The Fort Worth Museum of Science and History is bringing a touch of Cook Children’s imagination and magic to the newly renovated TCU Children’s Gallery, set to reopen on March 7.

Since 2009, the Children’s Gallery has been a favorite stop for children exploring the Museum, inviting them to learn through playful, hands-on activities and exhibits. The reimagined TCU Children’s Gallery features the same immersive experience but with a new touch of whimsy. 

“After more than a decade of play, we wanted to reimagine the Children’s Gallery for a new generation of learners by updating the physical environment, incorporating modern experiences, and creating a space that feels fresh, inclusive, and connected to our community,” said Karla Hernandez, Fort Worth Museum of Science and History Marketing Manager. “The goal wasn’t to replace, only to refresh and elevate the experience for the children of today.”

Where the Future Begins

The Children’s Gallery is a space full of possibilities for curious minds. Anchored by an otherworldly spaceship and launch pad play area, it welcomes visitors to explore Fort Worth’s Cowtown culture and imagine the city’s promising future. The space is drenched in bright colors and features a fantastical facade of Fort Worth’s most notable landmarks, like Texas Christian University’s iconic Frog Fountain, Amon G. Carter Stadium and Cook Children’s Medical Center.

As children and their caregivers move through the gallery, they will explore and experience displays such as a theater, train station, homestead, marketplace, hospital and more. Children can don costumes and play with props in each display as they learn about the community and all of the possibilities that exist for them.

“Our goal was to design a space that feels immersive, optimistic, and open-ended,” Hernandez said. “We wanted children to move naturally from one experience to another, creating their own story and way of playing. The layout encourages curiosity, independence, and collaborative play, allowing children ages 0 to 8 to engage with the exhibit pieces and other children at their own pace.”

Magical Moments at the Museum

In a nod to its 108-year history of improving the health of Fort Worth’s children, the interactive hospital display is marked by the signature blue peaks of Cook Children’s Medical Center. In this space, curiosity powers imaginative play as children experience the world of wellness.

“This gallery is inspired by the people, places, and culture of Fort Worth and Cook Children’s has been a trusted partner in our community for many years,” Hernandez said. “Having them represented in this space invites children to explore the world of medicine and imagine themselves as the future caregivers of our community. Experiencing a playful version of Cook Children’s will help make hospitals feel less intimidating and create a sense of comfort for families”

Cook Children’s Child Life department helped imagine and design the Cook Children’s exhibit, with the goal of bringing the medical center to Museum visitors and the community.

“This project was an opportunity to be creative and collaborative, and to dream up something special for the Museum and, more importantly, the kids who will play in and explore the space,” said Katie Campbell, Cook Children’s director of Family Support Services. “Personally, I love the Museum, and my boys spent tons of time in the space as little guys, so I know the importance of the gallery and the imagination it created.”

Peaks the Dragon on Display

A colorful mural depicting Cook Children’s Teddy Bear Transport and beloved mascot, Peaks the Dragon, serves as a backdrop for the exhibit and its play zones.

In the exam room zone, children can dress up in a lab coat and pretend to be a doctor, and get a whimsical look at themselves in the floor-length giggle mirror. This area also features a countertop and faux sink, just like in a real exam room. Toy medical tools, such as a stethoscope and thermometer, allow make-believing children to check vital signs.

In another zone, children can pull up a magical medical chart on a 55-inch touchscreen, similar to a shopping mall directory. By opening the chart, children are empowered to discover six of the body’s major systems, like the circulatory and respiratory systems, for example. Funny and engaging animations illustrate the function of each system as museumgoers tap through a browsable diagram of the human form.

In the center of the Cook Children’s exhibit, a wooden MRI scanner play set invites children to explore the world of medical imaging. Visitors can recline into the play set or place a doll or stuffed animal. With the push of a button, the scanner simulates the looping lights and sounds of a typical MRI machine, plus a few silly and musical audio effects. From there, kids can step over to the digital imaging viewer to get an up-close view of stock x-rays and scans.

“Play is a child’s work. It is how they explore and learn,” Campbell said. “The opportunity to ‘play’ with hospital equipment, learn about parts of the hospital, and lay the foundation for emotionally safe experiences around health care and wellness are crucial to helping kids grow into a positive relationship with wellness and health care as grown-ups. It’s important to talk to kids about what happens at the hospital before they need to visit one, and this exhibit allows kids to become comfortable and familiar with the hospital in a stress-free environment.”

Museum members got a first look at the TCU Children’s Gallery during the member preview on Friday, March 6. A grand opening will be held on Saturday, March 7, at 10 a.m. Click here for more information.

Whew! We have almost made it through another holiday season. School has wrapped up and now it’s time for the mad dash to finish all the gifts and stocking stuffers. 

I recently wrote a guide to fostering gratitude and I mentioned the importance of teaching our children how to be good givers. This year, my husband and I decided to give our kids a small budget and asked them to think about what they wanted to get for each other and a few extended family members. 

Our girls truly love to create, and it is through their creations that we see their unique style and natural talents shine. They pour their heart and genuine thoughts into every gift they make. 

Just looking around my mother's house, I see she has treasured and kept so many of the things my girls have made for her over the years. In fact, many of the homemade gifts they've given me are my absolute favorites of all! Homemade gifts are the most thoughtful because they come straight from the heart and represent time lovingly spent on the creation.

Thinking of homemade gifts doesn't have to be daunting! I tapped into the expertise of our resident artists at Cook Children's, Sydney Peel and Suzanne Minatra, to share simple, fun ideas that your kids can create this year. Imagine transforming dollar store finds into beautiful, one-of-a-kind treasures. 

The artists shared several fantastic projects that are easy to complete on a very small budget and require minimal time.

Do-It-Yourself Swirly Shaped Crayons

These are a great gift for kids to give to other kids. They can be molded into different shapes and are fun to color with. 

• Peel used crayons
• Break the crayons into small chunks
• Place the crayon pieces in shaped silicone mold of choice
• Melt in oven until swirly (with the help of an adult)
• Let cool completely

Do-It-Yourself Keychains and Bag Charms

Keychains and bag charms are a great option for school-aged kids and teens to give to the adults in their life. They can be created with:

• Clips
• Strings or ribbons
• Assorted beads
• Letter beads 

Many bead kits should have everything you would need for this, but items can be purchased separately. These are fun because they can be used on purses, bags, keychains, and so much more! 

Air-Dry Clay

Air-dry clay is fun and forgiving! It’s a wonderful medium for kids to work with, offering endless possibilities for creative projects. Once dry, the finished pieces can be enhanced with acrylic paint, paint markers, regular markers, or a clear glaze coating.

Textured clay ornaments make a wonderful gift for family members or teachers. Here's what you'll need to create them:

• Air-dry clay
• Ribbon or string (for hanging)
• Texturing tools (texture rollers, mats, or DIY items like lace or stamps)
• Cookie cutters
• Acrylic paint and paintbrushes

You can also create adorable hand or foot mold ornaments with air-dry clay. These are some of my most cherished ornaments on my tree—we even have our dog’s paw print!

Gift-giving doesn't need to be hard, complicated, or expensive. These simple, last-minute ideas help us teach our children how to give gifts that express their personality and offer the true value of time and thoughtfulness.

“Handmade gifts are a perfect way to add a special memory into the holiday season," Peel shared. "Having children make handmade gifts not only allows them to learn about the gift of giving but also gives family and friends special keepsakes to enjoy for years to come.” 

Don’t underestimate what your kids are capable of. I have found that when my kids make a gift for someone, they don’t want to stop. They want everyone to have a piece of their he(art)!

As we approach the season of gratitude followed immediately by the season of gift-giving and receiving, it’s easy to feel the whiplash of these two periods. These seasons can make for a tough ending to the year for parents and caregivers. There is an influx of desire and wants for all of us. Social media and other media are filled with things we hope we can have. We are consumed with wish lists right after we have given thanks for the blessings of the year. 

While the Thanksgiving holiday is set aside to reflect on all the good gifts of the year, research repeatedly shows that gratitude as a practice is beneficial for physical, mental and spiritual health. However, focusing on our blessings for one month a year isn’t sufficient. The practice of gratitude must extend beyond November to truly benefit everyone. Depression, sadness, and hopelessness are continually rising, especially among young people, yet research tells us that the practice of gratitude is a simple and effective way to combat the crisis we are facing. 

So how do we teach gratitude to our kids? I have a mix of personalities in my house. For one kiddo, “thank you” comes quickly and easily, while another sees the empty half of every glass and often misses the good. It can feel near impossible to convince my more negative kiddo that good things surround her. To be honest, if I focus on the things that are hard or that I dislike in life, I also feel quite overwhelmed, and it can be difficult to convince me to be thankful for any of the good things. This is why gratitude is a practice. And that is we need to do first… practice. 

Practice Gratitude

First, we cannot ask our kids to do things that we are unwilling to do ourselves. Start by practicing gratitude and then work with your kids to do the same. 

There are many ways to do this, but a simple gratitude journal is a great start. There are specific gratitude journals for kids and teens, or you can simply use a notebook. I spend time writing down three things I’m grateful for each day. If you do this every day, after a year, you will have a record of 1,000 things for which you are grateful. 

I have also heard of gratitude jars that families look through at the end of the year. It’s so encouraging to look back through a gratitude journal and see all the good gifts of life. 

You can also practice gratitude by asking about the highs and lows of the day. This is great to do in the car or at the dinner table. When we encourage each other to look for the good in the day or situation, it helps to retrain our brains to focus on the positive. This establishes healthy neural pathways. 

It’s also good to take a mindful moment and name things you are grateful for in a moment – cool air, a comfortable chair, the ability to take deep breaths. 

The practice of gratitude can be difficult to start, but once you begin, it can be a helpful practice in a world that often feels sad and burdensome. You quickly begin to realize that there are huge gifts and good even in the midst of the hardest of experiences. Gratitude leads to more joy and more hope as you acknowledge even the small gifts in the moments and days. 

Practice Generosity

When we take time to give things away, either to others or for others, we witness the practice of gratitude. 

Gratitude is contagious. Watching others offer thanks for our generosity helps us, as humans, to remember the good gifts we have been given and, in turn, to be thankful for them. 

We can help our kids practice generosity in lots of practical ways. We can help them pick out one of their toys to give to a child who may not have one or pass on clothes they no longer wear. We can encourage them to share with their peers and classmates. 

During this season, my family often chooses an organization to donate to so that our girls have the opportunity to practice generosity in a hands-on way. This year, they each filled a Samaritan’s Purse shoebox for a child. Continued generosity reminds us all to think of others. This often leads us to be grateful for the many ways that others have been generous to us. 

Serve Others

It is also true that when we serve others, gratitude often follows. The beauty of serving others, like generosity, is that the focus is taken off yourself and off material things. The focus is on other human beings. 

Serving combats the constant thought of wanting or needing more. Serving others often puts us in a place to see others’ vulnerability and struggles face-to-face. This leads to desiring to be more generous with our time and resources while simultaneously recognizing the good and important parts of our lives. 

Teaching our children to serve others also allows them to experience other’s gratitude and joy. This could look like visiting a shelter or nursing home, making dinner for a neighbor, offering to clean a house or mowing a person’s yard. Any time we prioritize serving others, we open space in our hearts to see the good in our own lives and the lives of others. 

Cultivating gratitude in our own hearts and in our children’s hearts does not happen overnight. However, with time and intentionality, we can help our children to grow in gratitude. What are some things that you are grateful for this year? Go share those answers with your kids and ask them the same question. 

The event was modeled after “Grandmother of Juneteenth” Opal Lee's annual Walk for Freedom, a 2.5-mile walk that serves as a reminder that it took 2.5 years after the Emancipation Proclamation for the news to reach South Texas. 

“The partnership between Cook Children’s and Twisted X reaffirms our commitment to providing both patients and families with individualized resources tailored to their health care needs,” said Cook Children's Health Foundation Director of National and Regional Partnerships Natalie Houghton. “We continually strive to provide compassionate care and are proud to come together with Twisted X who shares this philanthropic focus.”  

Twisted X will continue to donate 100 percent of wholesale proceeds from every pair sold directly to Cook Children’s to benefit the Creative Arts Program. The program enables patients to explore new ways of expressing themselves through visual arts, connecting the creative arts with the art of healing. This initiative aims to help children relax, gain confidence, make choices, practice control, solve problems, adjust to the hospital, and achieve social, emotional, and physical goals. To date, $75,000 has been given back to the program, which served 2,700 patients in the last year. 

“Partnering with Cook Children’s is a chance to make a positive change in our community and we’re proud to support the Creative Arts Program,” said Twisted X CEO Prasad Reddy. “We continue to believe that little steps can make a big impact and it’s been incredibly rewarding to see this collection embody the joy of footwear design.” 

The updated collection includes two thoughtfully designed shoes created by patient-artists Brianna and Alex, who worked alongside Twisted X Designer Tuan Le to bring their visions to life. Each pair is named after the young designer and represents their dream shoe—a lightweight, slip-resistant design tailored for comfort and style. These shoes are ideal for medical staff, patient families, and supporters of Cook Children’s everywhere. 

To celebrate the new launch, Cook Children’s and Twisted X hosted a special event today at Cook Children’s Medical Center – Fort Worth. The event honored the patient designers and provided a fun, interactive experience for patients and families at the medical center.

The collection will be available in the gift shops at Cook Children’s medical centers in Fort Worth and Prosper. To learn more about the special collection, visit twistedx.com/pages/cook-childrens. 

What exactly is Child Life? Child life specialists are asked this question daily. Despite its decades-old presence, child life specialists regularly explain the basics of their practice to others, often provoking surprise and appreciation. The “wow” following the explanation is a shared experience, a moment where child life specialists themselves reflect on the remarkable, and sometimes hard-to-grasp, nature of their profession.

Child life, though rooted in 1920s “play programs,” gained formal recognition in hospitals during the 1960s. While the profession has evolved significantly since then, just as the world has, its foundations still guide and direct every interaction. Child life is an essential component of pediatric care, supporting children’s healing throughout their medical journeys.   

Play

The foundational principles of child life services include emotional support, preparation for medical procedures, parental involvement and play.

At the heart of child life lies play, a fundamental principle that guides all other aspects of the profession. While play can sound simple and unimportant to the world, it is the primary way to relate to children. Children communicate through play in many ways: parallel play, cooperative play, constructive play, physical play and more.

As Fred Rogers, a television host and author better known as Mister Rogers stated, “Play is a child’s most important means of communication. Children are not self-conscious about playing. They play out what they think is real. That’s the ultimate honesty. Children bring their whole inner drama to any relationship.”

He also said, “Play is the work of childhood,” highlighting its crucial role in learning and development. Play is the best framework for every interaction with children.

So when a child is experiencing something new, different, scary, or confusing like the hospital, play becomes the essential starting point. It remains central to normalizing the hospital environment and facilitating healing.  

In The Story of Child Life, authors Susan Wojtasik and Claire White state, “Preparation for medical encounters, supporting family centered care, pain management, coping with grief and loss are as fundamental to child life practice today as is play. Nevertheless, play continues as a central experience in the hospital lives of children. It is a mode of healing.”

In some ways play has evolved over time with the development of technology. However, it has not changed a child’s need for free play, dress-up, or face-to-face interaction over a good card game or Barbie playtime.

Medical play, a cornerstone of child life practice, empowers children to process their medical experiences. By taking on the roles of doctors or nurses, children gain control and express their emotions, allowing child life specialists to understand their interpretations of their diagnoses and treatments.

So while the landscape of play has expanded, its core purpose – to learn, express and cope – remains unchanged. Children still thrive through pretending, competing and building, both independently and with others.

Emotional Support

While play is the foundation for communication with children, another principle of child life is emotional support.

Over the years, child life specialists have become essential in providing this support to patients and families, occupying a unique position within the health care team.

They are not responsible for making medical decisions for the patients or carrying out medical procedures; however, they serve as a constant, empathetic presence, guiding patients and families through the emotional complexities of their medical journey.

While other professionals can provide emotional support, child life specialists have the unique role in a therapeutic relationship with patients and families that includes a lot of play and fun. This type of relationship breaks down emotional barriers and fosters trust.

From initial hospital admission to end-of-life care, child life specialists offer unwavering emotional support to patients, families and friends. Over the past century, their reach has expanded significantly, extending beyond inpatient settings to outpatient clinics, specialty clinics, emergency departments and many other spaces. Today, emotional safety is at the forefront of pediatric care, and child life specialists are leading the charge to ensure that the emotional well-being of children is protected within their health care experiences.

Preparation

Preparing and supporting patients for medical procedures and experiences is another foundational principal for child life. Since its inception, the profession has emphasized the value of preparing children for medical experiences.

There are many ways to prepare children, but we know that play is the foundation of communication with children; therefore, effective preparation incorporates play and demonstration, including medical play.  Preparation also includes sensory information for the patients – what they will feel, see, smell, and hear – before, during and after procedures. Child life specialists can prepare patients and families for a wide variety of medical experiences, from blood pressure cuff placement to an IV start, MRIs and end-of-life care.

Child life specialists are trained to use developmentally appropriate language with children, translating complex medical terms into understandable concepts, like describing a tourniquet as a “tight squeeze.” This language helps alleviate fear.

Child life specialists also educate patients about new diagnoses and collaborate with families to create personalized coping plans. Over time, this aspect of child life has become increasingly specialized, making child life specialists essential in helping patients navigate and cope with their medical environments and experiences.

Parent Involvement

Lastly, child life specialists foundationally believe in parent involvement. A century ago, parental presence was not a given in hospital settings.

One of my favorite books is Curious George goes to the Hospital by H.A. and Margaret Rey. It was originally published in 1966, and the Man with the Yellow Hat was not allowed to stay at the hospital with George. While this book is chalked full of the foundations of child life, it is clear that family-centered care was not yet a standard practice.

It wasn’t until 1980s that family-centered care was introduced to hospitals and not until 2003 that the American Academy of Pediatrics added family-centered care to their policies. Child life specialists were instrumental in advocating for parental inclusion in a child’s hospital stay and care. They were guided by family systems theory, which recognizes that a child’s medical experience affects the entire family.

Today, family-centered care is essential to medical care, especially pediatric care, with child life specialists championing parental presence and involvement in all aspects of care, from comfort positioning to education about procedures and diagnoses.

So, what is child life? Child life is the foundation of caring for children in the medical setting. Child life specialists exist to bring comfort and understanding to children within the medical environment and ensure their emotional safety through play, emotional support, preparation and parent involvement. A century later, child life specialists still play – first and foremost – provide emotional support, prepare, support and educate patient families, and advocate for family-centered care. As we celebrate child life month, we celebrate the incredible role that child life specialists play within the health care team.

References

Gaynard, L., Association for the Care of Children’s Health., & ACCH Child Life Research Project. (1990). Psychosocial care of children in hospitals : a clinical practice manual from the ACCH Child Life Research Project. Association for the Care of Children’s Health.

