Play – A secret ingredient in hospital care for children

Coming to a hospital can be a scary experience for children, especially during a time when they are not feeling well. Child life programs help ease some of the anxieties children and teenagers face in hospital. The Pulse sat down with Kerri Caplan, a Certified Child Life Specialist at North York General Hospital, to learn more about how play can turn a hospital into a magical place of exploration.

1. What is the role of a child life specialist?

My role as a child life specialist involves working closely with families and the health care team to:

  • Prepare for procedures and treatments using medical play

  • Develop coping techniques for stress and anxiety

  • Provide distraction therapy during procedures

  • Provide fun, engaging activities for normal development and distraction

Certified child life specialists must pass the Child Life Council's certification exam, adhere to the code of ethics and standards, as well as continue to complete professional developmental hours to maintain their certification.

Kerri Caplan, Child Life Specialist, North York General Hospital
Kerri Caplan, Child Life Specialist, Child and Teen Program, North York General Hospital

2. What is distraction therapy and medical play?

Distraction therapy helps children cope by directing their focus on something else during a procedure or if they are feeling any discomfort, anxiety or pain. I use a variety of distraction tools depending on the age of the patient.

  •  Infants: the best distractions are the parents or caregivers. I usually recommend a parent or caregiver hold their baby during a procedure and feed them sugar water as a distraction.

  • Toddlers: any toy that lights up and/or plays music works really well as a distraction tool for toddlers.

  • School age and up: iPads are very popular and a very effective distraction tool for this age group. Patients can watch their favourite videos on YouTube, or play and explore different apps.

I always offer distraction therapy to patients even if they appear calm before the procedures just in case their anxiety does rise.

Medical play is a great way to help young patients feel in control, explore a new environment safely, and make the hospital experience less frightening. We have different techniques for each age group and customize it to the child.

Toddlers ages 1 to 3 years:

  • Pretend play doctor kits

  • Picture books to explain what you see, hear, feel and touch at the hospital

Children ages 4 to 6 years:

  • Actual equipment modelled by a child life specialist (e.g. I would model how an IV is placed into the vein)
  • Picture books with words to describe the hospital experience

  •  Letting the patient take on the role of a doctor or nurse

Children ages 6 to 12 years:

  • Medical teaching doll
  • Actual medical equipment involved in a procedure (e.g. for a blood test I show them a tourniquet, alcohol wipes, butterfly needle, gauze and collection tube)

  • Pictures and sounds related to the procedure on an iPad (e.g. photos of an MRI machine and the sounds it makes)

  • Detailed and honest answers to a patient's questions

Teens ages 13 to 17 years:

  • Actual medical equipment involved in a procedure (see example above)
  • Pictures and sounds related to the procedure on an iPad (see example above)

  • Detailed and honest answer to a patient's questions

3. How do you make a child's hospital experience special?

A big part of my job is to help children cope with being in a hospital environment and help them understand what's happening to them using play and distraction therapy.

One of my favourite tools for younger children is a teaching doll called Medikin, used to help explain procedures like starting an IV. With the teaching doll, I can show them how an IV works, and reassure them the needle doesn't stay in the arm. It's a great tool because children will often take on the role of doctor or nurse and pretend to perform the procedure on the doll. This type of explorative role play helps children understand what's going to happen and overcome any fears or anxiety they may have.

4. What can parents and caregivers expect?

Parents and caregivers can expect their child will receive patient- and family-centred care with a child life specialist who will advocate for your child. On the Child and Teen Unit, we have lots of activities and programs to keep children of all ages engaged during their hospital stay including: toys, arts and crafts, movies and cartoons, video games, ipads and books.

Learn more about North York General Hospital's paediatric care, clinics and services.

This article first appeared in the September 2016 issue of The Pulse.

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