'Child Life is a calling, not a job'

In honor of Child Life Month, we are highlighting three of our child life specialists - Ashley Brady, Jill Bringhurst and Ruthie Davis. Read below to find out why they pursued child life as a career and more about their roles.

What is Child Life and how did you discover the profession?

Ashley Brady: Child life specialists work in many areas of the hospital from the Emergency Department to the ICU. I discovered the child life profession in my second year of college when I was looking for a career that combined the medical field and working with children. I graduated from college and did my child life internship, which is a 15-week unpaid clinical experience. During my internship, I fell in love with the field of child life and truly feel that being a child life specialist is a calling rather than a job.

Jill Bringhurst: A child life specialist will prepare a patient for surgery or an invasive procedure, provide support during imaging or medical testing and debrief those involved in a traumatic event. The role of a child life specialist in a pediatric setting is a key component to the psychosocial support families receive at Children's.

Ruthie Davis: Our job is broad, ranging from community outreach, school re-integration, new diagnosis teaching on an age appropriate level, medical play and normative play, playrooms to encourage normal growth and development, sibling support and education, procedural preparation and support, bereavement care and legacy building activities for both patients and siblings, and developmental assessments.

Why is Child Life important in a hospital setting?

JB: Child Life is an entire discipline focused solely on the psychosocial needs of pediatric patients. At Children's, we have many people caring for the medical needs of a patient, but the child life specialist can address the developmental, emotional and social needs of the patient.

AB: We understand that children are not little adults. Children of every age have specific needs. Hospitalized children need to be involved in play which promotes normalization of a sometimes scary environment as well as way to express feelings. Teens have their own space in the hospital where they can hang out with kids their age.

How does Child Life make a difference in the child's care?

AB: We use our expertise in child development to tailor our interventions to help the children cope. Studies show when children know what to expect in the medical setting, they do better. I have had many experiences in the surgery unit where I walk into a room and the child is hiding in the bed, scared and crying. When I begin to blow bubbles, the child slowly comes out from under the covers. The child then makes eye contact with mom to make sure I am a safe person and engages in the bubble play which helps me build rapport with him. Once the child is comfortable with me, I am able to talk with him about things that might be scary or hard, such as the upcoming surgery. We also work with the entire family. When siblings come to visit their brother or sister in the ICU, we educate the siblings about what to expect. When a child is newly diagnosed with a chronic illness, we explain the complexities of the diagnosis using kid friendly language and teaching dolls.

RD: We give the child tools they can use in the future, control when most of their control has been lost or taken away, and predictability with a routine or structure. We also provide toys and activities in the playroom which can help make a scary or unfamiliar place fun, give the child age appropriate information and knowledge about their disease or condition, and take away their fear of coming back to the hospital.

Why did you decide to pursue child life as a career?

JB: I was fascinated by the hospital and medical field and also drawn to working with children and making things better for them.

RD: I didn't want to be a doctor or nurse but still wanted to work with children in the hospital setting, making their experience better.

AB: It is a job that challenges me in many ways but is so rewarding. I feel very blessed to have a job that I love, and that every day I have an opportunity to directly impact patients and their families.

The doctors Corrigan

As a third-year pediatric resident at Children’s Medical Center Dallas, Dr. Nicole Corrigan can still be expected to have lots of medical questions. And while she can ask her colleagues for the answers, she can also call her mom.

That’s because Nicole’s mother is Dr. Suzanne Corrigan, who was a pediatric resident at Children’s 30 years ago and is a clinical associate professor of Pediatrics at the University of Texas Southwestern Medical Center.

Nicole and her sister Danielle, who’s a second-year pediatric resident at Children’s Mercy in Kansas City, “call about day-to-day life that comes up in the practice of medicine that no one prepares you for,” Suzanne said.

Together, Nicole and Suzanne Corrigan are believed to be the only mother-daughter physician duo that has undergone pediatric residency training at Children’s.