Wojtasik, S. P., & White, C. L. A. I. R. E. (2009). The story of child life. The handbook of child life: A guide for pediatric psychosocial care, 3-22.

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A Look Back: Celebrating 45 Years of Cook Children's Child Life Department

This exciting event coincides with one of the biggest fundraisers supporting Cook Children’s NICU. Join us for Cook Children’s Day at The Rodeo on February 5, 2025. Half the cost of your ticket will benefit Cook Children's Neonatal Intensive Care Unit (NICU). The Rodeo has long been a treasured partner of Cook Children’s, benefitting the NICU for more than ten years.

Our Level IV NICU, with all-private patient rooms, provides the highest level of care for babies in our region. Grab your boots and come support our tiniest Texans!

Learn more about this exciting night here: https://www.cookchildrenspromise.org/events/rodeo/

The start of a new year provides a great opportunity for self-reflection and New Year’s resolutions. While adults all over the world are reflecting and hoping to improve certain areas of their lives, this is a great time to connect with our kids and help them to look back on things that were hard or amazing and look ahead to the things they hope for. 

While setting New Year’s resolutions may be a high expectation for our kids, we can certainly help them look at their life currently and reflect on their thoughts and desires for the future. Self-reflection and self-awareness are such important practices for our children to learn to be able to grow and change. Asking a couple of questions about where they are and where they would like to be can help to set the stage for kids to grow. Even preschoolers can reflect on things they love and things they wish they could do better. 

It’s great to ask questions. Doing this alongside your children gives you a chance to share your own reflections with them, further developing your relationship. Having these conversations and documenting your children’s responses also provides an opportunity to touch base throughout the year and take inventory of how things are going. 

For younger kids, you could ask just two questions: 

• What is one thing that is hard for you that you wish you could do better?
• Who is one person that you would like to get to know more (or spend more time with)?

For older kids, you could ask them to look at things a little more in-depth: 

• Friendship – Who is one friend that you are glad to have in your life? Who is someone you would like to spend more time with? How can you be a good friend to them? 
• School – What do you love about school? What is one thing you wish was could be different at school? What is one thing you would like to improve in at school? 
• Home – What is your favorite thing about our family? Is there something you wish looked different at home? What is one thing that you would like to improve on at home (chores, tidiness, sleep, etc.)? 
• Hobbies – What is one thing you love doing? What is one new thing you would like to try? 
• Health – What is your favorite activity or sport to do? What is one way that you could choose to be healthier this year? 

Asking questions that allow your children to reflect on one thing they are grateful for now and one thing they want to change is a good format for self-reflection and self-awareness. Allow your children to come up with their own answers. As parents, we always have our own ideas of what we hope can improve for our kids. Sometimes we wish they read more, cleaned up their room more frequently or made their beds every day. This is not an opportunity for you to share what you hope they improve on. However, your child may need some guidance when answering the questions. Your positive reflections of their life and character will always be encouraging. So you could help them by saying, “I see you being a good friend when you _____. “ Or “I know you’ve said you wished you could _____.” These are great positive prompts to help your children learn to be self-reflective. 

I cannot ignore that some pre-teens and teens may roll their eyes at an activity like this. I encourage parents and caregivers to use this as an opportunity to connect. Take your kiddo to lunch or set up a picnic. Do something a little out of the ordinary to help them have a positive experience with this self-reflection. I would not encourage having this conversation at bedtime.

Finding ways to remind one another of these reflections and desires can be helpful. For younger kids, that may look like hanging a poster in their room to remind them of their answers and focus for the coming year. For older kids, it may be a journal or a piece of paper they can have readily available to look back on. 

New years are not a magical reset – it takes some kind of intentional reflection. New years provide a space for new beginnings and can be a beautiful opportunity to reset and connect with ourselves and others. I encourage you to use this new year to connect with your kids and provide a space for open dialogue that helps them reflect on themselves and their place in this world. The hope is that they can see what brings them joy and help to bring others joy as they grow! 
 

Camps for Kids are specialized camps that offer unforgettable experiences – from reeling in a fish to conquering the ropes course. They also go beyond traditional fun as they provide opportunities for campers to build supportive, lasting relationships with others who share similar life experiences.

Each weeklong camp and weekend retreat focuses on a different diagnosis or patient population. The goal is to create a sense of normalcy by providing experiences that help campers learn skills and gain independence. Click here to view a list of summer and weekend camps opportunities provided for eligible patients.  

Camp staff and medical staff work together to operate the camps, which creates a safe environment where kids can simply be themselves and share the magic of camp.

Kimberly Henry, a respiratory therapist at Cook Children's, has volunteered at camps for 18 years. 

Henry says these camps are an opportunity for education and learning more about what's necessary for daily care and health. Campers learn and grow alongside other children like themselves.

“I love the time spent with the campers making sure they are having a great time and learning how to take ownership,” Henry said. “To me, it’s rewarding to turn a child’s thoughts from ‘I can’t do that because I have muscular dystrophy or asthma’ to, ‘I can do that and I have muscular dystrophy or asthma.’”

Liz Barriteau, respiratory patient family asthma and trach educator at Cook Children’s, encourages volunteers to get involved with Camps for Kids. She says the most rewarding aspect of volunteering at Camps for Kids is “seeing the children being set free.”

“My advice is that if you like working with children, just do it!” Barriteau said. “It is very rewarding, and it is for a great cause. Camps need counselors, male and female, in order for camps to function well and safely. Without counselors, there is no Camps for Kids.”

If you’d like to volunteer at a camp this summer, please reach out to that camp’s coordinator listed here.

To donate:
Camps for Kids is a donor-funded program ensuring that all campers’ fees are provided. Each camp is targeted to provide memorable experiences to campers with a similar diagnosis. If you’d like to donate and provide these deserving children an experience that will impact them for the rest of their lives, click here.

March is Child Life Month! This year, we are celebrating 45 years of Cook Children’s Child Life Department. I can’t imagine Cook Children’s or any pediatric facility without child life, but nine times out of 10 when I tell people what I do, they immediately ask, “So what exactly does a child life specialist do?” I have to wonder if there is a blessing in people not knowing exactly what child life specialists are. It most likely means they or someone they know has not ever had to spend time at the hospital with a child. Yet, child life is so vital to the care pediatric facilities provide patients and families.

History of Child Life 

Child life services, or some version of play in the pediatric setting, dates back to the 1920s. Michigan and New York both had pediatric hospitals developing play programs for their patients in the early 20s. Play is essential to children’s development, so it is not surprising that it became clear that even hospitalized children still needed play interactions. Emma Plank, known as the mother of child life, was asked by Dr. Fred Robbins – a Nobel Prize-winning pediatrician – to create a program to “address the social, emotional, and educational needs of hospitalized children” (ACLP, 2023) at the Cleveland City Hospital in 1955. 

Plank went on to be the director of that child life program until 1972, and in 1962, she authored a book titled Working with Children in Hospitals. At the same time in 1965, a group of child life pioneers met in Boston to discuss child and family-friendly hospital settings. This meeting led to a professional organization that became the Association for the Care of Children in Hospitals (ACCH) in 1967. This group was made up of doctors, nurses, child life specialists, other professionals, and parents.

The 1970s was a time of growth in the field of child life. A group of child life professionals met to establish the theoretical framework of the profession and begin to establish educational requirements for becoming a child life specialist. The number of child life programs increased during this time, including Cook Children’s own child life program. Lisa Pool graduated from Texas Woman’s University as a recreational therapist. Upon completing her residency required for her degree in a child life program, she changed her profession and became Cook Children’s first-ever child life specialist in 1978. In 1979, Cook Children’s had an official Child Life Department, which is celebrating 45 years this year!

In 1982, the Child Life Council was established. It is now known as the Association of Child Life Professionals (2016). They began a national conference for child life professionals and requirements for professional certification were also established. Much work was done in the 1980s and 1990s to support the child life profession by creating and upholding standards for child life programs and individuals in the field of child life. 

Now, child life specialists must complete certain coursework in play, child development, grief and bereavement, and other related courses along with a bachelor’s degree and a minimum of 600-hour internship under a certified child life specialist to be eligible to sit for the Child Life Certification Exam. To maintain their certification, child life specialists must continue their education or take the exam every five years.

Child Life Today

There are over 5,500 child life professionals in the world today. Cook Children’s has over 89 individuals in the child life department including Certified Child Life Specialists, activity coordinators, music therapists, art therapists, recording and broadcast producers in the Child Life Zone and many other individuals who are a part of our Sit, Stay, and Play and CARP programs, Sibling Center staff, experience ambassadors and community program coordinator.

When I think of how far child life has come as a profession, I am so proud to be a part of not only apart of this profession, but specifically the Child Life Department here at Cook Children’s. Jill Koss, Director of Family Support Services, has been at Cook Children’s for 33 years and has served as a pillar of the child life profession becoming the 2023 ACLP Distinguished Service Award recipient. She values serving patients and families above all, and she continues to empower our department to remain true to the practice of helping children through hospitalization even though the world of healthcare is constantly changing.

Today, all over the world, you will find child life specialists impacting children who are experiencing hospitalization. Child life specialists meet children and families to support their continued development and emotional safety. Child life specialists do this by promoting play and normalization, preparing and supporting patients through painful procedures, teaching children coping skills, supporting patients and families through grief and bereavement and providing patients and families with creative outlets through art, music, broadcasting and much more!

Child life specialists have become an essential part of the pediatric health care team and are honored to advocate for patients and families throughout their hospital journeys. While the child life profession is fairly young compared to others, it is safe to say that child life professionals have impacted children and families well beyond their years. Happy Child Life Month and Happy 45 Years of Cook Children’s Child Life Department!

If you would like to learn more about what Child Life Specialist do each day, you can check out the following articles:

• Entering Someone Else’s Story: What It Means to Be a Child Life Specialist
• How Child Life Specialists Can Help Patients Through an Important Aspect to Pediatric Health Care

How many times has your child told you that they brushed their teeth only to find a dry toothbrush when you inevitably go check? How many times did you tell your own parents that you brushed your teeth when you, in fact, did not? Brushing teeth might be the most lied about subject in my home. As far as I know, there has not been a research study on why children lie about brushing their teeth, but it seems to be a universal phenomenon.  Honestly, brushing your teeth is like any other good habit. It must be taught, practiced, and repeated to become a daily habit. Your children do not know or understand the long-term effects of not brushing their teeth, nor do they see an immediate reward for brushing. For all of us, not practicing good oral health has its consequences at least once every six months if you are seeing a dentist. The lack of good oral health can lead to long-term health consequences and years of dental work that can not only be painful but costly. However, children do not have the forethought to know this or the ability to understand it.

This is why it is so important to establish good oral health habits at home. Good oral health is crucial to your child’s overall health and development. As parents, the way we approach oral health in the home can help to establish life-long habits for our children. While it can be difficult and time-consuming to help your children brush their teeth daily, it is a habit that can help prevent them from having to experience difficult and traumatizing dental procedures now or later in life.

Betsy Hillyard, CCLS (Certified Child Life Specialist) and oral health program coordinator at Cook Children’s Center for Community Health has three tips to encourage parents as you establish good oral health habits at home. As parents, modeling good oral health, having realistic expectations, and having the right tools available can help to make the daily practice of oral health easier for children.

1. Model good oral health. As parents and caregivers, much of what we teach our children stems from what we do. If your children don’t see you brushing your teeth, flossing or prioritizing your own oral health, they are not likely going to want to do it. However, children are often motivated by what they see adults doing and often want to do those things simply because an adult is doing them. Allowing your young children to brush their teeth alongside you can be a great way to encourage them while also monitoring their brushing times and techniques. It is also important to start modeling from a very young age. You can start brushing even your baby’s teeth with a toothbrush (no toothpaste) to begin to get them used to it.  Modeling frequency and times will help your children be able to establish their routine. If you brush your teeth 2 times a day every day, before leaving the house and again before going to bed, your children will likely adopt this same routine. It’s important to model whatever your expectations are. This is true for any habit you are trying to teach your children. It is also encouraged that you monitor your child’s oral health routine until they are 9 years old.
2. Have realistic expectations. If oral health has always been a challenge for your family, it is important to start somewhere, and it is never too late to start implementing good oral health practices. If your child is currently not getting their teeth brushed at all during the day, start with making it a priority to get at least one time a day in and increase to 2 times a day. If your children don’t spend enough time brushing their teeth, it may be good to have them try to brush for at least 30 seconds and then adding more time as they accomplish their goals. Take time to celebrate the one time a day or the 30 seconds that your child can brush. The goal would be to work up to 2 minutes of brushing time, 2 times a day. If your child has mastered brushing their teeth, but flossing is not happening, start with a goal of flossing once or twice a week and work your way up to daily. It’s important to keep oral health a positive topic with your kids. Giving them manageable and attainable goals will help to build their confidence. Positive reinforcement is always helpful when establishing a habit. Using brushing incentive calendars is a great way to keep your expectations realistic while rewarding any goals your child accomplishes. Setting a goal like brushing ten times a week and flossing twice could mean a small prize or extra screen time at the end of the week.
3. Have the right tools available to your kids. Brushing your teeth can be much more fun if you love your toothbrush and the flavor of your toothpaste. This is a great place to allow your child to have choices. While it is important to get your child the right sized toothbrush, allowing your child to pick a toothbrush that they love with their favorite color or character can help. Also, it is important to choose a flavor of toothpaste that your child likes. I know my girls often found minty toothpaste to be way too “spicy” for them when they were younger. Just make sure that you choose a toothpaste that is approved by the ADA (American Dental Association). Finding some type of timer that works for your children is also helpful. It can be a simple sand timer or there are apps with brushing timers for kids. When encouraging flossing, I find that for myself and for my girls that flosser holders are much more user friendly than string floss. They also make flossers in fun colors. My girls get flossing done more easily and frequently with flossing holders available. Anything that can aide your child in meeting their brushing and flossing goals is a win!

As always, it can be helpful to use books and videos to help encourage your children’s oral health.

• I Care for My Teeth by Martha E. H. Rustad
• Caring for Your Teeth by Sian Smith
• Daniel Tiger’s Brushing Teeth Song by PBS

Brushing teeth and flossing are habits that help your child’s overall health for their lifetime. While it can be challenging to establish any good habit, it is important to remember that the effort and time you take to help your children will allow them to continue healthy habits into adulthood. If you run into any challenges or difficulties (i.e. thumb sucking, pacifiers, dexterity with the toothbrush, etc) with your child’s oral health, it is important to reach out to your child’s dentist as they can help you navigate this. Happy brushing!

Going to the dentist and taking your kids to the dentist may bring up a lot of emotions and most likely some anxiety for many of us. One of my own traumatic memories as a child was at a dentist appointment. I was scheduled to have several teeth pulled for orthodontic purposes, and in short, I refused to let the dentist touch me. My mom called my dad from the dentist office to convince me to do it, and then they both decided after complete refusal that it would be better if I went to a pediatric dentist where there may be more options for me as a kid. This was in the 1990s, and thankfully things have changed for the better over the last thirty years. However, the fears that we experienced ourselves as a child can very much affect how we approach the dentist with our own children. I often tell people that my dental experiences may be the very reason I became a child life specialist.

While there may be fears and hesitancy, oral health among children is incredibly important. The CDC reports, “On average, 34 million school hours are lost each year because of unplanned (emergency) dental care, and over $45 billion in US productivity is lost each year due to untreated dental disease.” They also report that “By age 8, over half of children (52%) have had a cavity in their primary (baby) teeth.” In our area, Cook Children’s Community Health Needs Assessment found:

• 1 in 4 children in our 8-county service area does NOT have excellent or very good dental health.
• 1 in 7 children (ages 1-17) in our 8-county service area did not receive all needed dental care.

This month is National Children’s Dental Health Month, and we want to help you know how to prepare and support your children as they visit the dentist. We know that this area can be challenging for kids and parents to navigate, and we want to give you tools so that you and your child can feel more comfortable in the dentist chair. Lack of dental care can lead to even more traumatic medical and dental experiences for children. Our hope is that these tools can empower you and your child to not fear their next dental visit. In speaking with Betsy Hillyard, CCLS, oral health program coordinator at Cook Children’s Center for Community Health, she shared some top things to remember in preparing for the dentist. As a certified child life specialist (CCLS), Betsy not only helps and prepares children, she also educates parents, community partners, and dental professionals on working with children through dental experiences.

1. Know what to expect! If it is your child’s first-ever dental visit, make sure that you know what your children will be doing once they are there. The American Academy of Pediatric Dentistry recommends for children to see a dentist by their first birthday or once their first tooth has emerged. Often between the ages of 6 months to 3 years, children visit the dentist only for a lap visit for the dentist to count teeth, address any early concerns that may come up and educate families on proper oral health. Parents are often invited to be a part of these visits. As it becomes time for your child to begin getting their teeth cleaned, it is important for them to know whether you will be with them or not, what processes their dentist has (x-rays, cleaning, fluoride, etc.), and what they can do while they are in the dentist chair (watch a movie, listen to music, etc.). Betsy encourages to even ask your dentist if you could go and take a tour of the office before the visit. The more information you know about your child’s visit will help you be able to prepare your child more effectively for the most positive experience.

2. Prepare your child. It is so important for your children and you to know what to expect before going to the dentist so that you can use that information to help prepare your child for their specific appointment. There are lots of tools available to help you prepare them and provide you with child appropriate language. You can read books about the dentist, play dentist with some stuffed animals or dolls, practice opening big and wide, and watch some videos to help them have an idea of what to expect. Betsy created a video to help kids know what to expect when headed to the dentist. Seeing the tools that will be used and the process is very helpful to your child. Betsy recommends having your child draw a picture of what they expect about their visit before they go and then having them draw another picture about their experience after their appointment.

1.  A note about children with sensory needs: If your child struggles with certain noises or other sensations, it is important to work with your dental office to discuss possible comfort items and adaptations that are available to help your child. Having a conversation or appointment before to discuss this can be very helpful. Often weighted or warm blankets, earphones and sunglasses can be provided to help your child. Also, if your child has a certain comfort item, plan to bring that along like you would for a doctor’s appointment.

3. Keep it positive. It can be difficult for some adults to be positive about their own dental appointments and experiences. However, children pick up on our fears and worries and will often adopt your feelings before ever having their own experience. So, when preparing your child for the dentist, be careful and intentional with your words. When discussing the dentist and dental hygienist with your children, be careful not to use the dentist as a threat or a bad thing that they will experience. Make sure that you remind your children that dental appointments are necessary and helpful to our health and dentists help keep our mouths and teeth healthy. If you have your own fears of the dentist, make sure that you do not project those fears on your children. While validating their nerves and addressing their fears is encouraged, it is important not to make going to the dentist seem like a negative place or punishment. Use encouraging language with your children when discussing their appointments and be sure to praise your children when they do a good job at their appointments. 

