Because Children Need More Than Medicine to Thrive
Children of Bellevue: Get Connected
Featuring Information For Our Friends Who Care About Children in the Hospital
Dear Friends,                                                                             
Gloria Mattera, Director of Child Life and Development
Imagine you are a small child standing in the path of an oncoming car. Your mother, her instincts in high gear, throws you out of the way and, in the process, loses her leg. How do you cope with the fear of seeing your mother hurt, and the guilt of seeing her in the hospital?

"Our doctors and nurses have the best interests of our patients and families at heart and provide compassionate care as they execute their medical tasks," explained Gloria Mattera, Director of Child Life and Development at Bellevue Hospital Center. "When they move on to care for the next patient, Child Life Specialists remain for families like these, helping them process their feelings about their injuries which, in turn, helps them heal. This child had a great deal of guilt about what had happened to his mother. We were able to listen to him and his family, helping them work through complex emotions and come through knowing that no one was at fault."
  
Child Life Specialists are trained professionals with expertise in helping children and their families overcome life's most challenging events. They have earned a minimum bachelor's or master's degree, with an educational emphasis on human growth and development, education, psychology, or a related field of study. Child Life professionals understand the unique perspectives of children of all ages, who may experience emotions such as fear, shame, confusion and loneliness. These can inhibit their natural development, and have lasting negative effects on their well-being.
  
At Bellevue, our Child Life Specialists promote effective coping through play, preparation, education, and self-expression activities. Our programs include art therapy, horticultural therapy, clown therapy, music therapy and pet therapy! In addition to caring for hospitalized children, our programs cast a wide net in the outpatient setting with special programs such as Pre-Hospitalization, Adolescent Parents Group, Early Learning Group, and many more!
  
And so we dedicate this issue of our quarterly newsletter entirely to our devoted team of Child Life Specialists. We hope you enjoy reading this small sample of the work they do. Gloria feels fortunate to lead a team of committed, experienced and skilled professionals who give their all for the families and children of Bellevue, and we are all grateful for the generous support of our donors who make our programs thrive.
 
Sincerely,   

 
Jean Folsom
Director of Development
 
Inside the Diabetic Clinic
by Cheryl Reich, Board Member

Natalie Schrape, Child Life Specialist
The Diabetic Clinic provides special support to children living with the chronic illness of diabetes. If you are a child or teen, the constant monitoring of your carbohydrate intake, the constant reminder that you are different from your siblings, your friends, your classmates, the knowledge that while everyone else can have ice cream, pizza, pasta or French fries -you cannot - takes an emotional toll. Children in the clinic might be able to express their frustration through art or play - which enables Natalie Schrape, a NYS Licensed Therapist and Board Certified M.S. in Art Therapy, to engage the children further.  
 
Art therapy, play therapy, medical play - all enable Natalie and therapists like her to engage children in discussing their emotions and help them recognize and process their feelings. They can view their circumstances in a positive, action-oriented way. Natalie typically uses art therapy with adolescents and with younger children, and she often uses play therapy. "It seems like this doll might be angry; why do you think she is angry?"
 
One of Natalie's patients is Juan, a sweet, bright boy that she has known and worked with for two years. Juan's mother has significant cognitive delays and great difficulty with math and with memory. A home health care worker helps her with Juan. It is an additional challenge for Juan that his mother needs assistance.  
 
Natalie mentioned that when Juan came into the clinic last week, he was markedly sad.   Natalie asked him what was making him feel so sad and he told her that his grandmother had died. He added that he hadn't known her, but the fact that she'd passed just made him feel very alone in the world.
 
Natalie told Juan that we all have the families we are born with, but that we also meet and get close to other people who are like a family that we choose. They love us and support us too, and we are not all alone when we have those people who do care about us. Juan listened to her very solemnly, his eyes very big as he took her words in. Then he said, "Ever since I've known you, I haven't felt so alone."
 
David Levine, Horticultural Therapist
What is Horticultural Therapy and How Does It Work?
by Cheryl Reich, Board Member
Horticultural therapy engages patients in gardening activities, facilitated by a trained therapist. The interaction of people and plants has a calming and positive effect on patients. Children focus on the task at hand such as planting a seedling and this offers them a release from dwelling on their illness or difficulty.
 
