all of those leisure activities and then connect them with those local resources that are close to home so that they are able to participate in all of those same activities and sports and programs that their friends are doing.

Melanie: Allison, along those lines, you are a Certified Child Life Specialist. Tell us what is Child Life and how is it used at Shriner’s Hospitals?

Allison Goldstein (Guest): My goal as a Child Life Specialist, is to help kids and their families coping with being in the hospital. As you mentioned, it's pretty stressful and can be a pretty scary place, so we provide different interventions depending on what their needs are. Sometimes, if it's a kid who is coming for a surgery, doing some pre-op tours or medical play, depending on their age, and really preparing them and educating them so that they know what to expect, but providing different play opportunities to allow for different outlets for them to be able to express themselves and see what is going on while they’re here in their hospital stay. We’re a huge fan of play in order to see how they’re feeling and how we can cope with them — help them cope.

Melanie: That pretty much ties together, you two, in what you do for Shriner's. And so, Allison, back to you for a minute, let's start with talking about preparing their child. What do you tell parents before they come in because I would like to talk about how to play and recreational therapy can help with children and that stress — for their families as well? What do you tell them before they come in that you want them to think about or do with their children to get them ready for a procedure or a medical necessity?

Allison: That’s a great question. It really depends on their developmental level, but in general, I encourage families to use age-appropriate language, and really be honest with your child and let them know what’s going on. We wouldn’t want someone to show up and have no idea they’re coming for surgery. That’s even more scary. Really, being honest with them, giving them different choices and empowering them, also it’s really helpful if they can get ahold of books or videos to kind of help prepare them — I actually have my own little surgical slideshow that I give families as well — but sticking to routines, giving them different opportunities to ask questions — for the child to ask questions, but also for the parents to ask the children questions as well. I also encourage them to help bring them an overnight bag, to help them pack it, bring their favorite stuffed animal or maybe a family picture if the family is not able to stay in the hospital. Those are just some general tips. Depending on their age though, it varies a little bit.

Melanie: What about for teens?

Allison: For teens, I would encourage parents to sit down and talk with them — let them know that they’re there to support them and see what kinds of questions they may have. Sometimes, they kind of want to be on their own, so having the teen write their own list of questions and maybe bringing that list to their next doctor’s appointment to ask those questions about surgery to kind of give them that empowerment as well. But again, being honest with them and supportive.

Melanie: Amanda, when we’re looking at recreational therapy, how is it used in patient care at Shriner’s? If they’ve done all of these things and they are somebody that has to be in hospital temporarily, then what do you want them to know about some accessible patient activities, things that they can do while they’re there, and then even what they can do once they leave the hospital?

Amanda: Right, so while they’re here in the hospital, we provide them with a lot of variety of recreational programs, whether that be one-on-one activities that I’m meeting with them in their room or different group activities in the hospital just to make them feel comfortable while they’re here, have them participating in activities that they would usually be participating in, reducing their boredom. It overall increases their comfort and reduces their overall stress that they have while they’re here. I think a lot of our families appreciate that and are able to acknowledge that it helps it not feel as much like a hospital while they’re here because they have so many fun things that they’re going to be doing.

Following surgery, they may be limited or have some restrictions that they have to follow just to keep themselves safe. I just always encourage them to follow those doctor's recommendations just as much as they may want to get back on the court or their horse or involved in their program, they want to be healthy and safe about it too so that they don't have to wait even longer to get back into those activities. If they are going to be limited, just helping them to identify some different things they can do at home, maybe finding something new that they haven't tried before that they could start to develop while they're under those restrictions, but just overall, making sure that they're enjoying their time here and that they continue to be as independent as possible.

Melanie: Amanda, people think that recreational therapy is mostly involving physical things — and you mentioned limitations after surgery or a procedure, but it’s not always very physical. There’s art, and you also have therapy dogs as well. Speak about some of the other things that go on at Shriner’s that can help keep kids engaged.