When you know what to expect, take the time to prepare your children for their visit, and keep it positive, the dentist can be a great experience for your kids. Preventative dental care and oral health is so important to our children’s overall health and development. The more that we can do to prevent unplanned and emergent dental care, the more we support our children’s healthcare experiences and emotional safety. Thankfully my kids are having a much more developmentally appropriate and positive experience at their dental appointments than I did as a kid. We want to continue to support our children in making good choices for their health including their oral health.

I do not have adequate words for the pure joy and humility I felt this past week. Our family was chosen to attend the Kidd’s Kids 2023 trip to Disney World and was surprised alongside another incredible, resilient family! 

I was encouraged by some of the most incredible coworkers to apply for this trip. Over the past year and a half, these people have walked alongside our family with shared tears, unexplainable generosity and constant love. My husband and I were reluctant to apply since there are so many families and kiddos who would benefit from a trip like this.

I’ve volunteered and worked at Cook Children’s for two decades and have seen countless kiddos be chosen for Kidd’s Kids. I never thought I would ever be in a position where my own family qualified. However, as I reached out to my friends and coworkers for advice and thoughts, I was only met with encouragement to put in the application. We had just decided to cancel our plans to go to Disney later this year due to finances, so we ultimately decided we should put in the application and see what happened.

Our middle daughter, Averly, was diagnosed with a low-grade glioneuronal (brain) tumor in April 2022 after having a seizure at home on March 29th. Our PCP, M. Kathleen Powderly, M.D. of Cook Children's Pediatrics Magnolia, ordered an MRI in addition to many other tests and within a week found the tumor. 

The same week, we were attending my grandfather’s funeral and grappling with shock and grief. The next five months consisted of many doctor appointments seeking opinions from all over the country. 

This time last year, our daughter was headed into a nine-hour brain surgery to remove her tumor just behind her motor cortex that controls her right side. Her surgery was on Aug. 24, 2022. Our neurosurgeon was able to resect 98-99% of her tumor. She had right-sided weakness and loss of feeling in her right foot and great toe following surgery; however, she has regained nearly all her feeling and is very strong. Following surgery, Averly has followed up every three months at St. Jude Research Hospital to monitor the small amount of residue tumor and will continue to follow up there indefinitely.

All three of our girls have been so strong and resilient. Through moments of sadness and frustration, they have come out on the other side more beautiful and with deeper faith. Topics I never thought I would be addressing with them, though, have become normal conversations in our home – tumors, cancer, death, surgery, and countless stories of others we have met along the way. Averly has unwavering faith and has maintained an incredible sense of humor since her tumor (affectionately named Wally for his comparison to walnut-size) was evicted. My other girls have grown in empathy and flexibility. Yet – they are kids and this has all been too much at moments. 

When we returned from our vacation, I was expecting to come home to news about our selection status with Kidd’s Kids, but we had no mail. I dreamt Sunday night that we weren’t accepted. So in worry, I reached out to Daniel D. Guzman, M.D., on Monday. While he didn’t have an answer for me, he did need our family for a photo shoot for Aim for Safety on Tuesday. It was only the second day of school, but I figured there wouldn’t be a better time and this would be a fun experience for the girls.

I pulled everyone from their lunch hours on Tuesday and we headed up to the hospital. He had told me there would be another family with us, so I wasn’t surprised to see Danny Peltier and his family. As we walked into the Child Life Zone, I could never have envisioned that moment. 

So many precious faces staring back at all of us – “You’re going to Disney World!” It was the pinnacle of support and love! As I looked at my kids’ faces, my eyes blurred with tears. 

Averly had nothing but PURE joy and excitement. Emilynn, my oldest, was moved to tears and that just undid me – tears of joy and disbelief. My sweet Maelee was so confused and overwhelmed that she melted down. #reality

She was such a picture of receiving great news after hard times…sometimes you just don’t know how to step out of the hard. Eventually, it made sense to her and I can report that she is THRILLED!

Averly immediately bonded with the Peltier’s daughter. As I surveyed the room, I saw all those who had loved and supported us from the first day with true extravagance! I was so overjoyed for my girls.

When I met Kidd Kraddick at Cook Children’s a little over 20 years ago, I never imagined my future family would benefit from his love and legacy! This is going to be a trip of celebration for our family and all the other Kidd’s Kids families – celebration of resiliency and choosing to say ‘yes’ to hard! We are deeply grateful and humbled for this opportunity! 

Cook Children’s employees Ashley Pagenkopf and Danny Peltier were in for a big surprise Tuesday when Kidd’s Kids announced their families are going on an all-expenses-paid trip to Walt Disney World!

Every year, Kidd’s Kids takes 30 to 50 children with life-altering or life-threatening conditions and their families on an all-expenses-paid, five-day trip to the magic kingdom.

Emergency medicine physician Dan Guzman, M.D., who serves as a Kidd’s Kids board member, and Cook Children's team members surprised the two families with the announcement, Disney-themed balloons and pairs of Mickey Mouse ears at the Child Life Zone.

“We’re going to Disney!” said Ashley Pagenkopf, a child life specialist in the Cook Children’s emergency department. “I can’t believe it. None of my kids have ever been and I was 12 years old the last time I went, so it’s really exciting. We wanted to take the girls but we cancelled a trip because it was just too much. None of us expected this!”

In April 2022, Ashley’s middle daughter, Averly, began having seizures and was diagnosed with a glioneuronal tumor. She underwent surgery in August and has been seizure free since. Every three months, Averly visits St. Jude Children’s Research Hospital for follow-ups.

“She’s doing awesome – clearly!” Ashley said. “She’s so crazy strong. Kids are so resilient.”

Ashley said she looks forward to experiencing moments of magic with her girls and other families on the trip.

Danny Peltier, practice manager for Cook Children’s Outpatient Psychiatry, says he also looks forward to building memories with his family at Disney World.

“It’s just something we weren’t able to make happen on our own yet,” he said. "So this is going to be a lot of fun for the family!”

Peltier and his children, Will and Evelyn, have a rare genetic condition called hereditary spastic paraplegia, which presents similarly to cerebral palsy but only affects their lower extremities.

“I’m excited to see their faces once we get through the gates and they can just take it all in,” he said. “It’s going to be a lot of fun!”

Kidd’s Kids is a nonprofit founded by the nationally-syndicated Kidd Kraddick Morning Show based on 106.1 KISS FM in Dallas-Fort Worth. The annual Kidd’s Kids trip is made possible by donations and an army of volunteers, including doctors and nurses who make the trip to help the families. 

“We take a team of physicians, nurses, paramedics, child life specialists and respiratory therapists,” Dr. Guzman said. “We go and serve the kids.”

Dr. Guzman says oftentimes the children and families who go on the trips have been patients at Cook Children's. The medical team’s goal is to make sure that the children enjoy the parks without having to worry about any medical needs. If any issue does arise, the team is there to help the children get through it safely. 

“To be there, to enjoy it, to watch their faces and see that love – ah, it’s amazing - you can’t script that at all!” Dr. Guzman said.
 

Our Child Life teams utilize in-kind donations every day, all day. From stocking playrooms, celebrating birthdays, offering comfort, providing distraction, and meeting basic needs, donations are the backbone of serving patients and families.

Back in 2005, I began a Community Relations Internship at Cook Children’s alongside Kat Davitt, who at the time was the Community Relations Specialist. One thing has not changed over all these years: the generosity of the community is paramount to serving patients and families at the medical center. During my internship, I got a front-row seat to the vital role that donations play day in and day out. I also got to see the raw joy donations and gifts brought to patients and families. 

Over time, the job titles, employees that handle donations and departments have changed. Currently, Megan Hodges-Cook is our Community Programs Coordinator within the Child Life Department. She serves in one of the most important jobs within our department – she collects, sorts, and distributes all our donations along with coordinating all our special events for patients and families.

Every day in the Emergency Department, I hand out Legos to the kiddo that just made it through a really difficult procedure or I bring a fidget to the kiddo that just needs something to keep their hands busy.

We hand out stuffed animals, playdoh, crayons and Hot Wheels to normalize the environment that otherwise brings anxiety and fear. Donations change the atmosphere and offer peace and joy amid the hardest moments in a family’s life.

“I’ve seen many patients who just feel awful, and the moment they receive a toy or art project, their demeanor changes,” Hodges-Cook said. “They can begin their physical healing because we have attended to their spirit and soul.”

Cook Children’s provides family-centered care, so donations are not only for patients but also for siblings and other family members. We also utilize donations to celebrate birthdays, holidays, milestones, etc. We have full-blown parties and have even hosted a patient’s wedding in our garden!

One of our donors provides birthday celebration items. Her gifts of wrapping paper, gift bags, streamers, etc. probably touch every patient that celebrates a birthday with us.

Hodges-Cook also shared this story about a donor: “We have a family who brings backpacks once a year in honor of their daughter. A year after receiving a backpack, another family mailed the backpack they received filled with similar items and a note describing how the backpack fulfilled their needs and lifted their spirits when they were in crisis. So the legacy of this little girl has started a domino effect of giving.”

 “Hands down the best part of my job is that I am the only person who gets to witness the joy of the giver (because so many people are joyful in giving), the joy of the receiver when I pass out donations to patients and the joy of the staff who get to share donations with patients and families,” Hodges-Cook said.

Needs

We rely on donations year-round and use them throughout the system including outpatient clinics, urgent cares, neighborhood clinics, and within our therapy settings.

Currently, we receive 70% of our annual donations during December. However, because of this, we have gaps in our needs that often need fulfilling throughout the year. Our gaps include needs for specific age groups or high-demand items that go quickly. Infants and adolescents experience the highest gaps in donations.

• About 25% of our daily population is infants. Items like teethers, rattles, and Wubbanubs/pacifiers are one-time-use items and we often don’t have enough. We also need light-up infant toys regularly.
• Adult-sized items in clothing and adult coloring and activity books are always in short supply for our teens and caregivers.
• We have ongoing needs for clothing sized from Infant to Adult XXLG. We utilize many gender-neutral comfort clothing like sweatpants and t-shirts and underwear regularly to meet the needs of patients and families.
• Our high-demand items include coloring supplies, playdoh, decks of playing cards, sensory items (fidgets, kinetic sand, and slime cups), Hot Wheels cars, Lego kits, toiletries and clothing.

Some things to remember and consider before donating to the hospital:

• Due to the immunosuppressed nature of the patients we serve, we cannot accept used items. This includes any items that are in “like new” condition.
• Out of cultural humility to the diverse population we serve, we cannot accept religious items.
• We cannot accept items that are violent or rated anything higher than E for Everyone (video games) or PG (movies).
• Due to privacy and infectious control reasons, donors are unable to pass donations/gifts directly to patients.
• We ask that all donations are unwrapped so we can best match them to patients.

You are able to give online. You can use this special Christmas in July wish list: https://www.amazon.com/registries/gl/guest-view/2W1H6ULYM5O3L

In Fort Worth, you can bring all donations to the Main Entrance of the hospital located at 801 7^th Ave, Fort Worth, Texas 76104 where you will find a donation bin. For any questions or to schedule a time to bring a larger donation, you may email childlifedonations@cookchildrens.org.

To make a donation at Cook Children's Medical Center - Prosper, email childlifeprosper@cookchildrens.org.

You may also donate to the Cook Children's Health Foundation here and designate your gift to Child Life.

Thank you for your generosity as a community! We are humbled to serve patients and families and recognize that we could not do much of our job without the generosity and kindness of our communities. Please consider donating knowing that you are changing the atmosphere of the medical center, and blessing patients and families immensely!

“I want them [kids] to grow up and study hard so that you can run our country and not just be the president. Be a senator. Show the courage," Lee said. "We need strong young people so hurry up and grow up.”

“Study hard and make sure that what you speak is positive because when you speak things you believe it,” Jackson said.

Ms. Opal Lee, known by many as the “Grandmother of Juneteenth,” began “Opal’s Walk 2 DC” in 2016 at age 89. She started with the plan to walk the 1,400 miles from Fort Worth, Texas to Washington, DC in hopes of gaining support from Congress to officially name Juneteenth a national holiday. In 2021, Juneteenth was named a federal holiday.

The National Juneteenth Museum in Fort Worth will be open to the public in June 2024.

My girls are just beginning to experience the downtime of summer. My early-risers are finally trying to sleep in longer. They are no longer allowed to start their days with their iPads because it immediately affects their attitudes. But that means that the dining room table is covered in crafts and unfinished projects to keep little hands busy.

This is the season of yelling “CLOSE THE DOOR!” a million times a day, and for the next few months, I will be a short-order cook rotating between their desires for grilled cheese, quesadillas, mini-pizzas, chicken nuggets and everything in between. It’s so fun, but it takes us a good chunk of time to really get into our summer rhythm.

Summertime is long awaited for many kids and teens, but unfortunately, summer can bring about depression in children and teens similar to the cold days of winter. Often in the emergency room, we start to see kids begin to struggle during the last weeks of school and then again in the last weeks of summer. The number of kids struggling with their mental health rises during these times. We know that transitions can be difficult and surrounded by anxiety for kids and parents alike. 

As much as kids love the idea of not being tied down to schoolwork and getting a break from the grind, the routine and expectations of school coupled with time with friends and activities, can make summer feel chaotic, dull, and ultimately lonely. Many parents still have to work full-time jobs while their kids are out of school, which can mean a lot of unsupervised time for kids.

It is easy for kids to get their schedules completely flipped – sleeping all day and staying up all night. They begin to spend hours in front of their screens including video games, social media and hours of endless scrolling. Once the summer is in full swing, it can be easy to miss the signs of summer blues that your kids may be experiencing. There are a few things that you can do as a parent or caregiver to help with these blues and maybe prevent some of them.

Establish a Summertime Routine

Kids are immediately out of routine. They finally get to sleep in and have no real time constraints on their day. They have zero rhythm to their days and little expectation.

Years ago, I realized this was not going to work for my kids for the whole summer. To keep some peace in my home and give my girls the best chance for transitions back into school, we needed to have at the very least a loose schedule for the summer. For us that has looked like some quiet activities in the morning. This could be reading, crafts, or play time. iPads do not turn on before 10 am.

I ask them to get dressed, brush their teeth and get ready for the day. We make beds in our home, so we keep that up even in the summertime. They are in charge of their own breakfasts, but sometime before noon. When their iPads turn on at 10 am, they have a limited amount of time on them, so they have to manage when they use their time. We have lunch a little after noon, then they can do some outside activities. Sometimes we go on a bike ride, swim or they play with neighbors or friends.

When they were younger, we had another quiet time in the afternoon that was no screen time.  Around 4 pm, we do a clean-up time to get ready for dinner and then plan to spend time together as a family after dinner. Not every day looks exactly like this, but it has been so, so helpful to have a rhythm. This lets them know what to expect.

Many times, when we plan to go somewhere, I try to do that in the morning before lunch so that we can have some rhythm to our afternoon. For my school-aged girls and pre-teen, this rhythm is so important for their brains and emotions throughout the day.

Limit screen time

Limiting screen time is so important. It is so easy for all of us to fall into hours of screen time and not get anything done all day. I am guilty of this as an adult, and we know the damage it is having on our kids and teens. Hours of scrolling are not beneficial to their developing brains.

Our girls’ iPads have a filter on them that I control from my phone. This has been an important investment for us. I can control the time their iPads come “on” and the time that they are able to be on them in a day. I also can see EVERYTHING that they search or look at in a day while also blocking and filtering the content that they can see. I can do this from work, which is super helpful. There are many options for this, but I highly encourage this.

The level at which our kids are being exposed to developmentally inappropriate content along with engaging in dangerous material is astounding. The effects of screen time on children’s brains and development are proven to be detrimental in many ways.

We are seeing the mental health of our kids and teens suffer the more they scroll. My kids have screen time limited to 2 hours during the week and 3 hours on the weekend during the summer months. They are only able to have about 30 minutes on weekdays during the school year to talk with friends and then 3 hours on the weekend. My girls are school-age and preteen. I know that some of these limits will need to change as my girls get older. I also find, like I mentioned before, that our days go much better when my kids do not start their day or end their days with screen time. We try to keep screen time sandwiched in between other activities.

Set Aside Time to Connect with Your Kids

This is something that can be challenging especially if you are working full-time. This quality time is important in the summer as well as the school year. I find, though, that summertime is a great opportunity to reconnect in different ways with your kids without the intensity of school schedules and activities getting in the way.

I try to do bike rides, plan a special outing, read a book with my girls, play a game, etc. Any time that I can get with them one-on-one time with them is even better. Our kids are looking to connect and belong. We want to be the first place that they belong. Prioritizing this time will be one of the best things you do all summer for your kids!

Say YES Where You Can

Lastly, this is the challenge for the parents. We can help our kids by saying yes where we can. Say yes to the walk, to the game, or to friends coming over. If you are the stay-at-home mom, say yes to being the house where the kids can hang out for the afternoon. Say yes to water balloon fights and water play. Say yes to the mess when you can. Say “yes” and “sure” when your margin allows. Our yes is often the bright part of the day for our kids and the things they remember the most.

Summers can be a time when memories are made and the best moments are ingrained in our kids’ minds. So, while the summertime blues can pop up, with a little bit of intentionality and a few yeses, we can combat them and help our kids have some bright summer days!

PGA golfers Paul Haley II and Cameron Champ were here to bring smiles to patients.

Cook Children’s Child Life staff divided up into four teams to decorate and set up the holes – each with a different theme.

All holes have a bedpan at the end – that’s why it’s called the Bed Pan Open!

By Ashley Pagenkopf, MS, CCLS, Child Life Specialist at Cook Children's

It’s amazing to see what one bright-colored toy or fidget can do to change the feeling in an exam room. Recently, I have started grabbing something to take to patients when I get a call to help prepare them for a procedure or support them.

Typically, I grab something small – a pop-it, a Hot Wheels car or something else that I can offer them upon entering the room. You can see kids’ eyes when you walk into the room. They are scanning your hands to see why you came and what you are there for. They are really looking for a SHOT!

When they scan my hands, they often see an iPad and some small toy or fidget of some kind, and their face melts a bit. They soften. Why does this happen? Because play is magical…

Play is the act of engaging in something for fun or enjoyment. We know that play is universal and crosses many cultural and language barriers. In fact, child life specialists would say that play can be a language of its own. Play is a pillar of child life practice, and we could not engage patients and families without it.

We see the expression of a child’s emotions and experiences being worked out in play often more than words. We also know that play is an integral part of cognitive, speech/language, social/emotional, and gross and fine motor development.

This makes play essential in a pediatric health care setting. It is our goal to continue the normal growth and development of children even during stressful experiences like hospitalizations, traumatic experiences and chronic illnesses.

There are several ways that we utilize play in the health care environment. We use play for normalizing the environment, preparing and teaching the patient and family about medical procedures, and for processing their experiences.

Normalizing the Hospital Experience

Developmentally appropriate play is the most natural aspect of childhood that kids know and understand. We use developmentally-appropriate play to help normalize what is otherwise a very stressful place. Just as I referenced in the story above, walking in with a toy or a stuffed animal immediately changes the atmosphere.