Times have changed
Times have changed a lot in 30 years of pediatric residency training. For one, the hours of training are significantly shorter now and mandated by law. In Suzanne’s day, pediatric residents worked every third night or every other night, sometimes 100-120 hours per week. Today, Nicole legally can work no more than 80 hours a week.

Nicole also has more support staff to assist during shifts. During Suzanne’s days as a resident, they had to do their own blood draws and microscope work.

Additionally, there also weren’t nearly as many women in medicine 30 years ago. “There were 10 woman out of 200 in my class at UTSW and only four women in residency my year,” Suzanne said.

“It’s also very different for them than it was for us in terms of sheer volume of patients but also the severity of illness that Children’s physicians see,” Suzanne said.

Suzanne knew all this when Nicole was accepted as a pediatric resident at Children’s but also knew that her daughter would receive excellent training. “I told Nicole she was going to work really hard but would get the best training anywhere.”

Suzanne added: “I can’t say enough good things about the preparation we received and that they’re getting now — giving them the skills they need to critically think, analyze and put solutions together.”

Advice on medicine as a career
Suzanne’s advice for residents and medical students is simple: “If you’re going into medicine to make money, that the wrong way to go. You need to want to take care of children who are really ill. It’s a full-time job and you need to give completely of yourself when you are on the job. You also need a partner or someone who can be there for support,” she said. “You need to be able to put your cares aside. When you’re here, the patients, they’re your priority. You need to be able to compartmentalize.”

“The other big part of medicine is working with the parents and fighting for what’s right for the kids in the community. If you’re not working to do that, then you shouldn’t be in medicine.”

Nicole’s path
Nicole will be continuing her career at Children’s. She completes her residency in June and has accepted the position of third attending physician as a general pediatrician in Children’s Emergency Department.

Nicole said she “feels lucky to have such great training and exposure to superb role model pediatricians, especially her mother and feels blessed to have found her calling in pediatrics.” She added: “In what other professions are families so grateful for your care that you create a special bond with them, I feel lucky to be their doctor.”

Talking about tragedies

In light of the recent shooting tragedy in Tucson and the one-year anniversary of the Haiti earthquake, parents should be prepared to talk to their children about these events.

In fact, First Lady Michelle Obama has penned an eloquent letter to parents that offers some insights into talking with your children about tragedies such as Tucson.

Pete Stavinoha, Ph.D., a child neuropsychologist at Children’s Medical Center in Dallas, says these events provide a starting point for discussions with your children. But, these are also subjects that could raise anxieties in children who see the images on TV or hear about them on the radio or the Internet, so it is important to monitor their time listening to, watching and interacting with the news.

Tips for talking to children

Stavinoha suggests parents:

• Listen to children and encourage them to ask questions at their own level of understanding. It’s OK to say you don’t know all the answers. It’s also OK not to overwhelm them with information that they may not understand.


• Pay attention to younger children’s play and drawings. They may give you a clue about what they are feeling or what they know about these tragedies. This may provide the opportunity to talk about it and perhaps clarify their questions.


• Don’t downplay the seriousness of the situation. Especially for older children, it is important to acknowledge the significance of the event.


• Model healthy parental coping during stressful times. This does not mean hiding your feelings, but rather staying aware of your reactions and showing your children how you deal with a tragedy in a healthy manner.


• Participate in activities that help put you and your children back in control of the otherwise disturbing situation such as attending prayer services.


• Seek support from family, friends, church or other social and emotional supports.

If your child is old enough, watch news reports or read the news together to encourage conversation about the topic. PBS has age-appropriate guidelines about how much news children should be watching and what they will understand about the news that are helpful.

Demi Lovato and the long-term effects of bullying

Demi Lovato, the Disney starlet and singer, is in treatment for emotional and physical issues. By now you’ve probably heard that from your child or seen it on the news. Her representative told the media that the issues Lovato’s being seen for in treatment are some that “she has dealt with for some time. Demi has decided to take responsibility for her actions and seek help.”