Amanda: Sure, so like you mentioned, we do have a lot of outlets for all different kinds of arts and self-expression. We have a fantastic art room that we’re able to have a whole variety of different supplies for them to use. We also have a horticulture therapy program, so utilizing the wonderful outdoor space that we have here at the hospital, with our patient garden, or bringing those activities inside during the Chicago Winters. We do have our pet therapy that goes around, and they can either work therapeutically within their different goals in their therapy sessions or even just provide comfort while they're bedside in their room. Whenever the dogs come there are tons of smiles around the hospital, so we're very lucky to have them come to visit. Music therapy is another great outlet that we have for our kids, and just being able to interact socially with the other kids here is an awesome thing that they can share experiences and see what other kids and families are going through the exact same thing just kind of help to neutralize that experience that they're not the only ones going through this and can be themselves and not have to focus as much on the medical reason as to why they're here.

Melanie: Allison, what about siblings? As Amanda is discussing some of these things, and art, and music therapy, and even bringing the dogs in, do siblings get to get involved because sometimes it’s as scary for the sibling as it is for the child going through it?

Allison: Yeah, sometimes they do. If siblings are here while the patient is in the hospital, we encourage them to join us in our activities that we're doing. That way, they can see this is what's going on, and this is what their sibling is going through. We encourage them to do that if they are around. Unfortunately, in the Winter months, that's not always the case with the restrictions going on, but if the siblings are in the waiting area, we'll engage with them and see what sort of questions they may have as well. One thing that I do tell families it is really hard sometimes, if a parent is staying in the hospital with a hospitalized child and the sibling is at home, is to really try to stick to routines that they have and try to allow normalization for the siblings as well as for the patient that is currently in the hospital.

Melanie: Amanda, how can the parents encourage and help their children to find activities that they enjoy and to try some of these programs and to be social and get involved.

Amanda: Sure. While I’m working with some of our patients, lots of times it's just as important to work with the family to make sure that they are on board. A lot of kids are very comfortable or turn to mom or dad or a family member for that encouragement and support to try new things, so having them both on board is very crucial. A lot of times, our play sessions, and treatment sessions, and having the dogs here, are just as beneficial for the parents to keep them feeling comfortable and less anxious while they're all here. Having everyone on board with that is a key piece when you're trying to have these kids try new things that are a little bit out of their comfort zone.

Melanie: So then, Allison, I'll start with you for the wrap up — you're the best information for parents, and for children, and for siblings, about child life at Shriner's Hospitals for Children Chicago — what they can expect, and what you really want them to know about your services, and your team, and how you can help children feel more comfortable with whatever it is they have to have done.

Allison: I would really want to inform them of all of our Child Life Services, which can be kind of a handful. We’re here to make their experience better and to help the whole family cope and to educate them about different interventions, and provide different coping strategies, and allowing for normalization within. When they come in for the clinic when they first are here, before any surgery happens, asking maybe to meet Child Life, so that way, we can start to build that rapport and the patient can feel much more comfortable, as well as the family as a whole.

I get referrals all of the time when I see a kid right before they're coming for surgery, but it would be really great if I can actually meet them beforehand and really start to build that rapport.

Melanie: And Amanda, what about you? What would you like them to know about the importance of recreational therapy, and feeling comfortable when they're in the hospital, and keeping up with even some of it when they leave?

Amanda: Right, so, I just want to make sure that they’re having a positive experience while they’re here and working with them to make sure that they know all of the cool and exciting things that they can do once they leave here. As much as Allison’s focus is here, within the walls of the hospital, I kind of like to differentiate us that we provide them the resources, and the confidence, and the skills, to be able to take everything that they’ve worked on while they’re here and be an active member of their community and their families while they’re at home. Providing all of those activities while they’re here is just providing them that exposure and confidence so that they know, and their parents know and that everybody is aware of all of the cool things that they can do despite any of their disabilities or limitations.

Melanie: What a wonderful program for kids and their families. Thank you, ladies, so much, for being with us, today. This is Pediatric Specialty Care Spotlight with Shriner's Hospitals for Children Chicago. For more information, please visit ShrinersChicago.org, that's ShrinersChicago.org. This is Melanie Cole. Thanks so much, for tuning in.