Basic things like coloring, Play-Doh and bubbles are the framework of breaking barriers with kids in this seemingly very scary place. You will notice in many exam rooms around the hospital and medical center that there are eye-spy art pictures for children to engage in while they wait.

Each age group plays differently and has different needs. When I would meet kids as an inpatient child life specialist, I would often ask kids what they loved to do if they were stuck in bed at their house. We want to start with their favorite things and what brings the most comfort. Thankfully, we are able to provide play opportunities to every kid that enters our doors in some way.

Through hospital allocations and community donations, play is always possible. I’ve played countless hours of Barbies and Battleship with kids. UNO tournaments were a norm in our inpatient playroom. Nerf guns and over the door basketball hoops can bring incredible laughter and smiles even on the worst of days.

Even in the NICU, our babies experience play. We make sure that babies have stimulation at the bedside with mobiles and textured lovies, and jumpers are provided as they are able.

Developmentally appropriate play is just a standard part of childhood. We want to meet the basic needs of children in the health care environment, too. Play is essential.

Processing - Therapeutic Play

While a large part of the play within the health care environment is just for fun, we also spend a lot of time playing with purpose. This is therapeutic play. Therapeutic play can be led by a patient (non-directive) or led by the child life specialist (directive) with the goal of emotional expression, medical teaching or to be physiologically enhancing (blowing bubbles to encourage deep breaths) (Koller).

Some could argue that all play is therapeutic allowing a child to express themselves and process their experiences. However, therapeutic play within the hospital environment is vital. These type of play experiences allow children to build their resilience while developing and practicing new coping skills. We utilize specific medical play often which is discussed in detail a little later.

We also provide art and music opportunities through our CARPE program and other play modalities for patients to express their feelings and work out their thoughts. Remembering that play is a language, we can learn a lot about our patients and families by watching them play or engaging in play with them. These things allow us to better serve our patients and families and develop care and coping plans during their stay.

Preparing for Procedures or Teaching a New Diagnosis

We also utilize play when preparing children for procedures or teaching them about a new diagnosis. This is a type of therapeutic play with a very specific purpose. We often utilize a stuffed animal or doll to first demonstrate a procedure. We may tie a tourniquet around a stuffed animal’s arm so that a child can see what that looks like. We frequently place IVs in dolls and stuffed animals so that the child feels less alone in their experiences while also seeing the steps and understanding the process.

As child life specialists, we facilitate what is called medical play. This may be as simple as a toy doctor’s kit to more complex play using real medical supplies while teaching with a patient and/or sibling.

One of my favorite activities is using an insulin syringe to inject dye into a medical play doll. This ultimately makes a tie-dyed doll, but it also allows a patient to get comfortable with the needle and syringe (under the supervision of a child life specialist).

At Cook Children’s, we host a Kid’s Clinic for patients to come down for a specific time just to do patient-led medical play. Patients are given a medical play doll and then are invited to use medical equipment on their doll. Patients place IVs, casts, and more.

This play often mimics their own experiences while giving them an opportunity to get more comfortable with medical equipment and process their feelings around their own story. Children not only learn from this type of play, but they leave feeling more empowered in their own medical care.

As child life specialists, play is not only essential but also at the forefront of every interaction with a patient and family. Cook Children’s recently lost a precious child life specialist. Amy Johnson was a child life specialist extraordinaire. As we were attending her funeral, many past patients’ families shared stories of Amy.

I was profoundly impacted that what the patients and parents remembered most fondly about Amy was her ability to PLAY – nerf gun wars, water gun fights and more! She had SO much fun during some of the worst moments, and this is the memory that the patients and families had ingrained in their hearts forever. Play is not only essential, but it also changes the environment and allows children to be the very best versions of themselves!

By Lauren Bridge, MS, CCLS, AYA Child Life Specialist at Cook Children’s Hematology and Oncology Center

Most often, the title “child life specialist” resonates with toddler, preschool and school-aged children. However, our scope of practice spans through young adulthood. I am Lauren, our Oncology Adolescent and Young Adult (AYA) child life specialist. The AYA population includes those diagnosed with cancer ranging from ages 15 to 39.

How is this role similar to other child life specialists?

As a child life specialist, I still provide diagnosis education, procedure preparation, procedural support and general emotional support for coping. All of that education and support is customized to meet the developmental needs of a teenager or young adult.

The medical environment can still be very confusing for our older population and the educational background of a child life specialist allows for breaking down information in easier-to-understand terms.

Let’s not forget play. Play is an integral part of a child life specialist’s role and imperative to coping well in the hospital environment.

What are the unique needs of AYAs?

First, let’s look at the developmental needs of adolescents without a chronic illness. During this stage of development, teens are seeking autonomy, making self-discoveries, learning about their changing bodies and acquiring their own set of values and morals all while their social life becomes a priority.

Throw in a cancer diagnosis and suddenly these developmental needs become increasingly difficult. Autonomy is difficult as caregivers and medical staff are constantly near with instruction, invading personal space. Cancer adds to the confusion of self-discovery. How much of their identity lies in diagnosis or not?

Changes in their body increase as hair is lost, weight fluctuates, menstrual cycles are paused and illness affects their physical well-being. Social life is put on the backburner as immune systems become low, energy decreases and feelings of self-consciousness set in. The sense of invincibility is shattered and many adolescents and young adults question their values and faith during this time.

Looking beyond the age of 18, as AYAs enter young adulthood, developmental needs continue and grow. Young adults continue to seek autonomy and self-discovery, are entering more schooling or the workforce, have increasingly more financial independence and responsibility, are exploring their sexuality, are forming intimate relationships and in some cases are starting families.

Cancer turns these developmental needs upside down. Autonomy is stunted by hospitalizations and the need for help. School or work are disrupted or put on hold. Body consciousness and side effects of chemotherapy become more prominent making exploring sexuality a struggle. As the immune system weakens, emotions run high and the body’s physical exhaustion, many find themselves isolated. Collectively making forming deep relationships challenging.

How can Child Life help?

As an AYA child life specialist, my goal is to help adolescents and young adults cope with new challenges, express emotions, meet developmental milestones and maintain a sense of normalcy.

Recognizing the importance of autonomy, I offer patients as many choices as possible. I, along with our AYA multidisciplinary team, want to give the AYA population a say in what is done to their body. Allowing our patients to share what comforts them, people they want present when ill, how much medical intervention they wish to have and end-of-life wishes give them control in a powerless circumstance.

Most often I can be found holding space in a patient’s room offering a safe place for expression, providing port education prior to the procedure, creating a coping plan with a patient, debating who will win a game of pool, exchanging jokes, giving choices for space and autonomy, validating emotions, creating art and having some deep conversations.

Building trust with the adolescent and young adult population is not always simple. For this reason, I follow the AYA patients inpatient, outpatient and in the ICU. I have to earn my space in their room. I strive to show up consistently and genuinely. It is with a true sense of honor that these amazing young people allow me to be a part of their care. I am forever grateful for this unique population and their trust in me to serve as their child life specialist.

By Baylee Simmons, CCLS, Child Life Specialist at Cook Children’s Neonatal Intensive Care Unit

A child life specialist is commonly known as someone who can help a child understand and cope with his or her hospitalization, diagnosis or medical experience.

That being said, I am often asked what role a child life specialist plays in the Cook Children's Neonatal Intensive Care Unit (NICU) where patients are far too young to talk, comprehend preparation for procedures, diagnosis education or participate in play and therapeutic activities typically provided by child life. 

Great question! Child life in the NICU looks very different than in other areas of the hospital. Still, our goal is the same -- to provide support and interventions that promote emotional safety, improve patients' and families’ ability to cope, and reduce the negative effects of unavoidable stress and trauma they endure.

Stress and coping in the NICU

When an infant is born prematurely or with medical needs leading to a NICU admission, the whole family is affected. Most parents expect to take their baby home to a quiet, calm environment where they can heal, bond with this new baby and begin adjusting to life with a new member of their family.

A NICU admission can turn all of those expectations upside down. For the first few days, the mother is often still admitted to another hospital, the delivery hospital. While this is necessary for moms to heal and recover, it creates a lot of stress for the family. The baby’s father and/or other family members have to navigate where to spend their time, who will care for any children at home and so much more.

Patients admit to the NICU for many, many different reasons and these admissions range from a few days to many months depending on the severity of their condition and medical needs. Over the course of a patient’s admission, the stress may change but continues to bring new challenges.

Some parents grieve their first days or months with this baby not looking how they thought, some struggle to feel connected with their baby amidst the restrictions and treatments needed to grow or heal, or wonder how to support, explain things to and include the baby’s siblings without overwhelming them.

Other families find themselves unable to understand/process their baby’s diagnosis and care, juggling time between work and the hospital to maintain income, or processing a tragic situation where their baby might die and making decisions about how to honor their child’s memory or explain that to their siblings. All of that stress impacts a family’s ability to cope with the hospitalization and ultimately provide a secure, nurturing environment for their baby, which plays a critical role in their development and health.

Child Life in the NICU

As a NICU child life specialist, I can often be found hanging a name banner in a new patient’s room, making ink prints of tiny feet or seated on the couch next to an overwhelmed parent listening to whatever troubles their mind that day. These are a few ways I begin getting to know a family, what is meaningful to them, and what individual stressors or challenges they bring to the NICU experience.

This careful assessment allows me to identify what support, education or therapeutic intervention they might benefit from on any given day. I strive to give families the tools they need to be successful in the NICU environment and overcome the stress they inevitably encounter here. That could be using my knowledge of child development to help validate or explain why their 4-year-old daughter is regressing and acting out uncharacteristically or offering a more simplified explanation of new medical equipment being used on their baby using a teaching doll or other resources to strengthen the family and siblings’ understanding. 

I make ink prints or take photos of big moments and milestones babies meet to help encourage their parents and foster that connection throughout their stay. We celebrate holidays and “firsts” throughout the unit to bring a little bit of joy or normalcy into a place where most families feel that they are missing them. And on the darkest days when families are told their baby will not be coming home with them, I offer bereavement support and the opportunity for families to choose how they will honor and memorialize their child’s last moments of life.

Child Life exists in the NICU to support the WHOLE family so that they can better care for and support their baby both in our unit and as they transition home.

By Ashley Pagenkopf, MS, CCLS, Child Life Specialist at Cook Children's

Every shift in the Emergency Room, I enter rooms of patients and families that have never graced the doors of a hospital, and within a few minutes of meeting them, we will be starting an IV, drawing blood and swabbing their nose and throat most likely. They will have already met upwards of 10 new people. Sometimes, within 10 minutes, I have prepared them for surgery.

I have less than five minutes to build rapport, establish trust and prepare them for this moment, but they are arguably the most critical five minutes for the patient’s emotional safety. Many people have never heard of Child Life before entering the hospital, and many leave without fully understanding what child life can provide. The Association of Child Life Professionals (ACLP) states that our mission is as follows:

We, as child life professionals, strive to reduce the negative impact of stressful or traumatic life events and situations that affect the development, health and well-being of infants, children, youth and families. We embrace the value of play as a healing modality as we work to enhance the optimal growth and development of infants, children and youth through assessment, intervention, prevention, advocacy, and education. 

Child Life exists within the hospital environment to combat the unavoidable stress that accompanies children and families from the moment they enter our doors.  We work alongside the doctors and nurses to build rapport and establish trust with the patients and families.

Medical care is a part of all our lives. However, many adults do not seek adequate medical care due to traumatic experiences as a child. If we can normalize the hospital environment and make it feel more comfortable, then we are able to meet the needs of children while also providing them with the care they need.

The emotional safety of children and families is our top priority, and we help children and families cope with stress. The ACLP defines emotional safety as “an intentional, interdisciplinary practice to promote resiliency, healing and trust for pediatric patients and their families during medical experiences.”

Assessing the patient

First, a Child Life Specialist will assess the patient. We establish how a child relates to and experiences the world. We create a plan to help them cope with their health care experience. Every child is different, and every age group responds differently.

We learn what is helpful for them, what they enjoy, what they fear and how they will respond. We are also assessing the same things in their caregivers and their siblings.

Babies need comfort and the assurance of security. Toddlers and preschoolers need some control as well as comfort. School-age children often need all the information and the opportunity to ask questions. Pre-teens and teens need and desire autonomy and independence.

Preparing for a treatment or procedure

Child Life Specialists prepare patients and families for what they are going to experience. Children respond to their senses, and we know from research that children can respond better when they know what they will see, feel, hear, taste and smell in advance.

The most important part of preparing children is the use of developmentally appropriate language. Child life specialists prepare patients for all procedures including taking their blood pressure (arm hug), inserting an IV (medicine straw), going to surgery, getting stitches (string band-aids), and much more.

When children know what to expect, they can more effectively respond to what they are feeling. Procedures take less time and are accomplished more effectively when a child understands what is happening before it is happening to them.

Supporting patients and families

Next, child life specialists support patients and families through procedures and experiences. Child Life can assist parents and caregivers in comfort positioning. We can also help patients utilize deep breathing and other techniques.

Often, patients cope beautifully with distraction. Typically, distraction works most effective after a child has been prepared and established trust with the medical team. This is where you will see a child life specialist utilize an iPad or other distraction tool.

Child life specialists also support patients and families through traumatic experiences by utilizing debriefing techniques and emotionally supporting patients and families with new diagnoses. We also support patients and their families through trauma, death, and dying experiences.

Child life specialists are educated in grief and bereavement and support families with legacy items and on-going grief support following trauma and tragedy.

Education

Child life specialists also educate patients and families on new diagnoses and other new information.

I often tell kids that we are paid to tell the truth. We believe that children cope better and are more successful with hard procedures by understanding what is happening and why. One moment we educate children about why an IV is the best way to help their bodies, and the next moment we explain what cancer is and how it affects their bodies.

Play

Often the best thing that we can do within a stressful environment is to bring a little bit of normal to the mix. For children, their normal is play. By incorporating play in every aspect of what we are doing at the hospital, we can communicate with the patients more effectively and allow the hospital environment to become much less threatening.

This looks like toys in every area from the ER to the clinics to the inpatient floors. We also provide medical play where children can be in control of the medical procedure and process through their own experiences.

This also looks like decorating rooms and celebrating events even in the hospital from birthdays to holidays to Easter egg hunts. I would argue that our patients and families have some of the most fun of their lives within our walls and this is one of the best parts of being a child life specialist.

Child Life has a unique role and goal within the health care team. Our job is to bridge a gap between very scary health care experiences and children. We want kids to walk away very proud of themselves even after a hard day. They can sit still. They can take deep breaths. They can do the hard one more time, one more day.

We want children to see that they have what it takes to get through hard things, and it’s our job to call it out and help them utilize their internal strengths. Child Life Specialists are available throughout the Cook Children’s system. It is our pleasure to support your children

, a Twisted X Global Brands company, have joined together to create the Cook Children’s by Twisted X Collection. Twisted X will donate 100 percent of wholesale proceeds from every pair of shoes sold from this collection directly to Cook Children’s.  

“The partnership between Cook Children’s and Twisted X furthers our commitment to providing patients and families with a one-of-a-kind resource tailored around their health care needs to enhance the overall experience,” said Cook Children's Health Foundation Senior Vice President and Chief Development Officer Grant Harris. “We are constantly looking for new ways to provide compassionate care and we are proud to come together with Twisted X who shares this passion and embraces creativity as a therapeutic outlet.” 

From factory to retailer, the entire supply chain has come together in support of the collection to deliver the footwear at a reduced cost to maximize the donation. The collection includes four unique designs made by patients at Cook Children’s with the help of Twisted X Designer, Tuan Lee. Each pair is named after the artist and embodies their dream pair of footwear to achieve a perfect balance of style and comfort in the form of a slip-on kick.  

• The Alex: Alex is a 6-year-old with Ketotic Hypoglycemia. She loves math, enjoys riding her bike and uses her imagination to go on adventures as colorful as her bright shoe design.  
• The Rowan: Rowan is a 9-year-old with Sigmoid Sinus Vein Thrombosis. She loves riding horses and is a member of 4H, which is highlighted by the western vibes of her cactus green design.  
• The Brianna: Brianna is a 14-year-old with Epidermolysis Bullosa. She has painted several canvases displayed inside Cook Children’s Media Center and especially loves to paint butterflies, which are prominently featured in her sky-blue design.  
• The Isaac: Isaac is a 15-year-old with Spina Bifida. He enjoys art, video games and Marvel movies, using Iron Man as the inspiration behind his sleek silver design. 

"Twisted X is dedicated to making a positive impact on the community we serve, and Cook Children’s is a perfect partner for us,” said Twisted X CEO Prasad Reddy. “We know that little steps can make a big impact and our hope is to raise awareness within the western industry for the amazing care provided at Cook Children’s in order to give back to those who need it most. This collection is a true embodiment of comfort that gives back and brings so much joy to footwear design.”  

"I like my shoe and my favorite part about it is that it’s rainbow colored and I love rainbows. And I love this shoe the best because I painted it and I got to make it however I want,” said Alex. “Art helps me relax and calm down my nerves from the pain that I get from my skin condition. I usually paint butterflies because it represents my illness. It’s like butterfly skin because it’s fragile,” said Brianna.  

Cook Children’s and Twisted X will celebrate the collection with a launch event today at Cook Children’s Fort Worth Campus. The collection is now available online at twistedx.com/pages/cook-childrens and in-store at select retailers nationwide. To learn more about the collection and the shoe’s young designers, visit cookchildrens.org/twistedx.    

Texas Country artist Josh Abbott visited patients and staff members at Cook Children’s Medical Center on Jan. 6 to share his music and to bring some smiles.

While at the children’s hospital, Abbott talked about his partnership with the Texas Dairy Queen Operators’ Council. In June 2022, Abbott was chosen to create a fresh new sound for DQ® restaurants in Texas with one of the most recognizable jingles in the Lone Star State, “That’s What I like About Texas.”

“I loved visiting Cook Children’s to meet the kids and the team caring for these incredible human beings,” Abbott said. “It was great to sing, laugh, and learn about the Life Zones where the kids can forget about why they are in the hospital for a moment. It also was fun to be interviewed for Cook Children’s internal television station, CLZ TV.”

Abbott is the voice for Texas Dairy Queen. Dairy Queen is a Children’s Miracle Network Hospitals  partner and many locations throughout our Fort Worth and surrounding areas participate and do national fundraising initiatives through CMN Hospitals (Miracle Treat Day, Point of Sale fundraising, Dip It for the Kids). 100% of the funds raised to through these initiatives in our fundraising market benefit Cook Children’s.

Abbott sang the iconic jingle as well as several of his songs for the kids and team. He talked about his music journey, the band and his family, which includes his wife Taylor, daughter Emery and son Luck.

“I love what I do, and I get to entertain people because I have a very supportive family,” Abbott said. “This visit was a wonderful opportunity to share music which can be therapeutic and healing.”

Before his departure, Abbott handed out Dairy Queen Dilly Bars for the kids and staff.

The Josh Abbott Band will play at Billy Bob’s in Fort Worth on Jan. 6 & 7.

