- The Washington Times - Tuesday, March 5, 2002

Hunter "Patch" Adams prescribes laughter as one of the best medicines. Dr. Adams, who was portrayed by actor Robin Williams in the Universal Studios film, "Patch Adams," visited patients at the Georgetown University Hospital of MedStar Health in Northwest last month with about 20 of his proteges. As founder of the Gesundheit Institute in Hillsboro, W.Va., his goal is to spread healing through humor, bringing fun, friendship and the joy of service to health care.
"A hospital should be full of love," he said, while interacting with a child at the hospital. He donned a clown costume, including a red clown nose, a cotton duck on his head, mismatched socks and oversized red and yellow shoes.
The holistic practices of Dr. Adams have been an inspiration for many certified child life specialists. Child life programs have become widely used in large pediatric settings to attend to the psychological and social needs of children receiving medical care. The specialists help children and families with coping skills, offer play opportunities, provide information about medical procedures and form therapeutic relationships with children and their families.
Kathleen Oliver Wagner, certified child life specialist at Georgetown University Hospital of MedStar Health in Northwest, organizes events for pediatric patients, such as the visit from Dr. Adams and friends. She says such activities meet the developmental and emotional needs of children in the hospital. The child life program began at the center in 1987, serving pediatrics, the pediatric intensive care unit, and the neonatal intensive care unit.
"Nobody wants to be in the hospital," Ms. Oliver Wagner says. "I try to provide the opportunity to just be a kid."
Often she plays card games or video games with children, as a distraction from the loneliness the hospital brings. She also assists them in staying on track with their schoolwork by arranging for tutors if necessary.
For infants, Ms. Oliver Wagner regularly plays recordings of lullaby music to drown out beeping monitors in their rooms. She also dims the lights to help them sleep.
"I help to maintain a sense of normalcy," she says. "The emotional health of the children directly impacts the medical and physical aspects of their healing."
• • •
Natalie Chango, certified child life specialist at Penn State Children's Hospital at the Milton S. Hershey Medical Center in Hershey, Pa., says helping children through medical procedures is an important aspect of her job. This includes preparing them for the treatment, when she might use a doll as a model to explain what will occur.
She says the most common medical procedure that she observes is hooking up a catheter line into the upper arm of patients to deliver medicine through a vein. Often this line allows patients to receive medicine at home.
"As it's inserted, we try to provide something that will capture the child's attention rather than worrying about what the nurses or doctors are doing," Miss Chango says. "We have a stash of distraction toys in our treatment room, such as 'I Spy' books and viewfinders."
If a child becomes uncooperative during a procedure, Miss Chango says, it is never her place to assist the doctors or nurses in completing the task. If the parents are present, she allows them to serve as the main support person.
"We reassure the kids and give them a hand to hold," she says. "We try to build trusting relationships with the kids and their families. We want to be seen as safe people. We aren't the ones who do any painful things to the kids."
Carolyn Parse, certified child life specialist at Johns Hopkins Children's Center in Baltimore, says she works from a family-centered approach, advocating for the needs of both outpatient and inpatient children and their families.
"If they are afraid to ask questions, I need to identify that to help lower their anxiety level," she says. "I can't imagine a children's facility without child life specialists."
The hospital, whose child life program began in 1944, employs about 21 certified specialists in the field. This includes a special events coordinator, who plans activities such as visits from Hershey's "Kissmobile," professional athletes, hand painters and fraternities that sponsor pizza parties.
The center takes part in the Starbright World Program, a closed computer network of about 100 children's hospitals, Ms. Parse says. Hospitalized children throughout the United States and Canada can talk to each other through online chat rooms and video conferencing. The child life program also runs play rooms, which are "safe zones" where no medical procedures can take place.
These opportunities allow the children to escape from the stressfulness of their illnesses, Ms. Parse says. If a child is worried about re-entering school after being in the hospital, she visits the class to help prepare for the child's return.
"We try to explain everything in the softest language that is honest," Ms. Parse says.
Donna Wecker of Elkridge, Md., says the certified child life specialists at Johns Hopkins, have helped her 10-year-old son Cameron when hospitalized for X-LAAD, which is a genetic immune problem. He has spent time at the center over the past eight years.
"We benefited immensely from having the child life program," Mrs. Wecker says. "It was nice to have someone else besides his mom or dad making sure he was OK."
Mrs. Wecker says the child life staff set up a chart with points and prizes to motivate Cameron for his tests and treatments. He also enjoyed weekly bingo through closed-circuit television.
"For Cameron it wasn't a scary or bad place, but a place with lots of friends because he has formed relationships with people," she says. "To us, many of the specialists are like family."
• • •
Deborah Brouse, executive director of the Child Life Council in Rockville, says to become a certified child life specialist a person must pass a professional examination. To apply for the exam, one needs a bachelor's degree with at least 10 courses relevant to the child life field and a minimum of 480 hours of clinical child life experience, supervised by a certified child life specialist.
About 400 child life programs exist in the United States and Canada, Ms. Brouse says. The earliest specialists began their work in about 1920, when professionals identified that children recovered from illness faster when they were treated as children, not adults. The field grew a great deal due to the work of Emma Plank at Cleveland City Hospital in Ohio from 1955 to 1972. She is considered by many as the mother of child life.
"We would love to see child life services offered anywhere children are served in a medical setting," Ms. Brouse says. "Child life is serving people increasingly beyond hospital walls, in places such as rehab centers, hospices, dental offices, funeral homes, and family courts."
Dr. Erin Stucky, a pediatric hospitalist, at the Children's Hospital of San Diego, Calif., says child life services should be a standard part of every pediatric hospital. She is a member of the American Academy of Pediatrics, serving on the national committee for hospital care.
"It's not an extra service," she says. "It's integral to the child's recovery."
Dr. Stucky emphasizes that certified child life specialists act as much more than baby sitters, who simply play with the children. She says their services make the job of nurses and doctors easier.
"They can help the child and family understand more, which decreases anxiety," she says.
"Understanding leads to control in a typical situation that is usually frightening and out of control."

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