Reportedly, those issues stem from bullying and may include past instances of an eating disorder and cutting, a form of self-injury that some people do as a way to alleviate feelings of pain or emotional distress.

Bullying can happen to anyoneLovato has spoken out against bullying in the past and acknowledged that it has happened to her. She left middle school because of verbal harassment and was home schooled after that. She recently made a public service announcement denouncing bullying for National Bullying Prevention Month.

Crista Wetherington, a psychologist at Children’s Medical Center in Dallas, says if bullying has been an issue for Lovato, the 18-year-old is not alone.

“While Lovato is not your typical teen, her example points to the fact that bullying can happen to anybody,” Wetherington said. “Additionally, it shows that bullying can have a significant and long-term impact on children and teenagers who are bullied. Bullying can even contribute to eating disorders and self-injury.”

Parents, teachers and other adults involved in the lives of children must commit to creating safe environments where bullying is not tolerated. Parents and teachers should also be aware of changes in the child’s behavior that may suggest he or she is being bullied, Wetherington said, such as refusal to attend school, missing possessions or money, unexplained bruises/cuts/injuries, reluctance to talk about school, anxiety, and seeming withdrawn.

Tips for parents
Wetherington has these suggestions:

• Keep an open dialogue with your child about their feelings.
• Ask them about bullying at school. You may have to probe for answers. It may help to ask them first about how other children at school are treated before they are comfortable talking about their own experiences.
• Tell them they are not alone, that they have a right to be safe, and that it is the responsibility of you as parents and their teachers to ensure that the bullying stops.
• Work with the school to identify the bully and ensure measures are put into place to stop the bullying. If your child reports bullying of another child, discuss that with the school as well. Bullies may be targeting several kids.
• Parents and children should be aware of how they treat those around them. Words and actions can be unintentionally harmful. It’s all about character development and how you treat your friends and other people.
• Work to keep your child in school if they’ve been bullied. It’s up to the school to change the environment to one that is safe for all children.

Wetherington said: “We hope that the publicity around Lovato’s decision to enter treatment helps children and teens who are being bullied or experiencing mental health issues realize that it is important to communicate with adults they trust to get the help they need. We hope she gets the help she needs in treatment for whatever health issues she’s having.”

A search for support

Life is frustrating. Work is hard. Family is harder. And cars always have something wrong with them. But I can at least take comfort in being able to share my gripes with others who endure the same things.

It's not that simple for Jennifer Cagle. Her 6-year-old son, Tanner, suffers from a disease that affects only 15 in every 100,000 people. You don't need to be a mathematician to know that means very few people can relate with what she goes through as Tanner's mother.

"When I tell people that my son has nephrotic syndrome, they don't even know what it is," Jennifer said.

Nephrotic syndrome is a kidney disease that causes the body to excrete too much protein in urine. It results in kidney damage and excessive fluid retention.

Tanner's case is so severe that he will eventually require a kidney transplant to survive. But, because of the way his disease works, his body will most likely attack the new transplant, too.

Focusing on the present with the President
Jennifer doesn't know Tanner's longterm prognosis, but she doesn't focus on the uncertainty.

"I can either mope and be depressed about it and be like, 'Oh, poor me. Poor him.' Or I can enjoy every moment that I have with him, especially when he is in remission because those moments can be taken away so fast. I don't want to have regrets. And I would regret burying my head in a pillow and missing out on his life."

Tanner is currently in remission and has been for the last several months. Although Jennifer is grateful, she knows it won't last forever.

Her main focus now is raising awareness of the disease. She helped organize the NephCure Foundation's first-ever walk in Dallas this past April, which ended up raising around $14,000. She has also gotten the word out by exchanging letters with President Obama about her son's illness.

Looking for a support group
Jennifer hopes that generating attention about nephrotic syndrome will encourage more research of the disease, which hopefully one day will lead to a cure. But her efforts aren't solely geared to that end.