Media partners may use this content for news stories and broadcasts with credit to Cook Children's.

By Ashley Pagenkopf, MS, CCLS, Child Life Specialist at Cook Children's

The last few years have been filled with collective challenges. The pandemic seemed to touch every single person in some way. It was the first experience of my lifetime that seemed to affect every single person I know.

We seem to be coming out of the grief and fog, but some lasting changes and effects will forever remind us of this time. Yet, in the middle of a pandemic, life continued to happen. Babies were born. Family members received new diagnoses. Some of us said goodbye to those closest to us. Joy and sadness shared space just like they always have and always will. 

When 2022 began, I filled out my yearly “dream guide” and walked into this year with joy and excitement to leave the intensity of the past two years behind. I wanted a break from the hard and literal constant changes. For our family, this year was a mile-marker year. My husband and I celebrated 15 years of marriage, and I entered my fourth decade of life. I was ready – ready to celebrate at every turn and really enjoy this year.

Grief and Grace

At the end of March, our world changed yet again. My middle daughter had a seizure and was diagnosed with a brain tumor. Time stood very, very still. Only a week after her first seizure, my grandfather (who I truly believed would live forever), died unexpectedly. We found out about her tumor two days before my grandfather’s funeral. 

I’ve never really known grief like I knew that weekend. It was physically painful. I remember wondering if the pain would ever subside or if it was going to be my new normal. There were many moments I could not breathe. My girls were devastated over the death of their great-grandfather, and we still had to tell them about a tumor. I just thought that pandemic was hard. This was a new level.

For the next several months, my daughter endured tests and imaging, and we talked to countless doctors to decide our next steps. We spent the summer in many, many consults and trying to make huge decisions.

At the beginning of August on our way to our summer vacation, I found myself completely void of any hope. I was shutting down. The moment I realized I was not okay was in the security line at the airport with the unkindest person that ever existed. 

After several very difficult shifts in the ER where many families lost their precious babies coupled with the intense decisions we were making for my daughter, the one lady working security caused me to completely fall apart. I wondered if she had recently lost someone or watched someone else grieve their child or if her child had a new diagnosis… I had to ask myself this so maybe I could give her some grace. I really had nothing left, though. 

I sobbed as I put my shoes on. My kids stared as I didn’t even try to hold it together. My husband was angrier than ever. I made my way to Starbucks, barely able to catch my breath and not even attempting to hide my hot, alligator tears. Once on the airplane, I proceeded to sit on my coffee that I had set down to put a bag away. Things felt completely hopeless. Life felt unraveled.

Have you looked at this past year and wished it would just end? Have you had one too many phone calls from the school with your kid as the subject? Has your kiddo been diagnosed with a new illness? Did you think that you were done with treatment, only to find yourself back in hard? Has your job felt like it is robbing you of all your energy and sanity? Have you lost someone dear to you this year? Has your world felt like it was ending, and you couldn’t see a way to stop it? Have you had a moment like mine in the airport where you had nothing left for the mean person and then you sat on your coffee?

Embrace Hope Now

I’ve heard a lot of people say recently that they are ready to have 2022 in their rearview mirror. I would be lying if I said I didn’t feel the same way. But I’ve spent a lot of time thinking about this. I am the first to embrace new beginnings. I love the New Year – new goals, new resolutions, new starts. But I have been reminded often that hope is here, now. It is at this very moment. In my desperate desire to leave this year behind and start over, I may miss the very moment where hope meets me now.

Literally, in every hard moment of this year, something beautiful has shared space with it. That something beautiful has often reminded me that hope is here. Hope is defined as “confident expectation” or “forward-looking faith.” Hope reminds us that there is good coming and beauty to be had.

Yet, this year, what I’ve always hoped for has met me in every hard moment. The hope for people who would support me, the hope for strength to shine in my kids in the face of adversity, the hope that I would be able to be present for my family when we faced pain and the hope that I could still find comfort and peace amid grief… All those hopes have been real this year. Thank goodness for those few sips of Starbucks before I sat on it. (Starbucks has provided a great deal of hope in the middle of hard this year.)

While on the said vacation, a wonderful photographer captured our family on the beach of Lake Tahoe. Hope that we could still smile and laugh and find joy met me in those moments. When tears streamed down people’s faces as they shared their prayers and hopes for our family, hope met me there. When my Cook Children’s family extravagantly showered our family with gifts and love, hope was tangible. When my very best friends drove seven hours for my daughter’s surgery and surprised me, hope met me. With every letter and encouragement and tear, I met hope.

What would happen if we could embrace hope now? Hope – the beauty that is to be had – doesn’t have to be next year. Hope is here, now. 

You can be hope to someone, and you can find hope in the simple. You can hand that bag of essentials out the window to the next man or woman you see on the corner and offer them hope. You can pay for the car behind you in the drive-thru and be hope for them. You can smile and ask your cashier how their day is and be hope for them at that moment. 

You can offer the beauty that is to be had – the hope – to those around you. And you can find hope in your next cup of coffee that warms you up. You can see hope in your kiddo that chooses kindness towards their sibling. You can experience hope in the next phone call or text message or next hug that comes your way. You can experience hope the next time your kiddo is brave like you never knew. You can see hope in the way that one tiny candle lights up the darkest room. Hope is here, now.

By Ashley Pagenkopf, MS, CCLS, Child Life Specialist at Cook Children's

I have a middle schooler in my home for the first time this year. I have spent a great deal of time over the last couple of months deciphering the BIG emotions that middle school inevitably brings. It can take some time to get to the real emotion, the real issue. But once we do, I am often reminded of how hard middle school is and that none of it makes sense. Still – all these years later – middle school is still dumb. The only thing left to do is to agree with my daughter about how dumb it really is. So that’s what I try to do – I try to validate her very big emotions…most of the time.

What is validation?

If you are wondering what validation is, that’s OK. We are all learning as we go. (This is an example of validation.) The dictionary defines validation as the “recognition or affirmation that a person or their feelings or opinions are valid or worthwhile.”

Validation plays a significant role in children feeling known and understood and creating an emotionally safe environment in the healthcare setting and at home. When a child can feel understood and heard, they have space to begin to cope with the emotion they are feeling. Without that space, it is very easy for any of us to get wrapped up in the emotion and not be able to find our coping skills. Once we can help children name their emotions more effectively and affirm that their emotion is valid, we will begin to see children regulate their own emotions more effectively. 

Often our children’s big emotions and feelings are met with our own big emotions or feelings, not validation. It is easy to be frustrated and overwhelmed by others’ emotions. As we explore emotional safety among our children, we have to recognize the importance of validation. Children cannot feel emotionally safe if we dismiss their emotions.

I work with children and families in an environment where emotions are always big – the emergency room. All areas of the hospital and doctor’s offices can produce big emotions in our kiddos. It may be helpful to hear what is *not* validating and does not promote emotional safety in the healthcare environment or at home.

1. Threatening is not validating. As parents, we love the “if you don’t _____, then ____” statements. One we often hear as child life specialists is “if you don’t stop crying, they will give you a shot.” This does not help anyone. Not only does this break trust with the health care professionals trying to help your child, but it also intensifies fear amid a child’s already high emotions. Health care professionals are there to help, and a shot may be necessary at some point. Shots are not punishment. We don’t want to punish children in any way for their emotions. Instead, we want to teach them how to cope with them.
2. Promising things is not validating. It is a basic rule in the health care environment not to make promises. Honestly as a parent, there is little that I can promise will or won’t happen. Statements like “If you just do this, then we will go home” does not validate your child’s emotions. This only establishes an expectation that no one in the room can promise. It is not wrong to want to promise these things to try to de-escalate your child, but this also can break trust and give children false hope when a promise cannot be met.
3. Disengaging or leaving is not validating. Often when our children are expressing intense emotions, it is super easy to check out – emotionally or physically. We don’t want to engage the emotions either out of embarrassment, fear of making it worse or we feel the same way and cannot control our own emotions. However, what we communicate to our kids when we disengage is that they are too much and that we can’t be there for them.

These are all responses that happen as we struggle to know what to do as parents. We are desiring to de-escalate the moment, and truthfully we just want to be on the other side of it.

Let’s explore how validation can not only de-escalate the moment, but it also gives our children language to their feelings. It creates a space between the emotion and the moment which allows them to regulate their own emotions more effectively.

• Let your presence be validating. The way you show up for your child matters. Practice being with them amid their emotions. This does not mean matching your child’s emotions. This means staying, listening, and hearing them. It means comforting them and engaging them in the midst of their big emotions. Even if you don’t understand what they are feeling, you can be there to recognize and affirm their emotions.
• Let your words be validating. You can use normalizing language like “It is OK to be scared, worried, etc…” or “Most kids feel anxious about…” or “I remember feeling nervous about…” When you can normalize how kids are feeling, it reminds them that they are not alone and that others have felt these feelings and still been able to keep going. I often remind kids that it is totally normal to feel afraid of an IV or needles. Most kids have some amount of fear of getting an IV or poke. This one statement of validation often changes the tone of a room. Also, let your language be reflective. You can reflect back to them what you are seeing and hearing. “I see that you are feeling nervous about this…” or “This is a lot of information to process. I bet you are feeling a little overwhelmed.” If your child is telling you their emotions, you can reflect back on what they are saying to you. “You are wishing that you could go home” or “You don’t want to do this again and you are totally over this.” Just the recognition of emotion allows room for emotional regulation and being able to put the emotion in its proper place.

Validation is not difficult, but as a parent and caregiver, it does take practice and intentionality. Often it does not come naturally. However, the more time that you spend practicing validating your child, you will find it easier and easier. Validating our kids can be hard, but you’ve got this! ;)

By Ashley Pagenkopf, MS, CCLS, Child Life Specialist at Cook Children's

Recently I was helping one of my daughters prepare for surgery. We were up before dawn to do what is called a chlorohexidine bath the morning of her surgery. This is just a bath that helps to prevent infections and cleanse the skin of bacteria before surgery. We were standing in the bathroom, and I could slowly see her face changing. She burst into tears and uttered the only thing she was feeling – “I am so scared.” To which I burst into tears at almost 40 years old and replied, “I know you are, and I am too.” We both just sobbed as we finished the “bath.” Honestly, this was the first time in months of knowing about surgery that she had expressed fear or shed a tear. They were needed and necessary tears.

As a child life specialist, I am very comfortable with tears. The hospital is a combination of a new environment, painful procedures, and difficult experiences so tears are something that naturally flow. However, there is a stigma around tears and much of the world is not comfortable with or even accepting of them. 

We hear a lot of things about tears and children crying from parents, caregivers and medical staff. At the first sight of tears, an adult may say: “Don’t cry. Be brave,” “You’re a big kid. Don’t cry,” or “Crying isn’t helping anything.” As we explore emotional safety within the healthcare setting and elsewhere, we need to first establish that crying is OK. Not only is crying OK, but it is also actually beneficial and a needed part of the human experience for kids and adults. 

Let’s explore some of the truths about crying that may help us as parents, caregivers and staff as we respond to kids and their tears.

Crying is coping. 

Coping is how we handle difficult or stressful situations. Often crying is viewed as a sign of weakness or a negative way to cope with emotions. However, while there are many negative coping behaviors (anger, addiction, impulsivity, hysterical crying), crying itself is not a negative coping skill. It is a way of self-soothing and often helps our bodies relax. It can actually help kids find their bravery in the midst of challenging moments. Following crying, kids can move past that initial overwhelming feeling of “I can’t do this!”

While excessive crying (multiple times a day) can be a sign of depression and hysterical crying can create more stress, it is important to acknowledge that crying during a difficult or stressful experience is an appropriate coping mechanism and should be welcomed. Distraction, guided imagery, counting and many other things can be used to cope. However, tears can be trusted as a positive coping skill also, and accepting tears amid difficult experiences promotes an emotionally safe environment.

Crying does actually help. 

Often as a parent, our first thought when we see our kids cry is “Stop crying. That is not helping anything” as we are thinking of what they actually could do to help themselves. The truth is, though, that crying does actually help. Research tells us that crying releases oxytocin and endorphins. 

Oxytocin is a hormone that once released can immediately help lessen stress and anxiety. Its release can also help us to regulate our emotions more effectively. Also, when endorphins are released, they can help naturally lessen pain. Both of these effects of crying can help greatly during stressful or difficult experiences within healthcare, home or school. Research has also shown that when we over-restrict our emotions and hold in tears, it can contribute to poor emotional regulation in the short and long term. It is clear to see that crying can definitely help someone and often does.

Crying is not just something babies do. 

I’m sure you’ve heard an adult say in response to tears, “Don’t be a baby.” While in the early months of life, crying is a baby’s only means of communication, crying is not only meant for babies. Crying is a natural part of the human experience even into adulthood, and is developmentally appropriate at all ages. When we respond empathetically to tears, it can help our relationships with others. Between a parent and a child, a positive attachment can be established by responding compassionately to your child’s tears. 

Research has shown that a parent’s response to a child’s tears affects how the child can regulate their own emotions. Over time, if the response from the parent is consistently negative, the child will ultimately have poor emotional regulation. If we as parents can respond and validate our child’s tears, we have a better chance of also helping them establish good coping and emotional regulation over their lifetime. Some things that you could say are: “It’s OK to cry. Let’s also take some deep breaths,” “I know this is super hard and overwhelming. I’m sorry you have to do this. I am here with you,” or “This is super hard, but you can do hard things.”

It is also OK for you to cry. Something I witness often is a parent telling a child not to cry while also crying or attempting to hold back tears themselves. Sometimes parents or caregivers will leave a situation because they are crying. While a parent or caregiver crying can be unsettling to a child, it is OK for you to cry. I will say that this is only helpful if you can regulate your own emotions and communicate with your child what you are feeling. If your crying becomes hysterical or overshadows the person experiencing difficulty, it is not helpful or compassionate. True empathy and tears can validate someone else and make space for them to feel emotionally safe with their own emotions.

So, as we strive for an emotionally safe environment for our kids, let’s remember that crying is OK. We are encouraging positive and appropriate coping skills when we allow children to cry. Tears can be physically and emotionally helpful amid difficult and stressful experiences. Babies, kids and adults all experience emotions that lead to tears. As I think about the times in my life that have been stressful and challenging, tears have accompanied all of those times even now as an almost 40-year-old woman. We shouldn’t fear tears. Crying is a natural and helpful part of the human experience that allows us to grow in compassion and empathy and cope with this crazy life. Cheers to tears!

By Ashley Pagenkopf, MS, CCLS, Child Life Specialist at Cook Children's

I truly cannot believe that the summer is over. The summer months typically provide respite and regrouping for families. That is true for our family, but it is about this time that I start feeling ready to begin the new routine and move through the awkward first weeks of school.  One of my kiddos will have major surgery the second week of school and another kiddo starts middle school this year so my mom heart is extra anxious!

Summer months typically provide some respite at the hospital too. We see less illness and historically a fewer number of patients. I don’t think that any of us would say that this summer felt restful, though. While there is less illness in the summer, the number of traumas tends to increase, and we see a great deal of tragedy over the summer months.  This summer has been no exception. 

What is the well-known saying? We need a vacation from our vacation. I can’t imagine that I’m the only one feeling that at the close of this summer. Just like the beginning of a new year, we can all appreciate the reset that a new school year can bring. But we can’t ignore the intense emotions, anxiety and stress that a new school year inevitably brings to kids and families.

The weeks before and the first few weeks of school, the emergency room experiences an uptick in the number of kids coming in for behavioral health needs. There are so many stressors to starting something new, and post-pandemic we are needing more than ever to be aware of this and address it in every environment a child encounters – home, school and healthcare.

The Association of Child Life Professionals recently began an initiative nationwide addressing emotional safety within the healthcare environment. Emotional safety is defined by the ACLP as “an intentional, interdisciplinary practice to promote resiliency, healing and trust for pediatric patients and their families during medical experiences.”

This means that when a child walks through the doors of the hospital, we are all working together to be trustworthy adults that help a child recover more quickly from difficult experiences and help them work towards emotional, physical, and spiritual healing. While child life specialists promote and advocate for emotional safety, it is the job of the entire multidisciplinary team to provide this high level of care to patients and families.

When I look at this definition of emotional safety, I am reminded as a parent that this is what I want for my kids within my own home. I want my children to be able to recover quickly and withstand the storms of life. I want them to trust themselves, peers that are trustworthy, and adults that are trustworthy. I deeply desire for my girls to experience a balanced, healed life physically, emotionally and spiritually.

I don’t know about you, but as a mom, I am certain that I am not always promoting emotional safety within my home. I always desire it, but I know that I can often get in the way of my children feeling emotionally safe. In my exhaustion and selfishness, I can forget to really take the time to process the difficult emotions and validate my girls’ feelings. I often want them to just get over the hard without ever acknowledging how hard it may be. (And just in case you aren’t aware, things have been HARD over the last couple of years – especially for our kids.)

I have three girls that often cry in response to hard things. Even I cry often in response to hard things, but I can still find myself being annoyed at their tears. When in reality, the expression of our emotions often leads to healing and tears are needed.

I have also found that my kids need me at this time in their life to be their cheerleader and their advocate. My kids count on me to fight for them and to help them feel safe in all situations. Even my oldest, who is learning to advocate for herself, needs me to be there to help her when her school world or friend world is crumbling around her. 

As a child life specialist, emotional safety is extremely important to me in the healthcare environment. It is a right of every human to feel safe in every way while they are receiving healthcare services.

As a parent, it is also my responsibility to provide an emotionally safe home. This provides the framework for my girls to know what emotional safety is. When our children can understand what emotional safety is, they will be able to advocate for it not only in their healthcare experiences but also at school and at their jobs.

As we begin another new school year, I want to challenge you as parents and grandparents to consider this definition of emotional safety. Consider how you can promote resiliency among your kids and grandkids. Take some time to be with your kids in the next few days and weeks.  Allow them to really express their emotions to you (tears and all), validate their emotions and cheer them on towards the next right thing. Our kids need us to model in our homes what an emotionally safe environment should look like so that they can truly expect that level of safety in their all encounters.

Six years ago, Ashley Brock, MLS, AHIP, Family Library/Literacy Program manager, visited a family member after their surgery at Cook Children’s Medical Center and found her dream job.

During the visit, Brock discovered the Matustik Family Health Library – a space on the first floor of the medical center where patient families obtain health information on a consumer level.

“I thought it was such a neat place for families to go,” Brock said. “I have always been interested in the medical field, so I remember thinking this would be a perfect fit.”

Brock’s library career started at a public library in Frisco while working on a master’s degree in Library Sciences at Texas Woman’s University and then moved on to the Dallas Public Library. But she has always been interested in the medical field.

Soon after visiting Cook Children’s, Brock applied and was hired as a librarian for the Schwarz Health Sciences Library which is a place for all employees, health care providers with admitting and clinical privileges and students while on a rotation.

Four health sciences librarians and a pediatric clinical nurse specialist provide timely and relevant print and electronic resources in support of evidence-based practice and research.

