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While working with children may seem like a minor aspect of healthcare, the experiences of the child life specialists at Hoops Family Children’s Hospital in Huntington, West Virginia show their work is anything but routine.
In late summer of 2023 at Cabell Huntington Hospital’s emergency department, Jenny Yuhnke encountered a 10-year-old girl who was crying so hard it was difficult to decipher her words. The main issue that emerged: she was scared and wanted to go home.
Trying to get the girl composed, Yuhnke ended up sitting on the floor with her and talking for an hour to stop the flow of tears. When they did, the child life specialist discovered the girl liked the card game, Uno.
As the game proceeded, the girl opened up and shared that she was worried about the ultrasound. She needed one to check for the source of the abdominal pains that had sent her to the emergency room.
Yuhnke showed her some pictures about the procedure and developed a plan for things she could do to occupy herself during the test. To further occupy the girl, the specialist played games of “Thumb War” with the patient. She made it through with no further difficulties.
“After that interaction she didn’t cry the rest of the time she was there,” Yuhnke said. “A lot of people dismiss the crying and those tears, but for a child that can be a traumatic experience, especially if you’re scared and already guarded.
“Being able to have the time to spend with her was so important. Other staff members are so busy they don’t have time to spend with a patient, but I was able to sit with her and figure out what was wrong.”
Time isn’t the only valuable component of the child life team. About a year ago the family of an 18-year-old woman with autism brought her to Hoops, concerned because she wasn’t eating and getting the nutrients she needed. To complicate the situation, because she was non-verbal, the woman couldn’t relate what was wrong.
Doctors, nurses, and a speech therapist tried to help but found no solutions. What ultimately worked was music. Music Therapist Carleigh Cazad used melodies and tunes to convince the girl (who had the mental capacity of a six-year-old) to eat, get out of bed, and walk the hallways. After a month, she was able to return home.
“I was the one who happened to click with her and get on her level, which is one thing people forget about working with children—you can’t speak to them like you would a 30-year-old adult,” said Cazad, a graduate of Belmont University in Nashville. “You have to get on their level and make sure they understand what you’re saying before you can ask them to do anything.”
Child Life Specialist Stephanie Cape is the original member of the team, starting the year the hospital opened in 2015. The office she now occupies didn’t exist back then, nor did many of the beautifully furnished patient rooms.
Fortunately, after five years as a one-member department, additional funding allowed significant expansion. The department is looking for a specialist to replace the coordinator who moved in the fall of 2023 for family reasons and hopes to expand its internship program. There were two child life interns over the past year, with another scheduled to join the music therapy program for three months, starting in June of 2024.
A graduate of Michigan State University with a Bachelor of Arts in Family Community Services, Cape got interested in the field partially because of being sickly as a child. She thought about becoming a doctor, but as she grew older realized math and science weren’t her strengths, making a career in medicine impractical.
However, she knew she wanted to continue working with children. Pursuing studies towards a career in the field, Cape had an “a ha” moment the day a visitor came to a class and talked about working as a child life specialist.
“I thought, ‘That’s what I want to do,’” Cape recalled. “I went to my advisor and changed my major that day and haven’t looked back. I was only halfway through and the degree I was working on was similar to child life so I had time to pivot. I had already been gaining experiences with children leading up to that, so it made it easier to transition.”
Cazad had a similar epiphany halfway through her freshman year at Marshall University. Ironically, she didn’t want to work in a hospital or do direct patient care, so she started on the track to pharmacy school. But she missed the music that had been a major part of her life growing up. So one day she Googled the question, “How can I incorporate music into helping people?”
The answer she found was music therapy.
“I knew then that’s what I wanted to do,” said Cazad. “Marshall doesn’t have a music therapy program so I transferred to Belmont University in Nashville. I grew up in Huntington so changing my major, changing schools, and moving away was a lot in itself. But it paid off because I was able to bring it home and bring something that isn’t too familiar to our area.”
Cazad said education is a strong element of their work with children. They try to bring complex medical issues down to kids’ level to help them understand what is expected of them and different ways of coping with their sometimes challenging treatments.
“We use child-friendly terms and ways of expression,” the music therapist said. “We bring toys in here that are miniature models of what we’re doing, or allow them to creatively use materials so they can better understand what they are used for in the hospital. For them, they get to use them to paint or blow bubbles so they’re not as scary to encounter along the way.”
Cape said most children’s hospitals traditionally have at least one child specialist, with the option becoming more prevalent in adult hospitals that have a children’s unit attached to them. Still, as a newer field and one that doesn’t produce any revenue because of the non-chargeable nature of its services, specialists often have to advocate for their value.
“There’s not an asset to us other than helping your patients,” Cazad said. “But the hospitals that are doing what is best for their patients are getting music therapists and child life specialists—all those kinds of things to support their patients in the best way possible, even though it doesn’t bring them a monetary gain.”
Yuhnke enjoys working at Hoops because although it is a smaller hospital, as the only children’s hospital in a two-hour radius they see a variety of cases. While they handle stomach bugs and minor ailments, they also deal with cancer and traumatic brain injuries.
This all occurs in a family-like setting, where the child life specialists know all the doctors and feel free to consult with them and offer suggestions about problems and treatments.
“In bigger hospitals you don’t always have that because there are so many people and so much turnover,” said Yuhnke, who has a Bachelor of Science in Psychology – Child Life from Utica University in New York. “It’s nice because we can work closely with each care team with as many different patients as we have. Most of the doctors are willing to talk with us, brainstorm, and know how we can best achieve the patient’s goals.”
The secret to a successful child life program is making it look easy, said Cazad.
“If we’re doing our job right it looks like we’re playing and entertaining kids and keeping them occupied but so many other things are going on behind the scenes,” the music therapist pointed out.
“We’re assessing constantly and building treatment plans, plus adapting to what we’re assessing because you can have a treatment plan in your head and then when you get in there, kids are unpredictable. Treatments are unpredictable. All our plans go out the window and we have to adapt to figure out what’s going to be best for that child and their family.”