Children learn, express themselves and cope with traumatic experiences through play. It’s how they come to understand the world. Because play is a child-directed means of expression, it’s also one of their greatest barriers to traumatic stress. The role of Child Life Specialists like Sarah Buckland is to bring play to the children we serve and make them feel comfortable, safe and empowered during the time that they spend here at the center.
For this month’s employee spotlight, Sarah spoke to us about the importance of play, and the work she does with our clients:
I’m on a team of highly trained child development professionals who help children cope with traumatic or potentially traumatic situations. At ChicagoCAC, I support children and teens for both Forensic Interviews and medical exams. My team and I try to create a trauma-informed, child-friendly environment.
A lot of my job involves assessing a child’s development, such as their personal coping strategies, how they’re coping in the moment and their family dynamics, so I can help them through that traumatic or potentially traumatic event in a way that leaves them feeling confident and empowered.
Sometimes kids understand what’s happening, sometimes they don’t, or maybe they only have an idea from what they’ve seen on TV. That can be very scary for a child, especially when the adults around them are focused on gathering evidence or relating to their caregivers. Normalizing play helps create a space they recognize. That can be anything from a game of Uno to playing with Mr. Potato Head, drawing, or creating crafts. Play breaks things down in a way that children can understand.
Part of my education to become a child life specialist was figuring out how kids learn, and how trauma affects the learning or coping process. I provide developmentally appropriate information at their level, in ways they can understand, and I’m constantly checking for how they’re coping with that information. If I assess that it’s too much for them, I take a step back and use coping strategies the child’s developed to help make them feel safe.
Children are often very aware of their own coping strategies, if you take the time to listen. If you ask a teenager, they might say “I like music, a walk in the garden, or taking deep breaths”. If you ask a five year old what makes them feel better, a lot of the time they’ll tell you, “I like talking to my mom, I like playing with my dog.” As we move through the process, if I see the child getting upset, I step in and provide an intervention. ChicagoCAC staff and our MDT partners are so fantastic and so responsive to the kids’ needs, as well as me advocating for those needs. If a child has siblings with them and they want to see ‘big brother go first’, that bond also gets reinforced.
Something I’m very passionate about is that kids and teens have a right to know what’s happening to them, even if it’s scary. My job is to break things down to where the child can understand what’s going on, and give them the power to say when they’re not comfortable. This is especially important during medical exams, because their body has potentially gone through something very traumatic, and trust has been broken as it involves their bodily integrity. Just telling them what’s going to happen isn’t going to be enough for a five year old, so I use play to explain the situation to them.
For example, I have a stuffed Kermit doll that I use in the clinic in ‘medical play’. I’ll let the children I work with actually use medical tools on Kermit, as if they are the doctor. They check his eyes and ears, they put a gown on him, and examine the situation from an outside perspective. There are even times where I’ll bring Kermit back out during exams.
Children may be nervous talking directly to me, but they can talk to Kermit all day! They are also less scared when Kermit has the medical procedures first, so Kermit goes around the entire unit with them and ‘talks’ to the doctors (they think this weird lady talking ‘for’ him is super cool). Once Kermit has done it, the children are more comfortable doing it themselves.
One last component of what I do is provide support to our clients and families, as well as emotional validation. Evidence has shown that when kids walk into a potentially traumatic situation, they immediately refer to their caregiver for how they’re supposed to respond. If the caregiver is (understandably) nervous or upset, the child will mirror and model that. My support of the caregiver directly impacts my support of the child.
In the clinic, I do check-ins with the caregivers and often they’ll share their own history with me. I can provide them the reassurance that I’ve spoken with their child, they know there’s a plan, and they’re part of that plan. After talking with me they’ve said they felt better. Seeing their child play and laugh with me also helps calm their nerves, helps them feel part of the process, and builds on their family bond.
Here’s an example of my day-to-day work:
I had a preschool child come in with possible developmental delays, which we weren’t aware of at the start. She was easily overstimulated and could become overwhelmed during normal play, even when it was positive. When we first tried to do a medical exam, which was very important, we were unable to complete it because she got nervous and scared. The caregivers decided to take a break and reschedule for the next week. Unfortunately, by the following week the child was still getting overstimulated, and was also extra nervous now that she knew what was going to happen.
Instead of pushing her into it, we took some time out and just played. She had fun and we built a rapport, but I started to notice her becoming overstimulated again. While preschoolers love pretend play, sensory play (play that engages the senses in a calming/soothing way, such as rubbing soft things or listening to things click) can help them calm down, especially if they have sensory sensitivities. I brought out a light-up wand that spins with nice neon colors, and she zoomed right in on it.
When that happened, I could see her whole demeanor change. She was focused on these glowing lines, talking about this ‘beautiful magic wand’ I’d given her. We were able to go back into the exam room with the ‘magic wand’ and start the exam. We had the child sit on a caregiver’s lap – what we call a ‘comfort hold’ or ‘hug’, in which the caregiver is actively providing physical support to the child during the procedure. By slowly desensitizing the situation for her, we were able to complete the exam and continue playing. She was much more relaxed and wasn’t withdrawing anymore. Her caregiver and I celebrated with her, saying ’You did such a good job, your body is healthy!’ She was so proud of her accomplishment.
WANT TO KNOW MORE?
Read more about our child life programming and the process children follow when they come to the Chicago Children’s Advocacy Center here.