She also just wants to find people to talk with about the disease.

"I want to meet other people in Texas who deal with this disease," she said. "Maybe we could develop some sort of support group and help each other."

Editor's note: If you've personally encountered nephrotic syndrome or know anyone who deals with the disease, will you please post a comment to show Jennifer that there are other people around her going through the same thing?

A first-hand account on sports supplements

Although the image I see in the mirror every day makes it harder and harder to believe, I once was a high school running back. I may not have been a very good running back, but I was a running back nonetheless.

As is the case with most running backs not named Bettis, Dayne or Lane, keeping fit was paramount for me. I'd work out in some form or fashion every day (which I later discovered to be counterproductive) and was an absolute fanatic about what I ate. Ask my poor mother, who had to endure my high-maintenance diet night after night.

"Hey, Craigo, what do you want for dinner tonight? Lasagna? Pork chops?" she'd ask me.

"Anything without fat in it, Ma. I don't want any of the Devil's food (my affectionate term for high-fat items)."

Most nights we'd eat grilled chicken salad. But I had extreme periods where I only ate fat-free deli meats and cheese slices. Obviously, like the daily workouts, this was actually worse for my health, but I didn't see it like that.

I was going to be the best high school running back I could possibly be. Keeping fat and calories out of my body, I thought, was essential to that goal.

Along came supplements
My obsession with fitness eventually led to me looking for some external boosts as well. To my credit, I never tried steroids because I knew about their dangerous consequences. BUT I did try everything I could buy over the counter without knowing a thing about their consequences: protein shakes, amino acid pills, creatine, androstene, fat burners and all sorts of different combinations of them together. I even took pseudophedrine every morning because I heard it increased your metabolism.

By grace alone, I survived all of my supplement experiments without incurring any long-term health damage - at least, that I'm aware of. But the more I learn about supplements as a medical writer, the more amazed I am that I didn't turn out worse for taking them.

Androstene, which Mark McGwire made famous during his "magical" 1998 home run barrage, was taken off the market in 2004 in the U.S. because it was found to potentially have some of the same side effects as anabolic steroids: testicular cancer, infertility, stroke and an increased risk of heart disease. Several of my teammates and I took it because we wanted to get stronger.

The fat burners, which I took daily, have even led to deaths. As for the creatine and protein shakes, they aren't nearly as harmful, although both in excess can lead to kidney issues.

Older and wiser (or, at least, better informed)
I don't obsess about exercise and diet today nearly as much as I did in high school. In fact, I have thought about them so little the past few years that I'm having to re-discipline myself to get in healthy BMI territory. It's hard. My wife can attest, because she's now enduring my same narrow diet demands that my mother dealt with when I was a teenager.

I have entertained the idea of using some of the same supplements I used to take, but those ideas don't last long. I always come back to one main thought: "It isn't worth the risk."

Dr. Shane Miller, a pediatric sports medicine specialist at Children's, agrees, especially in the case of young athletes. Supplements don't require FDA approval, and no studies have been performed to see their effects on childrens' bodies.

Moreover, he adds, they really haven't been proven to increase athletic performance at all. I can personally verify this since all of my supplement ingestion resulted in a whopping ZERO scholarship offers.

"If young athletes are eating healthy and working out, they don't need supplements," Dr. Miller says. "The body makes most of the things in supplements on its own, and we also get them from foods in our diet."

So, if your young athlete insists that he has to have supplements to be a good football player, tell him that he can get all the strength-building nutrients he needs from a balanced diet. Better yet, if he's anything like I was, tell him to enjoy an occasional hamburger.

Summer cleaning should include trampolines

Yep, summer is sneaking up on us. This month's students will be next month's worry-free-ers and sleep-in-ers. And I am flat jealous.

The truth is, though, I'm closer to being one of their parents than to being one of them. Swimming pools. Snow cones. Syndicated mid-morning TV. Shorts. Sandals. They're all yesterday's relics for me.

