St. Jude Children’s Research Hospital child life specialists collaborate closely with the patients, medical team and parents to make especially trying times as smooth and “normal” as possible for children struggling with cancer.

On the Good Health cover this month, patient Katelyn Atwell’s shares some of her interaction with child life through the artistic interpretation of her hands. Atwell has had acute lymphoblastic leukemia for eight years.
“People always comment how pretty my hands are. I wanted to show that they are so much more than meets the eye—just like me,” she said.

But art is only one tool the child life specialists use to achieve their goals. Using dolls and medical play, they promote desensitization to medical procedures for the anxious child. Using art, they encourage patients to express the fears, conflicts or problems they are facing. Events and activities help promote socialization in a child who is room bound.

“Our goal is to define the psychosocial needs of children here, decrease stress and increase coping,” said Shawna Grissom, director, child life.

Medical play affords the staff a chance to teach the child to address change or new things. Sometimes, staff will use picture books or examples from other children to prepare kids who might be unfamiliar with the medical equipment. The child life specialists are also trained in nonpharmacological techniques such as imagery and storytelling to teach patients to take the mind to another place during stressful situations. Some of the procedures can be routine, but not when a child is involved.

“If a child fears injections, we might use a doll and syringes so they can play through their fears and project their anxieties onto something else,” said Grissom. “They may not necessarily like it, but they can master it and get through it by having someone there to hold their hand, utilizing a diversional activity like a book, music or some relaxation skills like deep breathing and guided imagery.”

Another focus of the child life staffers is to try to keep the child on track developmentally and provide normalization for them. Outside the hospital they are going to have birthdays and holidays, and as best they can, the child life specialists to try provide experiences like that for them—even if it means putting together a graduation or a prom.

All child life staff have a bachelors or masters degree with an emphasis in human growth and development, education, psychology, or a related discipline. Child life specialists are required to complete an internship and pass a national exam before beginning careers. Their knowledge in human development assists them in assessing each child’s needs.

“We will look to the parents to establish what their baseline is. They had a baseline before coming to the hospital and then they will have a hospital baseline for behavior,” Grissom said. “From there, we can address regressions or delays. It is a dynamic process and changes due to diagnoses and treatments.”

The department also provides opportunities to create legacy items throughout a patient’s time at St. Jude. Healthy people build legacies every day through photos and videos without thinking of these records in terms of end of life. But, for St. Jude patients, in the case of a great outcome or not, their hospitalization is a part of their life story.

“We make sure they have the opportunity to put special things they have collected in a memory box or record music and videos,” said Grissom.

Another part of the job involves family and patient support before and during bereavement. Helping the patient to talk about death and process it, or helping siblings understand the process and find a way to get through the situation is the purpose.

“Everything, big or small,” Grissom said. “Everything that happens to the patient happens to the family.”

- Ginger H. Porter