The library houses 16 desktop computers, two laptops, a printer, scanner and fax machine. It is named after Edwin Schwarz, M.D., Fort Worth’s first pediatrician who dedicated his life to the well-being of Tarrant County’s children.

Empowering Families With Knowledge
In November 2021, Brock transitioned to the Matustik Family Health Library – a space on the first floor of the medical center where patient families obtain understandable, up-to-date information on a consumer level. The library honors Cassandra Matustik, M.D., who had a passion for improving children’s lives. Brock is a curator of the books for the collection and provides consults to patient families among other services.

“Being in the hospital is overwhelming on its own,” Brock said. “I want the families to feel empowered to care for their children by giving them quality information. They can trust us with that.”

Brock said they get a lot of foot traffic at the Matustik Family Health Library where families often use the computers, printers and fax machines – a difference maker during an unexpected stay. Whether they need to file FMLA paperwork or insurance for their job, Brock is there to help. She is also a notary and regularly notarizes documents for families.

“It seems simple, but these services are very valuable to families when they need it,” Brock said.

A Library For Kids
Patients also have their own library to visit – the Bomar Library named after William Bomar who was the founding chairman of the Board of Trustees at Cook Children’s and helped shape pediatric health care in Texas. He truly loved children and provided funding to endow the library. Thousands of patients benefit from the education and entertainment at the Bomar Library. In addition to fun books for all ages, the library offers puzzles and games for inpatients and their siblings to check out. Therapy dogs also visit to sit with the readers and to make the experience even more enjoyable.

“This library is very special and is run by volunteers for the most part,” said Brock, who manages the volunteers. “They catalog and take carts filled with books to the floor for patients to check out directly from their rooms.”

When receiving a new diagnosis, clinical staff sometimes recognize the need for families to have more information. Cook Children’s Medical Center is one of the first in Texas to integrate the consult service into medical records. Brock said they saw the way Child Life requests visits electronically and realized the opportunity to do the same with library consults. Once clinical staff requests a consult in the medical record, Brock takes information to the patient’s room, sends it through the patient portal or mails it to their home address.

“It’s a great way to get consumer information delivered to the bedside for inpatients,” Brock said.

Focusing On Health Literacy
Brock said the importance of health literacy has been realized worldwide due to the pandemic.

“As soon as COVID-19 started spreading, we all got the opportunity to see what patient families go through when encountering a new disease and understanding how to keep everyone safe while navigating new and sometimes changing information. Just like with the pandemic, patient families have better experiences and outcomes if we are providing them with clear and accessible messages.”

Consistency is key according to Brock. Her goal is to ensure all families receive the same information whether they are going to the clinic in Fort Worth or Willow Park.

“The same quality care for every child is so important,” Brock said. “The information they receive makes a difference in how well they are able to take care of their child.”

Fifteen years ago, I accepted my first job out of college at Cook Children’s. I never dreamed that this anniversary would fall during a pandemic. This has been one of the most challenging experiences to date as a parent and as a human, but I have surprisingly found peace under the Blue Peaks. When I look back and remember why I chose this profession and this place, it is the hope that I find here that anchors my heart no matter what is rocking the world. I knew then that I was signing up for a front row seat to suffering and I would be present for people’s most extreme moments in life. Even knowing that, I said yes because kids are amazing. They are the most beautiful representations of hope, resilience, endurance and faith in light of the most difficult struggles. While these beautiful, strong kiddos are the reason I chose this place and this career, the reason I stay is so much more.

September 7^th marked my 15-year anniversary as an employee of Cook Children’s, but my journey began in 1998 as a junior volunteer. For 22 years, over half my life, Cook Children’s has been a part of my story. I have truly grown up under the Blue Roofs. I’ve learned some of life’s hardest lessons, experienced the greatest milestone moments, and felt the most intense grief in my time at Cook. I’ve been a volunteer, an intern, an employee, and a parent. The skybridge still smells the same, and each time I cross it, I can envision myself in a white polo shirt and khaki pencil skirt walking in as a teenager. I was so incredibly naïve – and I had no idea the stories that I would encounter and how they would change me. I still get a little burst of magic in my bones when I walk into the Atrium at nighttime and look up. My heart still skips a beat when I remember the atrium filled with kids going to camp and loading busses for Camp John Marc.

I laugh that my time started as a medical records volunteer. For some unknown reason, I chose that position over a gift shop position. I quickly realized that I wanted to be with the kids, and I was transferred to Child Life as a volunteer on the inpatient hematology/oncology unit (3 Main at the time). I read books to kids, played games, braided my hair in silly patterns, and started falling in love with watching children resiliently live into their diagnosis. I had no idea at the time that my passions were falling into place, and I was getting a glimpse into my calling.

The summer of 2001 I volunteered at my first camps – Camp Jubilee and Camp Sanguinity. It was because of camp and the campers that child life became a dream. I went on to spend nine summers at Camp Sanguinity. Now, I tell people that my dream job is to be a full-time camp counselor. I graduated with a community health degree from Texas A&M the summer of 2005, and my long-time plan was to move to the Northeast and go to grad school to become a child life specialist. I finished my undergrad with an internship at Cook in the Community Relations department (now Family Support Services). I was falling more and more in love, and knew that child life was still my end goal, but leaving the Blue Roofs and Cowtown was not. I applied for and accepted a position in the volunteer services department in 2005 and started grad school at TWU in the spring of 2006. In April 2006, my husband picked me up in the front drive by the fountain for our first date. I moved into an activity coordinator role with Child Life in January 2007, got married in August 2007, completed a child life internship in Dallas in the Fall of 2008, and finally became a child life specialist in May of 2009! I worked on 5 South for several years with pulmonary, infectious disease and other patients. I had the joy of directing Camp Broncho for a few years in that position before moving into a half-time role as an evening child life specialist. I moved into my role in the emergency department in 2014 and found a niche I didn’t know existed. In September 2015, I experienced the Blue Roofs from the other side as a parent in the NICU with my third daughter.

If you work in pediatric healthcare, you have most certainly had someone say to you, “I could never do what you do” or “I don’t know how you do it.” It begs the question why – why do we do what we do every day and how do we continue to show up day after day in the wake of some of the worst moments any of us could have imagined? Like I said before, kids are amazing. I get a front row seat into watching kids do hard things so incredibly well. Often, they start off not believing they can do it, and finish with a confidence that they are the bravest kid to ever grace the Blue Peaks. It’s the most inspiring transformation to watch, and I often get the privilege of being the coach, cheerleader and encourager. The reason that I keep coming back is not only for the kids, though. Over the years I’ve also been inspired and changed by parents, siblings and the most incredible co-workers.

When you watch or walk through suffering at any level with other people, there is a bond – an intimacy – a vulnerability that can never be manufactured in any other experience. Please don’t misunderstand - I am present for some of the most painful, heartbreaking experiences for children and families that I would never wish on anyone. But, it’s the human connection that keeps me coming back. It’s the moments when tears well up because I totally understand why a mom is at the very end of herself. It’s the moments when I catch the eyes of a worried sibling and get to explain what is happening to their brother or sister. It’s the moments when a kiddo looks me right in the eyes and takes the deep breaths to cope through the pain. It’s the moments when I sit on the floor with a grieving mom or dad or when a co-worker’s arm wraps around me to remind me that I’m not alone in this moment. It’s the silly dad jokes that keep us all laughing through minor procedures. Some days, it’s the walk down to Starbucks with people that know me and love me. It’s the glimpses and moments where we are reminded that we are real, and we really need each other. This job and this place breed human connection in real time. In a world where so much connection is made through a virtual platform or on a surface level, what happens between these walls is genuine and raw. While it’s not always happy, joy is often present! It’s the laughter through tears. It’s the endless parties and celebrations, the syringe water fights, and the constant permission to be super silly because this is in fact a children’s hospital. Whether it’s a joy-filled moment, a silly moment, a painful moment or a gut-wrenching moment, it is moments that I would never, ever trade. All of these moments contribute to a bigger story of compassion, empathy, and love. This is a story that I don’t want to miss. So, I will keep learning, loving, growing and changing under the Blue Roofs. I will continue to keep my heart as soft as possible to the stories I encounter each shift because pandemic or no pandemic, this job is a gift simply because people are a gift. I am so very grateful for 15 years and pray for many, many more.

Our family moved through the week with my best friend, her firefighter husband, and their three kids the best we could. Three out of four of us are frontline workers, but we had yet to grasp all that was going to change. We headed home on Sunday night. As we drove, spring break had been extended by two weeks, our child care had been canceled, President Trump had said 10 or less people in one place, and grief began.

Dr. Alan Wolfeldt says, “In other words, grief is the instinctive human response to loss…It is the normal and necessary journey we embark on when something we have valued no longer exists.”

My two oldest girls attend public school – one is a first grader and the other a third grader. My youngest attends a preschool two days a week and has gone there for three years. My girls LOVE school. I realize this is not everyone’s story; but my girls love school, the people, the teachers, the events, all of it! (Please don’t hear that they have never pitched a fit in the early morning hours about going to school – but overall, they are big fans.)

We have close friends that attend a private school where they homeschool three days a week and attend school the other two. We have many other close friends that home school primarily. I also have friends that have their first baby or only babies at home. My parents are retired, empty-nesters. We have single friends and married-without-children friends. What I can tell you is this: everyone is grieving something.

You would think in my line of work that I would be prepared for the grief that my kids have experienced. We are often preparing patients and families for the losses associated with their diagnosis. For the Type 1 diabetic patient, they grieve that meal time and snack time will NEVER be the same. We prepare kids every day that break their arm or leg for the loss of a sports season that they were looking forward to, or the patient that needs an appendectomy and will miss a big trip due to surgery. Grief and grieving are wrapped up in most of what I do on a daily basis.

But nothing prepared me for the grief I would see from my children or FEEL on behalf of mine and others’ children.

I have now cried on the sidelines of every Zoom meeting my kids have had. I have wept for the seniors – all the losses that are once in a lifetime experiences. I have cried for and with my girls as they realized that there was most likely no church camp this summer or as they beg to play with the neighbors.

We have gone from grieving the big things like playing with friends, going back to school, and missing church to grieving the little things. My girls sat around at lunch the other day and said they missed the cafeteria! You know what…So do I!

I miss taking my girls their lunch and meeting and seeing their friends and teachers. They miss sharing their lunch with their friends. My oldest brought out her collection of bingo prizes from her teacher’s prize bucket and showed each one to us. She reflected, “I miss the prize bucket… Mrs. {Teacher} was the best…”

The “was” caught me off guard. We have yet to discuss that they are almost positively not going back to school this year, but my oldest is processing it. She is working on grieving the future. She has mentioned her locker filled with her things, and if she could have a class reunion when this is over. And she is not the only one…

Maybe you or your kids aren’t grieving like this. But here are the people I’m thinking about:

• The kiddo that looks forward to that one teacher or person that smiles at him every day and sure hopes that person is there next year.
• That kiddo that knew where his meal was coming from every day, but now is hungry and wondering.
• That new mama that wishes all her friends could come over and snuggle her baby while she took a nap.
• The teacher who woke up every morning knowing that what she/he did was a calling and wonders if their kids are getting hugs and encouragement at all during the day.
• The grandparent that desperately wants to see their grandkids and help their own kids.
• The parents who need a minute but there are no minutes or moments because they are working from home and homeschooling.
• The kids missing their lasts or celebrations from seniors in high school to seniors in college.
• The college kids that were just getting their groove and they are back home losing the independence they were gaining.
• The moms or dads who work on the frontlines and being home with their kiddos all day isn’t even an option.
• And so many, many more scenarios.

So how can you help your kids during this time? You are most likely are grieving too. And while positivity, hope, and gratitude are great things to remember and practice, most people in the middle of grief need to know that grieving is OK.

1. Grieve with your kids. Ask them what is hard about this time, who they can’t wait to see, what their favorite part of the school day was. Don’t attempt to constantly distract them from the grief. Let them tell you what is hard, what they hate, and then admit your own grief. Let them know that you miss your friends, you are looking forward to going to dinner at a restaurant again, and that you are sad about the losses too.
2. Offer space not solutions. Provide opportunity for your kids to share what is difficult without telling them how they should feel or what to do to fix it. Space means a platform to process. This could be a Facetime call with a friend, journaling each day about their feelings, or taking a drive by the places they miss. Space just means that you don’t attempt to replace their feelings with a solution – you give respect to what they are experiencing.
3. Trust the process of grief. Allowing the process of grief to occur is what brings about healing. You may assume that your children are not grieving because they have not verbalized their grief. However, you will often see unresolved grief show up as difficult behaviors. While working through grief may be difficult and overwhelming at times, it is important to allow grief to occur so that healing can follow. Taking the time to listen, be there, and validate their emotions will be worth the time and energy it takes.
4. Lastly, speak truth where you are able. My kids favorite grieving statement right now is “I will never see my friends again.” This is not true. I will often reply with, “I know it feels like you will never see them again, but there will be an end to this difficult time and you will get to see them.” The other thing I’ve heard in this grief is, “I love Mrs. {Teacher}, and she will never be my teacher again.” This is most likely true. Don’t sidestep this. “Yes, Mrs. {Teacher} will not be your teacher next year most likely, but she is your teacher for this year, and she has been such a special teacher.”

I know that this time is super difficult for many of us. You are not alone if your children are struggling. If your children haven’t verbalized their grief, check on them and make sure they have the invitation to grieve if needed. There has been so much lost in this time, and while it is not forever, we want these kids (and ourselves) to come out on the other side healthy and able to move into the next season with confidence.

“The pain passes, but the beauty remains.” Auguste Renoir

But spend some time in one of those rooms and you will see a big part of the child life specialist’s job is to help patients through tests and procedures, as well as coping with any life changes they may face. Even though NICU patients are tiny, child life specialists still play a vital role in not only providing support and stimulation for the child, but for the whole family.

“A lot of our parents need support during this time,” said Lauren Bridge, one of two child life specialists in the NICU. “In a way, it's a loss for them because they didn't have the pregnancy they expected. If they delivered early, they may have never had some of the experiences they anticipated.”

With the young patients, Bridge says she tries to focus on infant development and milestones. She and the other child life specialist, Lisa Pool, are always looking for ways to foster development, which could mean putting a mobile over the infant’s bed, making sure the lights are turned down or even just talking to them.

The other huge role they play is working with siblings. Often, parents aren’t sure whether or not they should bring their other children into the NICU. Bridge encourages NICU parents to include siblings in the baby’s care, though she says regressive behavior is common, especially among preschool age kids. This can mean wetting the bed even though they are potty trained, becoming clingier or refusing to sleep in their own bed. Child life specialists are there to help families navigate this stressful time and help siblings understand what is happening to their little brother or sister.

Ultimately, Bridge says she hopes she can help make NICU families’ time at Cook Children’s a little better.

“The best part of my job is seeing families become increasingly comfortable in the NICU and being an integrated part of their child’s care.”

When we were within close range, he read my badge, nodded, and said out loud, “Oh, Child Life.” It all made sense; this ridiculousness was Child Life. What he didn’t know was that I was on my way to help create joy for a patient who was at the end of his life, as requested by his grieving siblings. And nothing felt ridiculous about that. On the contrary, it felt painful and sad and very, very important.

Years later, in my current role as facility dog program coordinator (and handler of Ralph), I am often told I have the best job ever. And I agree with that to my core. In some ways it feels like I need to be pinched, because this cannot possibly be my job and my life.

What I don’t often talk about, however, is that it is not in any sense an easy job. In fact, there are many days that it is extremely difficult. While I am exceedingly proud of the comfort and happiness Ralph brings to so many, the reality is that in just one eight hour day as Ralph’s partner, I bear witness to some of the highest highs and the lowest lows experienced by patients and families.

On any given day, I may sit in utter silence while Ralph snuggles a patient who landed in the hospital after attempting suicide, and then leave to attend a breakout party for a child going home from the bone marrow transplant unit; we may distract a child from a blood draw and then leave to be present at the bedside of a dying child.

Some days we work to show a child who has been abused what gentleness looks like, and some days we put his paw print on a canvas to congratulate a family on reaching the end of treatment. Together as a pair we act as cheerleaders, tear-catchers, and secret-keepers. And the truth of this work is our hearts break often. It is the great challenge of this work, in my opinion, to continually put our hearts back together so that we can be available to the next child and family that need us.

Lucky for us, we also get to play a role in helping kids find joy through circumstances that are sometimes unimaginable, we get to celebrate achievements and milestones, however big or small, and we get to have a front row seat to the miracle of human resilience.

When I come to work, I try to always remember the enormous opportunity in front of me and Ralph, which far outweighs any challenge we encounter. At least a couple of times every week, a parent or caregiver tells me that meeting Ralph was the first time they saw their child smile in days or even weeks. That is the reason we do what we do.

This past January, the facility dog program celebrated its fourth Cook Children’s anniversary. The program’s impact on patients, families and staff in that time is frankly incalculable. And though there is much more to it than meets the eye, the giggles, the security, the unconditional love and acceptance brought to the medical center each day by our five dogs is second to none. We will come back and do it again every day we possibly can.

References:

American Veterinary Medical Association. (2017). Animal-Assisted Interventions: Definitions. Retrieved from https://www.avma.org/KB/Policies/Pages/Animal-Assisted-Interventions-Definitions.aspx.

Braun, C., Stangler, T., Narveson, J., & Pettingel, S. (2009). Animal-assisted therapy as a pain relief intervention for children. Complementary Therapies in Clinical Practice, 15, 105-109.

Calcaterra, V., Veggiotti, P., Palestrini, C., DeGiorgis, V., Raschetti, R., Tumminelli, M., Albertini, R. (2015). Postoperative benefits of animal-assisted therapy in pediatric surgery: A randomized study. PLoS One, 10(6), e0125813.

Creagan, E. T., Bauer, B. A., Thomley, B. S., & Borg, J. M. (2015). Animal-assisted therapy at Mayo Clinic: The time is now. Complementary Therapies in Clinical Practice, 21(2), 101-104. doi:10.1016/j.ctcp.2015.03.002

Gilmer, M. J., Baudino, M. N., Goddard, A. T., Vicker, D. C., & Akard, T. F., (2016).

Animal-assisted therapy in pediatric palliative care. Nursing Clinics of North America. 51(3), 381-395.

Signal, T., Taylor, N., Prentice, K., Mcdade, M., & Burke, K. J. (2016). Going to the dogs: A quasi-experimental assessment of animal assisted therapy for children who have experienced abuse. Applied Developmental Science, 21(2), 81-93. doi:10.1080/10888691.2016.1165098

Vagnoli, L., Caprilli, S., Vernucci, C., Zangni, S., Mugnai, F., &Messeri, A. (2015). Can

presence of a dog reduce pain and distress in children during venipuncture? Pain Management

Nursing, 16(2), 89-95.