So are trampolines. But, unlike the other things, I might be better off without them.

About 100,000 children are injured on trampolines every year according to the American Academy of Pediatrics. That number doesn't just include aspiring gymnasts and cheerleaders trying to perform 30-foot cartwheels in the gym, either. Most of the injuries involve kids horsing around in their own backyard.

Both the American Academy of Pediatrics and the American Academy of Orthopedic Surgeons created trampoline safety guidelines because of this. They recommend, among other things, the need for supervision and protective padding and that only one person at a time should be on the trampoline.

The guidelines are cautious and sensible, but even following them might not keep your children from getting injured.

Study reveals trampolines aren't safe, guidelines or not

Dr. Christine Ho, a pediatric orthopedic surgeon at Children's, recently completed a study to determine if following the guidelines makes a difference. She compiled data from 300 patients who came to Children's because of trampoline injuries during the last year.

"We unfortunately didn't find that there was any difference in the severity or frequency of injuries between the children that followed the trampoline safety measures and the ones who didn't," she said.

Children still broke bones on trampolines with padding, and they still fell off the sides when they were being supervised.

Dr. Ho's conclusion: "There is no such thing as a safe trampoline."

So, it's worth considering removing the trampoline from your backyard. It will give your children one less thing to get hurt on, and it will give you one less cause for worry.

Since most adults don't get summer breaks, you deserve at least one thing to be carefree about.

Children's leading the battle against child abuse

While the conclusion of April may mean the end of temporate weather in North Texas, the REACH staff at Children's is making sure that the end of the "National Child Abuse Prevention Month" does not mean the end of child abuse prevention.

Through clinical care, education, research and public advocacy, the REACH team led by Dr. Matthew Cox is setting the standard for child abuse prevention in Dallas.

"We're just trying to get through each day to make a bigger impact in the lives of children," Dr. Cox said.

Read more about the REACH team's efforts in a story on childrens.com.

Why pediatric-specific care matters

I saw a miracle on Monday. No, no one walked on water. Flying pigs weren’t around either. What I saw was just as unbelievable though.

Kaiden Beville, all 21 months of him, came back to Children’s to get a cast placed on his broken arm. The young boy, who sustained his injury jumping on his parent’s bed, plays hard and cries hard. I can attest to the latter, because I saw and heard him wailing when he first came to the emergency department last week. The Children’s staff handled and x-rayed his wounded wing (although done in the most kind and gentle fashion) and eventually identified that he fractured his humerus by landing on his locked right arm when he tumbled from his parent’s bed.

If that happened to me, I’d probably cry, too.

I expected his reaction during the follow-up visit to be about the same. After all, getting a cast is never fun – especially for a toddler. I fully anticipated that the staff putting on the cast would have to go to unusual measures to quiet the impending fit, maybe even sedation. But then something funny happened.

Benjamin Vance, the Orthopedic tech tasked with putting the cast on Kaiden, met the little guy with a big smile and soft words. Then Vance invited Child Life specialist Cecilia Nelson into the casting room when it came time for him to begin measuring Kaiden’s broken arm. Cecilia immediately began blowing bubbles. Kaiden gurgled “bubba” at each one and reached out for them with his free arm.

The moment he began to pay attention to Vance touching his arm, Cecilia quickly whipped out a new toy – a Sesame Street sound machine. She would press a button, and Kaiden would imitate the sound it produced. Pretty soon, Kaiden found an Elmo laugh button and began pressing it and imitating the sound all on his own. The next thing I knew, Kaiden had a brand new red cast on his right arm. The young boy, who I expected to be in hysterics or drugged at this point, waived “bye-bye” and blew kisses to us on his way out.

Now, I know that may not strike the same supernatural chord as say… the Cowboys winning the Super Bowl this season, but I’m confident that parents of toddler whirlwinds like Kaiden find it even more miraculous.