Between working two jobs to save money for my Fall Child Life Internship and taking online classes as a part of UCSB’s Child Life Certificate Program, there has not been a lot of spare time for blogging this summer. But I did want to share with you all a project that I worked on this week.
As a part of my class Children with Special Needs in the Healthcare Setting, I developed an adaptive therapeutic intervention. I was assigned a 12 y.o patient that was developmentally functioning at about the level of a 9 y.o. Due to the many medical conditions that this patient had, they were in a wheelchair, used slings to hold their arms up due to a lack of strength and also had communication issues due to a trach. Medical play is hard for this patient and they have severe anxiety before procedures. My idea for an intervention was to make an interactive schedule that the patient could put together along with guidance from the staff.
The goals of this intervention were to provide a sense of predictability and stability regarding each week’s routine. By allowing the patient to make the schedule each week, it would also give them a sense of control over their days. The materials I used were a wooden dowel, magnets, printed and laminated images of emotions, procedures and rewards, and then a piece of poster board for the schedule. Below are images of my schedule and brief descriptions of each step.
Procedures and Rewards
The first thing I did was print off procedures, rewards and emotions. The procedures were ones that the patient frequently encountered (such as x-rays, blood draws, trach changes, etc). And then I also printed possible rewards. While the patient might not be able to choose which procedures happen on which day, they would be able to make the decision whether they would like to play with the IPAD or hear a story after an unwanted medical procedure. I felt it was important to print off emotions to enhance communication between staff and the patient. Because of the trach, staff struggled to understand this patient. By allowing the patient to display an emotion each day, the staff can better support and comfort them.
I printed these images on card stock paper, cut them out into little squares and then laminated them. After laminating the squares, I glued a small magnet to the back of them. This magnet would allow the squares to attach to the board and also made it possible for the patient to lift them. Because of the patient’s need for slings in order to hold their arms up, there is not a lot of mobility. But the patient would be able to hold the dowel and drag it to the square with a magnet on it. While the patient might not be able to attach the square to the board without help, they would be the one who would select the procedure/emotions/reward and bring it to the appropriate place on the board. Staff could then help remove the dowel from the laminated square.
The words I chose for the headings were very intentional. I chose to use “have” for the medical procedures because the patient doesn’t have a lot of choice about which ones will happen and when they will occur. I used “I would like to” for the rewards to emphasize that this decision was the patient’s. They chose what they would like to do after the procedure that they had to have done.
Stay tuned for most posts about the projects that I’ve done for my summer classes. I’ll share them as my free time allows.