You walk through the door of the ER to see no one else signing in. You breathe a sigh of relief. This doesn’t look so bad. You get checked in, and it’s not long before they call you back to a room - triage. Your child gets their vitals taken, the nurse asks you a slew of questions and the doctor sees you. Then you are back in another waiting room...WAITING. You think it’s not going to be long, but 45 minutes turns into a couple of hours and you are still waiting.

The ER is just that - an emergency room. Most people try to avoid it completely, while for others, it’s their go-to for health care. No matter where you land in that mix, there is more going on behind the scenes than what you see in the waiting room. 

This is your first tip from an ED Child Life Specialist and mom. Every time I walk through the waiting room on my shift, I think like a mom for those few seconds. I don’t know about you, but as a mom I avoid waiting with my children for everything. This is why drive-thrus were invented! If I can’t avoid it, I come armed with everything possible to make it more bearable. Usually there is a bribe attached to this option.

As a mom with behind-the-scenes experience, there are a few things I think you should know before you sit and wait or, unfortunately, experience a really scary emergency.

The emergency room is a necessary place, and we know how much you don’t want to be there. Trust me, I’ve debated going at midnight with the screaming baby whose ear infection came on within a matter of hours on a Friday night. Confession: I let my oldest go two days with a broken arm and had no idea. The second time, I had her x-rayed the day of. Being a caregiver comes with so many decisions, and I know that deciding whether or not to go the emergency room is one of the hardest ones. Remember that we are here to help you and your child through these hard moments and illnesses that come with childhood. Our motto is: It’s all about the kids! And we mean it!

About the Author

Ashley Pagenkopf is a Child Life Specialist in the Emergency Department at Cook Children's Medical Center. The Child Life program at Cook Children's offers a variety of services, all designed to make your experience at Cook Children's the best it can be. Our services include educating, preparing and supporting your child through tests and procedures, as well as coping with any life challenges you and your child may face. 

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• New ED opens just in time for back-to-school injuries

Now with three kids of my own, I often hear, “Am I going to have to get a shot?” My 6-year-old tells me weekly that she doesn’t have to get any more shots until she is 11. She heard nothing else at her well-check appointment except what was said about the shot schedule.

I am a mom to three beautiful girls ages 18 months to 6 years. I am no stranger to doctor’s appointments, shots, and all the fretting that comes with all of it. Heck, some weeks I feel like the office staff at the pediatrician’s office knows what’s going on in my life better than some of my closest friends.

I spend every car ride on the way to an appointment walking my kids through exactly what to expect from their appointments. I walk them through standing on the scale, to the room, to the doctor coming in and finally, when they ask me if they are going to get a shot, I tell them the WHOLE truth. I tell them how many, and where, and even how we are going to sit when it’s time. Are you thinking I’m the crazy mom now? Are you wondering why in the world I would give my kids so much detail at such young ages?

Not only am I a mom, but I’m also a Certified Child Life Specialist (CCLS) at Cook Children’s Medical Center in the Emergency Department. My job is to prepare and support kids throughout their health care experience. Preparation is without a doubt the most important part of my job. On a regular basis, parents tell me that before we start an IV, give a shot of antibiotic, or suture a wound that they would rather we just did it and surprised their kiddo rather than tell them what is going to happen before it happens. Yet, every time I walk in a room, I say some version of this:

“Hi, my name is Ashley. I am a child life specialist, and my job is to make sure you know what’s going to happen before it happens. We don’t like surprises here at the hospital. So let me tell you what we are going to do next…”

And the whole room changes. Children immediately begin to engage with me in conversation.

Research over decades demonstrates preparation reduces stress and increases the child’s ability to cope with healthcare experiences. It is important to note that timing, the child’s age and developmental level, previous healthcare experience, type of procedure, the child’s learning style, and personality should all be considered when offering preparation. (Rollins, Bolig, & Mahan, 2005, p. 44).

My oldest needed to know months before her 4-year-old well-check that she was going to have shots, and she needed me to walk her through the experience over and over. She is an external processor, the first-born, and order is her love language. She even had to talk through her fears and shed a few tears before the visit…more than once.

Many of you may be thinking that this sounds like a lot of work. The intensity that can come with a child’s constant worries and fears can make you say, “Let’s just show up and get it over with!” Trust me when I say that I know that feeling well. You think they will get over it and recover, but the reality is, in those moments of “getting it done,” you may create a traumatic healthcare experience that will follow a child throughout their lifetime.

My youngest is a preemie, and we spent eight days in the NICU at Cook Children's. Every single time, since she was just under 1-years-old, that we walked into the doctor’s office whether it was for her or her sisters, she began to cry and suck her thumb. She is my only child that has had, what I would consider, traumatic healthcare experiences; however common belief is that she was too young for those experiences to affect her. I completely disagree. We walked into the dentist the other day for her sisters’ appointments, and she cried all the way down the hallway because it resembled the doctor’s office. It took her several minutes to feel safe enough to stop crying.

So, all of that to say, it matters. Your children need to have an opportunity to prepare their minds, process their emotions, and be a part of making a plan to help them cope. A few things to consider as you prepare your child for the doctor’s appointment:

My girls love going to the dentist…for real. They LOVE it. I truly believe this is because of the environment our dentist office has created. They prepare them for everything, let them ask questions, and they always let them leave with a prize. Don’t be above a prize. My mother-in-law says that as adults we get paid for our hard work, why shouldn’t they get paid for theirs too. If your child is successful and gives their best, reward their efforts.

A quick note on pain: Children interpret a lot of touch as pain. They are most concerned with what is going to hurt, and they immediately feel out of control. Also what they see is what they believe. So if something appears painful, it is. Your preparation helps to identify what will actually hurt, identify how other things are going to feel, and help them realize that they can be in control by making a plan on how they will handle what they feel. (Kuttner, 1996, p. 77-79)

Going to the doctor doesn’t have to be a horrible, dreaded experience. It really can be just another part of life that we do on a regular basis. So the next time your child asks if they are going to get a shot at the doctor, answer them truthfully, let them ask questions, validate their feelings and then go get some ice cream!

Kuttner, L. (1996). A Child In Pain: How To Help, What To Do. Vancouver: Hartley & Marks Publishers, Inc.

About the Author

Ashley Pagenkopf is a Child Life Specialist in the Emergency Department at Cook Children's Medical Center. The Child Life program at Cook Children's offers a variety of services, all designed to make your experience at Cook Children's the best it can be. Our services include educating, preparing and supporting your child through tests and procedures, as well as coping with any life challenges you and your child may face. 

Cook Children’s has brought in visiting dogs for decades as a way to help patients and their families cope with their situations, but it was one of the first hospitals nationwide to realize the value in having dogs as badge-yielding staff members.

“People wouldn’t have pets the way they do and treat them like family members if there wasn’t something to that,” said Facility Dog Program Coordinator Kizzy Marco.

Just over three years ago, Ralph and Chanel became the first dogs to join Sit...Stay....PLAY, the facility dog program at Cook Children's.

“We are pioneering something really new,” said Marco. “The majority of hospitals in the country have animal-assisted therapy or dogs that visit routinely and that’s wonderful, but having them here as residents and as employees makes such a difference.”

As facility dog program coordinator, a large portion of Marco’s job involves handling Ralph, answering referrals and working one-on-one with patients and their families.

“I feel like people moved mountains to make these dogs available for our patients and families,” said Marco. “I’ve always loved working at Cook Children’s, but that was the moment I realized how much this place cares, probably beyond words, about the emotional well-being of its patients. Of course health care exists to take care of people physically, but we also have a responsibility to take care of people emotionally and these dogs are doing that.”

When Ralph comes in contact with a patient, the atmosphere changes immediately.

“I’ve seen kids at their very sickest,” said Marco. “I’ve seen kids at the end of their lives light up to see Ralph.”

Stephanie Myers witnessed the power of dog therapy first-hand when her 4-year-old daughter Baylee was introduced to Ralph after being diagnosed with stage 4 neuroblastoma.

“She hadn’t walked or gotten out of bed in about a week,” said Myers. “Kizzy brought Ralph in and I saw a light in Baylee’s eyes I hadn’t seen in a while. She instantly wanted to sit up and then stand so she could pet him.”

Ralph brought normalcy and softness to the situation with Baylee, as he does with so many others.

“Anytime Baylee has needed a little push, Ralph has been there to guide her through it,” said Myers. “He is such an amazing therapy dog and has given our daughter strength and a smile when we thought she might be out.”

“What our dogs do for patients is deep. A patient once vulnerably told me that he loved Ralph because he knew Ralph would never judge him. That says it all right there,” said Marco.

Because of the large number of both inpatient and outpatient cases, therapy dogs are not able to sit on every child’s bed or walk the halls with them or get ready for surgery with them.

However, many patients, families and staff members get the experience of seeing one of the dogs in passing walking down the hallway or in the cafeteria, which Marco considers a therapeutic encounter.

“You don’t know what people are carrying emotionally when they’re walking through the hallways,” said Marco, “so adding this goofy, smiling, prancing, fluffy, handsome Golden Retriever to the environment is so important. If you never knew a single patient story, if you never knew how much of an impact these dogs make, just knowing that is huge.”

When Ralph does have the opportunity to work one-on-one with a patient, they form a bond so strong that every child thinks Ralph is their best friend. When they see him and start calling his name, his tail starts to wag, he squints his eyes and starts shaking around with excitement.

“It’s almost like he remembers every kid he’s ever met,” said Marco.

While the dogs are a friendly face for children at the medical center, they really do serve an important role in the physical and emotional well-being of these patients.

Whether giving a dog a syringe of water mixed with juice to get a child to take medicine or taking him for a walk to get kids up and moving, these animals are trained to relate to the patients and their difficult experiences in a way that normalizes their environment and gives them something else to focus on.

Using dogs as a means of reducing anxiety in patients is especially true for Child Advocacy Resources and Evaluation (CARE) Team, which assesses cases of child abuse.

“When you’re talking about abuse and really difficult subjects with these kids, having a dog there can really ease their anxiety and help them voice what happened to them,” said Jamye Coffman, M.D., a child abuse pediatrician at Cook Children’s. “When you reduce the anxiety in a child, it reduces all the stress hormones so you don’t have any of the effects of stress on the child that can contribute to illness.”

Dr. Coffman has handled Kitty since she came to Cook Children’s nearly a year and a-half ago. Kitty stays with the CARE Team and is trained to jump up on the couch with patients when they are being interviewed to help relax them and their parents, making the environment feel less like a doctor’s office and more like a home.

But there is also an art to the things that dogs can do innately, the things that cannot be taught.

Not long after Marco and Ralph began working as a team, they were asked to visit a patient with a severe developmental delay. Marco was admittedly nervous because this patient was unpredictable in her movements and she was not sure how Ralph would react.

Without hesitation, Ralph walked up to the patient, looked her in the eyes and put his head on her lap while he sat there and let her do whatever she wanted.

“That’s the true gift of our dogs is that they don’t see any differences,” said Marco. “We know patients whose illness or treatments make them look or behave in a certain way. We know the ones that have especially great challenges, and hopefully it doesn’t alter how we interact with them, but Ralph doesn’t even know those things.”

For that child and her family, interacting with Ralph was a completely normal experience and there was nothing atypical about the situation.

“That’s an innate art that is something that we as a health system found a way to provide. It had never been provided to our patients and their families before,” said Marco. “It is very humbling to know that our dogs can make moments like that happen for families.”

It's important to remember that Ralph is only one dog out of five at Cook Children’s, making up only one-fifth of the program. Our most recent addition is a 2 year old Golden named Lulu who started working in inpatient psychiatry and partial hospitalization program just about a month ago.

Every day these dogs have encounters like this one, and every day they are doing something to make the hospital a better place for patients and their families.

The impact that these dogs have made and the moments they have shared with people in the time they have been at Cook Children’s is remarkable.

“It is profound that they know and have the ability to mourn with people who are mourning, to celebrate with people who are celebrating and to play with people who are playing,” said Marco. “I think there is a bond or intuition that connects them to people exactly where they are, and to watch that is amazing."

How to Help

The generosity of donors helps make it possible for Cook Children's to bring programs like Sit ... Stay ... PLAY to our patients. To support our dog therapy program and other programs like it, please call 682-885-4105 or donate online by clicking here. Learn more about Sit ... Stay ... PLAY by clicking here.

As a child life specialist my job is help provide normalization during stressful and traumatic medical experiences. We educate, prepare and support children through tests and procedures, as well as coping with any life challenges children and their families face.

Somedays are full of amazing moments, like sending patients home after a long stay, or watching a hospital therapy dog light up a room.

But sometimes life is full of hard moments; moments that feel like mountains that kids can’t ever imagine overcoming. My job as a child life specialist gives me the opportunity to help families during those hard moments.

Sometimes it is giving a small child, afraid of the hospital and the people in it, the chance to play in the midst of all the new things happening around them.

Other times it's being there when a patient needs a poke, to help them learn coping skills that will help them right then, as well as in the future. One of my favorite moments was witnessing a 4 year old exclaim, “That wasn’t as hard as I thought it would be!” after getting a poke he had been very nervous about. Through preparation in terms he could understand and support using distraction, he was able to feel successful in the moment and hopefully be a little less nervous in the future.

From time to time my job includes supporting kids and their families when they get difficult news they didn't want to hear. Sometimes that looks like providing a developmentally appropriate explanation of a new diagnosis to a patient and their siblings, or standing at a parent's side to help them explain things that feel too heavy to find the words for on their own.

Every day is different and not every moment is full of bubbles and sunshine, but I feel so lucky to work as a child life specialist. It is an honor to walk alongside kids and their families during hard moments and so encouraging to celebrate with them during the good ones.

About the author

Zoe Growald is a Child Life specialist at Cook Children's on 4P and the Epilepsy Monitoring Unit. Our Child Life specialist work with kids and families to make their visit to the medical center easier and more comfortable. Our Child Life specialists offer your child and your family an opportunity to express and work through any fears and concerns you may have. We’ll provide an explanation about what’s going to happen during your visit and work with parents, brothers and sisters and other family members who may be involved in your child’s daily care. As a part of our commitment to family-centered care, Child Life specialists work with your child's medical team to advocate for and ensure your child’s and your family's needs are addressed in the most nurturing atmosphere possible. Click to learn more.

1. Save your bark for when you really need it. One afternoon when Ralph and I were on a walk through our quiet neighborhood, we were mutually startled by a big dog with an even bigger voice, sprinting back and forth behind a fence, barking ferociously at us. I squeezed the handle to his leash tightly for fear that he may want to take part in conversation with the barking dog. To my surprise, he did nothing but tilt his head, study the dog for a moment, and keep on his way. I was struck with the realization that Ralph barks so sparingly, that surely he is saving his bark for when he really needs it. In life, a lot of dogs are going to bark at you, and a lot of them are trying to get you to bark back, but maybe it's better to tune them out and just enjoy your walk. You can always bark when it's really necessary.

2. Meet people where they are. When I first returned to work with my new constant companion, I felt reasonably unsure of his ability to read the room in an unfamiliar environment. I worried when we were called to see very young patients, I worried when we were called to see very fragile patients, and I worried when we were called to see patients with conditions or diagnoses that changed their appearance. It turned out, of course, that my worry was for nothing. Ralph showed me that he instinctively knew to mourn with families who needed to mourn, to be very gentle with children who were critically ill, and to play with children who wanted to play. He showed no judgment to any child, only the love and reassurance they were looking for. I strive to be as unwaveringly accepting as Ralph has proven to be.

3. A little encouragement goes a long way. In a hospital that has four adorable golden retrievers on staff (who are often confused for each other), Ralph has become known as the one with the silly tricks. In teaching him to do new things, I have seen very clearly the difference between what happens when I am unenthusiastic and directive, versus when I am excited for him, cheer him on, and let him know I believe in him. He now recognizes the words, "you can do it" and "you got it," and when he hears those words, he almost always tries again (usually with more "umph!"). Maybe we should practice that with each other. Maybe we should pay attention to the difference it makes to our family members, our friends, our coworkers, even our pets, when we cheer them on. Sometimes all it takes is one voice saying what you already know deep down: you got it.

4. Seize every opportunity you possibly can. While at times Ralph has seized opportunities I am not as proud of (like helping "clean up" spilled food off the floor), he also seizes opportunities to find joy and make a difference. He beelines in the hallway to people I haven't noticed, who he somehow knows need him close. He photobombs families capturing a memory here at the hospital and by doing so, causes an eruption of laughter. He finds patches of dirt to roll in immediately after his bath. And he literally always stops to smell the roses. To Ralph, an elbow resting on the edge of a table is not an employee paying close attention to their work, it is an opportunity for a nose-nudge to initiate petting. To Ralph, unless it's nap time, every passing moment is an opportunity for something. Thinking about that makes me wonder how many opportunities I miss when I think I'm too busy to notice them.

5. Last but certainly not least, don't take yourself so seriously. I knew from the very beginning that Ralph had excellent comedic timing. One night while still in Georgia for training with Ralph, I was laying with him and telling a story. He reached his long arm out into the air and dropped his paw directly over my mouth, as if to say "shhhhh." He has been making me, and everyone else, laugh ever since. From perfectly-timed audible groans during long meetings, to prancing so wildly that he trips himself, Ralph is one funny dog. And even though he has an incredibly important job, he knows not to take himself so seriously. It's as if no amount of accolades, photos taken or articles written could ever make him arrogant. He does what he does because it is fun and joyful and it matters. It's as simple as that. Oh, and around 4:45 p.m. every day, you can find him rolling on his back care-free in the grass outside the south tower, reminding me as I stand there and laugh, to stop taking things so seriously. 

About the author

Kizzy Marco is a certified Child Life Specialist and the Facility Dog Program Coordinator at Cook Children's. She is Ralph's handler. Ralph came to Cook Children's with his sister Chanel. He is known for his big personality and many tricks! A warm and fuzzy hug can help anyone feel better. A dog's healing presence is known to have a positive influence on wellness. That's the driving force behind Sit...Stay....PLAY, the resident dog program at Cook Children's. Click to learn more about the program.

The Centers for Disease Control and Prevention and the American Academy of Pediatrics are recommending against spray vaccines, such as FluMist, after finding it only 3% effective in preventing the flu in children. Instead, they're urging parents and pediatricians to opt for the shot.

If your child is like most, this is bad news because needles are often enemy number one.

The good news is, there are ways to make this undesirable trip to the doctor's office a little less traumatic. At Cook Children's Medical Center, Child Life Manager Janis Smith discusses ways to help kids cope with pain and stress. When it comes to needles, she says a little distraction can go a long way.

"An iPad, a book, or even engaging conversation can often be enough to take a child's mind and eyes off of the shot," said Smith. "We also encourage deep breathing and sometimes utilize a cold spray to help numb the skin."

A newer technique taking the pain out of shots is called Buzzy. This friendly-looking device comes in the form of a bee or lady bug and can trick the body's nerves with cold and vibration.

"Buzzy's wings are made of ice packs and its body buzzes. When placed above the injection site, these sensations knock the nerves off their game and help eliminate and/or minimize the pain from the shot," said Smith.

While many pediatricians provide tools like Buzzy in their offices, parents can also buy their own in Cook Children's onsite pharmacy.

Another way to ease the sting of the flu shot is comfort positioning. This means creating a secure hold, like hugging, that offers comfort to the child while immobilizing the extremity needed for the procedure (such as the arm). This minimizes anxiety as well the need to hold a child down, which can be traumatic.

For older children, it may help to ask them to do something, such as focusing on an iPad.

"Allowing children to play an active role during the procedure process can often minimize fears and encourage positive coping,'" said Smith.

Smith also suggests offering validation to a child who is afraid of shots.

"Try saying something like, 'I know that you don't want to do this, but it's a way we can help you from getting the flu,'" said Smith. "In the end, no one likes shots. But when children do need shots, we want to provide them with opportunities to cope successfully and help make them as painless as possible."

About the Source

Janis Smith is a Child Life Manager at Cook Children's Medical Center in Fort Worth, Texas. Child Life specialists work with children and families to help them cope with the extra challenges of living with chronic illness.

Don’t be confused though. Julia and her dog, Journey, have a big responsibility at Cook Children's. Yes, they are there to play, but their mission is always to give patients and their families a sense of normalcy during a stressful time. From visiting children in their hospital rooms to supporting them during procedures, child life specialists, like Julia, help patients cope with what they are experiencing while giving them a sense of control.

"My favorite part of the job is being able to help children overcome their anxiety. It's incredible to watch something that was really scary to a patient at first become no big deal," she said.

If you've ever been to Cook Children's Medical Center, you may have seen Julia or others in child life shooting Nerf guns in the hallways, painting with patients or taking a golden retriever for a walk. Their jobs are fun, but also very important. They help educate, prepare and support children through tests and procedures. They are specially trained to speak to each child on his or her learning comprehension level.

"When I was a freshman in college, I couldn't decide whether I wanted to become a nurse or a teacher," said Julia. "Then a family friend was hit head-on by a drunk driver."

That friend was 9 months pregnant. Both survived, but the baby had a stroke and required extensive time in the hospital. It was a child life specialist who was called in to help the baby's older sibling during the family's difficult time.

"Helping siblings feel included is a big part of what we do," said Julia. "After I learned about child life, everything fell into place. For me, it was the perfect combination of medicine and child development."

She went on to get a bachelor's degree and become a certified child life specialist, taking a position with Joe DiMaggio Children's Hospital in Hollywood, Florida. In 2009, Julia packed her bags and took off for Texas where she would soon find her calling.

"I wanted to have Journey with me because I've seen the difference these dogs make," she said. "We visit a lot of patients with serious illnesses and it helps them open up. For some reason, when they are petting a dog they will start talking about things that they haven't mentioned before."

Journey not only accompanies Julia during her 8 hour shift, she also lives with her.

"In the morning, I put her vest on and she knows it's time for work. But at the end of the day, she rests and plays just like a regular dog," she said.

There are four certified therapy dogs at Cook Children's and more than 50 staff members in the child life department. Their roles range from specialists like Julia to music therapists, artists, educators and even clowns. It's one of the largest child life departments in the country and a vital part of Cook Children's promise to improve the health of every child in our region, by giving patients and their siblings the opportunity to be who they are first and foremost, kids.

I think in “Inside Out,” Riley’s family is always trying to be positive and give Riley joyful memories throughout her childhood. As the family moves and life starts to unfold negatively, we see other emotions; fear, anger, sadness and disgust, start creeping up in.

We see Joy work harder to keep Riley’s emotions as joyful as possible. Joy is an important part of our memories that we like to revisit. As a child life specialist at Cook Children’s, I try to help normalize the day and make joyful memories with patients and families.

These memories will help children cope with other struggles that they overcome and find joy in their life. As adults, we have a hard time with this because we have so many experiences with sadness, fear, anger and disgust it’s hard for us not to project our feeling on children especially when they are in the hospital.

Children that come into the hospital may experience different emotions, but joy can be found through these emotions, even when as adults we may think there is no joy.

Sometimes kids find so much joy that they don’t want to leave Cook Children’s because it has become a fun and not so scary place. We need to remember to look for joy with all that may go on in a hospital setting.

We might not think children do a great job at a procedure because maybe they cried. However, they may have held still and been able to recover with playing by the end of procedure. This can create a joyful memory with having families at the bedside showing comfort.

Sometimes going through these different periods of our life while growing up and experiencing many things good and bad allow our emotions to interact.

In “Inside Out,” we see that the character Joy realizes toward the end of the movie that you can mix your emotions and this can be considered normal. Joy realizes that you can cry tears of joy. So as a child life specialist we help families realize that tears in a difficult experience may help a child in the future to help to control his or her different emotions. The tears also allow us to look at our long-term memories and see how there might have been joy in that moment after all and change that core memory to be better than we thought.

This allows us to empower children with all these different emotions, especially joy, in their daily lives, in or out of the hospital. Joy is a great emotion which we all deserve to look for daily in our lives and others that live with us. What Joyful memory do you have?

Previous stories in our "Inside Out" series:

• Anger
• Disgust
• Sadness
• Fear

Heather Bayers is a Child Life specialist at Cook Children's. We know that a child’s illness or injury can impact a family physically, emotionally and financially. Fortunately, you don’t have to face these challenges alone. We provide a growing number of services for patients and families, all designed to help support, heal and encourage you through every step of your journey.

These moments can be quite amusing to watch because, let’s face it, we can all relate to having angry outbursts!

Anger is many times perceived as the ultimate negative emotion, however “Inside Out” gives us an interesting perspective that could teach us a few things. When Joy introduces us to Anger, she describes him as someone who “cares about what is fair.” If we really think about it, most of our anger is the result of feeling as if we have been wronged by someone or when a situation does not go as we feel it should.

Children and teens who are dealing with an illness, injury, and/or hospitalization have MANY reasons to feel as if they have been put into an unfair situation. They are missing out on events with friends and family, missing school, having to endure sometimes painful and scary procedures and experiencing so many things that they have so little control over.

The first step in helping kids cope with anger is to acknowledge why they feel angry and to let them know they have a right to feel angry about a difficult situation.

Big life changes and overwhelming situations can shake up our emotions and cause them to go into panic mode as they try to make sense of what is happening. This is what we see with Riley’s emotions when her family moves away. However, when Anger is able to fully take over Riley’s control board, she makes an impulsive and unsafe decision to run away in an effort to feel better and to fix what she sees as an unfair situation. She breaks her hockey stick, rolls her eyes, yells at her parents and is disrespectful. When children begin to show these negative behaviors (even when they are sick or hurt), they need clear reminders of what behaviors are not acceptable while validating the feeling behind them. Say to your child, “It is OK for you to feel angry. It is not OK for you to hurt yourself, hurt others or be disrespectful.”

But if we are going to remove the only way they know how to express anger, we must replace it with an acceptable and healthy outlet. Some simple activities may include punching a pillow, pounding play dough, breaking ice cubes outside, participating in sports or outdoor activities, taking deep breaths or tearing up paper. Providing these options prevents anger from being bottled up and eventually blowing up!

Is there a positive side to Anger?? Definitely. Anger is strong, determined, passionate and protective. Those are all things we want children to be. Children can learn to see things that are not fair and stand up for themselves and others. Anger can be an excellent motivator for change and reaching solutions. If we can teach a child to use their anger in a positive way, we can empower them to overcome difficult situations.

Related "Inside Out" topics:

• Disgust
• Sadness
• Fear

About the author

Angie Bradley is a Child Life specialist at Cook Children's. We know that a child’s illness or injury can impact a family physically, emotionally and financially. Fortunately, you don’t have to face these challenges alone. We provide a growing number of services for patients and families, all designed to help support, heal and encourage you through every step of your journey.

“Inside Out,” the new hit movie, helps us to understand, however, that sadness is just as important to our world and our perceptions, as joy and anger and all of the other emotions we encounter as human beings. We cannot pretend that sadness isn’t there. We cannot ignore it and hope it will go away. There is a reason for our sadness and if we don’t experience that feeling, it gets stuck inside where it grows and festers and can then prevent our other feelings from being realized.

We’ve heard the idea that we can’t know true joy without having known sorrow. The point in the movie where things change is when Riley’s parents stop and listen to her feelings. Riley tells her parents that she misses her old home and she wants to be with her old friends. Nobody is trying to change the way Riley feels. Nobody is trying, including Riley, to cover up her sadness with something else. Riley is allowing herself to feel the sadness and her parents are there with her, allowing her to feel. They are supporting her feelings and are listening to her.

As parents, we want our children to be happy. We want to protect them from pain. Unfortunately, that isn’t always possible. Once we understand that our children must go through pain and sadness, our job is to be there for them in those times.

We must allow those feelings to be experienced and we will likely experience the same feelings with them. Sometimes children (and adults too!) can’t put words to what they feel, but luckily words aren’t always necessary. As parents, we need to realize that at times silence is better. Don’t try to solve the pain. Don’t try to “make it better.”

As hard as it may be, let it happen.

As kids experience their feelings, they will begin to heal. Ask your child what they’re feeling and let them find their own way to tell you. They may not want to talk, so just be there. Hug them. Sit quietly with them and make sure they know you are willing to be by their side no matter what they are feeling. When they do talk about it, validate them. Tell them that it is okay to be sad, or angry, or confused. They need to know that whatever they are feeling is okay; it isn't wrong.

Here are a few examples of validating language that you can use:

“That sounds like it is really hard for you.”

“I can see that ___________ made you feel __________.” (Use their words for these blanks)

“I’m guessing you might have felt ______________ when _______________happened.” (When they aren’t providing you with answers of their own.)

Try to avoid these phrases/comments which invalidate someone:

“It’s not that big of a deal.”

“Don’t worry about it, you’re going to be fine!”

“You’ve got to be a big boy/girl, we’re not going to cry.”

Previous 'Inside Out' topics:

What 'Inside Out' teaches about fear

About the author

Shea Ingram is a music therapist at Cook Children's. At Cook Children's, music provides a creative intervention for children and young adults individually or in a small group format. It allows our young patients an outlet for the physical and emotional challenges they face in their lives.Music as an outlet and/or therapy aids communication and can be helpful to those who find it difficult to express themselves in words. Research supports music effectiveness in many areas such as: overall physical rehabilitation and facilitating movement, increasing people's motivation to become engaged in their treatment, providing emotional support for patients and their families, and providing an outlet for expression of feelings.

We can’t blame her, right? What parent doesn’t want joy to be the emotion that fills a child’s day, week, year and lifetime?

It’s the positive emotions, like joy, that we desire to be constantly filled with and to override the control center in our minds when any sign of the more ‘negative’ emotions, such as fear, sadness and anger start to rise.

Now, wanting to be a seemingly joyful, happy or content person is not at all a bad thing. Rather it’s that optimistic, glass half-full type of outlook on life that tends to attract others.

But what place do other negative emotions – like fear – have? Are they to simply be forever locked away in the subconscious realm of our minds? Could any expression of fear or anger or sadness, negative emotions that we so often seek to avoid, have a positive effect?

Fear is one of the emotions we hope our kids avoid. And when they inevitably do happen, we hope they overcome these emotions.

I believe that expressing our emotions, both positive and negative, can, in many cases create a more positive experience than suppressing or avoiding these more negative emotions such as fear.

Children who fear heights might not be the first in line to ride the rollercoaster. If someone fears snakes, they might bypass the reptile area at the zoo. When we fear something, we often try to avoid it. Sometimes, however, we inevitably are forced to come face-to-face with our fears. Or, we are placed in situations where we experience fears we didn’t know we had.

This happens all the time when children have to go to the hospital. For many children, going to see the doctor or coming to the hospital is a new experience. They often fear the unknown or their imaginations create a terrifying image of what is about to happen next. And when children have many hospital experiences and become ‘frequent flyers,’ they develop fears based on what they’ve experienced in the past.

Fears in this type of setting are almost inevitable. Our natural tendency as parents, adults or caregivers is to protect children from these fears by leaving out the scary details or distracting them so they won’t think about them.

However, many times these fears are still present and it is only a matter of time before they surface. So, rather than avoiding these fears to protect children from the hard or scary things, why not help children to process these fears and work through them?

Rather than telling children who might be scared that “there is nothing to be afraid of,” why not talk to children about what they are worried about? We can begin to work through these fears with them, developing strategies for facing fears that they might inevitably encounter, and empower them to overcome.

They may learn that just like in ‘Inside Out,’ fear is not so bad and sometimes needed.

About the author

Cristin D. Herbort is a Child Life Specialist at Cook Children's. Our Child Life specialists work with kids and families to make their visit to the medical center easier and more comfortable. Child Life staff members recognize that hospitalized children still need opportunities to just be kids. They help children and families cope with a hospital experience by providing emotional and developmental support, giving honest information geared to the child's level of understanding and providing fun activities. 

The first way is to prepare your child for the doctor’s visit. Studies show that children are less anxious for a doctor’s visit or medical procedure when they are informed beforehand. Honesty is the best policy when preparing a child for a blood draw, but it is important to use child friendly words.

Bringing a favorite toy or stuffed animal to the clinic can help. Familiar items help children feel safe and less anxious.

At the clinic it is important for you to stay cool, calm and collected. Children feed off of their parent’s emotions and an anxious parent could very easily make for an anxious child.

At Cook Children’s tips for preparation and comfort can be provided by the Child Life specialist on staff. Child Life specialists use their knowledge and background of child development to help practice successful distraction techniques and coping strategies. Comfort tips can be provided by the Child Life specialist to help with the blood draw such as comfort positioning, distraction and child friendly explanations.

Praise goes a long way. It is so important to support your child and provide encouragement during the blood draw and afterwards. Choose specific skills to praise such as, “You did a great job of holding still” or “You took good deep breaths.” Try to avoid any negative comments such as “Don’t cry” or “Be a good girl/boy” because it’s perfectly normal for a child to be nervous or anxious about a blood draw. Instead, validate your child’s feelings by saying, “That was hard, but you did a great job by holding your arm still.”

For more information on how you can help your child cope with blood draws, hospitals or clinic visits, you can read these resources:

http://childlife.org/files/PowerParentsTipSheet.pdf

http://childlife.org/files/ComfortMeasuresandTips.pdf

About the author

Laura Sonefeld is a Child Life specialist at Cook Children's. Our Child Life staff members recognize that hospitalized children still need opportunities to just be kids. They help children and families cope with a hospital experience by providing emotional and developmental support, giving honest information geared to the child's level of understanding and providing fun activities. The Child Life team works with medical and support staff to create a warm, child-friendly environment.

When I came to work here, I was in an as-needed position that required me to work anywhere and everywhere in patient care. One morning I was working in outpatient surgery when, to my surprise, an anesthesiologist asked me to help walk his patient back to the operating room due to high anxiety. What was even more surprising was when a second anesthesiologist made the same request just a few minutes later. I was in the middle of trying to make a decision about whose patient to help when the second doctor let me know he would wait for me to bring his patient back. Anyone in child life can tell you how huge that is; the recognition that the services provided by child life are so vital that they are worth waiting for, even in the fast-paced world of surgery.

Though to an outsider our work may look like many of the things that people innocuously comment (you have the best job ever; all you do is play all day; I wish I got paid to blow bubbles and play on an iPad), it is important to clarify that in all things a child life specialist does, there is a therapeutic value. I remember when I was a student in child life and my preceptor was referred to as a “glorified babysitter.” Though it may have stung her to hear that, it sparked an important conversation about what child life specialists aren’t, and more importantly, what they are.

Child life specialists are educated in child and human development; they have at least a bachelor’s degree, and in many cases, a master’s. They complete a semester of practicum, a 480-hour highly selective clinical internship, and must demonstrate theoretical and practical knowledge to pass a certification exam. Once certified, they are required to maintain certification by participating in professional development and continuing education. The knowledge gained on the way to becoming a certified child life specialist is used to build therapeutic relationships that help patients and their families master the health care experience.

With a child life specialist on the health care team, patients gain an understanding of their diagnosis and treatment in a way that meets their needs. The patient’s specialist may use medical dolls, messy activities and other forms of play to help the patient and any siblings clearly understand what they are going through. It is the work of child life specialists to assess the patient’s development, needs, and psychosocial goals. They then help to equip the whole family with knowledge and coping skills; they normalize a very abnormal environment, and perhaps most importantly, they make sure that kids have every possible opportunity to still be kids while they are here.

And yes, child life specialists do have the best job ever.

About the author 

Kizzy Marco is the Child Life Zone Program Coordinator at Cook Children's and the primary handler of Ralph Lauren, a therapy dog at Cook Children's. Cook Children's Child Life specialists work with kids and families to make their visit to the medical center easier and more comfortable.

Her day begins bright and early around 7 a.m. with cuddles from Mommy and then it’s time for her bottle feeding at 8. Other activities for the morning include a visit from the respiratory therapist (RT) for her breathing treatment and morning “massage.” Her “massage” is part of her chest physiotherapy where they use an oxygen mask to firmly pat her on her chest and back to help expand her lungs and break up any mucus she may have. This is one of Avery’s favorite parts of the day. We love to watch her as she lies in her bed on her stomach and dozes off to sleep as the RTs work their magic.

She may also get a visit from occupational or physical therapy for a morning workout where they work on fun things like learning to put her feet in her mouth and building her core strength to help her learn to roll over and sit up. They also have taught us about infant massage and given us stretches we can do with Avery to help her with her flexibility.

After her morning workout, she has likely worked up an appetite so it’s time to eat again. This time, a speech pathologist may come to give Avery her bottle. Learning to eat after 6 months is tough, so a speech pathologist is working with us on what bottles and nipples to use, positions to try when feeding her and different combinations of breast milk and formula to use. All of these things play an important factor in helping Avery to swallow efficiently and effectively and not having her food go down the “wrong way” which can cause aspiration and an infection in her lungs. We are about to introduce her to solid foods which will be another fun adventure!

Once she’s done eating, it’s usually time for a visit from Daddy, where she likes to squeeze in her afternoon nap on his lap. All the activity from the morning often wears her out for a few hours. She is, after all, a baby who needs her rest so she can grow healthy, new lung tissue.

In the afternoon, she may get a visit from the Child Life specialist for some “smile therapy” where we work on coaxing a smile out of her or arts and crafts activities with her footprints. The music therapist may come by to sing and play music while Avery works on her babbling.

Interspersed throughout this busy day of therapy visits, eating, naps and playtime, she also receives countless visits from the NICU staff and our family, all stopping by to see her outfit of the day and get an update on how she’s doing.

The late afternoon and early evening is reserved for family time where she plays on her play mat, works on tummy time or hangs out in her Bumbo® or exersaucer. By the time Shawn and I are ready to go home and sleep, Avery is usually asleep, worn out from all of the day’s activities. After all, she has to get a good night sleep so she can wake up and do it all over again the next day.

Related links:

• Avery's story - part 1
• Avery's story - part 2
• Avery's story - part 3
• Avery's story - part 4
• Avery's story - part 5
• Avery's journey - part 6