According to David Levine, a Horticultural Therapist who has been working with Children of Bellevue for a long time, "In the highly structured and controlled environment of the hospital, children do not have a lot of choices. I like to offer them their choice of plant. When they choose a plant, they are interacting with something alive. This is extremely effective therapy for children who do not speak English as the language of plants crosses all barriers."
 
Originally working in the marketing and advertising field, David found himself drawn to horticulture and motivated to become a horticultural therapist certified by the NY Botanical Garden. He worked at Mount Sinai and gained the requisite hours for certification working primarily in pediatrics at different hospitals. On Wednesdays, David can be seen working with a small group of children in the play room at Bellevue and then wheeling plants, supplies, and tools around to those children who are unable to leave their rooms. David makes sure the children have choices on what plant to grow, what kind of pot they are potted in, and how they can decorate the planter. All together these choices allow the children to have total ownership of something at a time when they may be feeling a loss of control over so much else.
 
He brought a particular ray of sunshine to an eleven year old boy named Brandon in April of this year when he offered an array of vegetable seedlings. Roxanne, Brandon's mom, wanted to join in the activity - she mentioned they had worked in a rooftop garden co-op in the past. She and Brandon chose carrots and worked with David to plant the seedlings and understand his instructions for the plant's ongoing care.
 
Last month, David spotted Brandon and Roxanne getting off the elevator. Brandon smiled broadly and said the plants had grown well on his fire escape and yielded two bunches of carrots. Roxanne said that after she and Brandon harvested the carrots, she made a soup which was shared by their family of five: Douglas, his mom, his sister Jasmine, his brother Chris, and their father Leo. Each of them got a cup of carrot soup! Now when they think back on the time Brandon was in the hospital - they have a warm and positive memory of that difficult time.
Pre-Hospitalization Program
How do you Prepare a Child for an Operation?
By Shannon Bell, Board Member

Maria Florencia Catanzaro,

Child Life Specialist

 
Child Life Specialists provide therapeutic services to children prior to surgery to help reduce the anxiety a child may feel about his or her procedure. They use therapeutic techniques including dolls, toys, medical materials, books, and related videos in the sessions, and parents are given materials so they can continue preparation at home.
 
At Bellevue, we work with families with many different backgrounds and therefore need to be sensitive to a range of needs.  We ensure the program takes into consideration the family's cultural and personal beliefs. Children of Bellevue has specialists that speak Spanish and Bangla and uses translators for other languages. 
 
Florencia Catanzaro started working with the Child Life Department in 1993 as a volunteer and was hired in 1994 to work in a satellite parenting program located in a homeless shelter. She has been the "Pre-Hosp" program coordinator in the outpatient clinic at Bellevue since 2002.
 
"I was looking for an opportunity to make an impact on a family's life. Children and parents often come to the program in a state of confusion and fear because this is their first surgery and they don't know what to expect. During the pre-hospitalization session, we talk about their anxiety, correct misconceptions, and address fears. Children and families generally leave the session with a sense of control - a sense of mastery." 
 
Florencia's average day is busy! "We serve about twelve families per session, which occurs twice a week. We are available on other days as needed for last minute surgeries so that means we see many patients each week. A unique aspect of our program is that preparation for surgery occurs during the medical visit. This means that a separate appointment to prepare for surgery is not necessary - for families this is important because it reduces visits to the hospital and therefore time missed from school or work."
 
For Florencia, each family and case is special, but it's especially gratifying when she sees the impact of her work. "I recently saw a child who was here for a second surgery. When a family comes to us a second time, it is a great opportunity for us to find out if they felt prepared for the original surgery. The family told us that on the day of the surgery everything went exactly as they expected. They felt so confident about their experience that they wanted to share it with another family in the session so the patient, an 8 year old boy who was about to have orthopedic surgery, helped me prepare another child with a similar surgery by sharing his experience. That made my day!"
Early Learning Group
Because Early Intervention Lasts a Life Time

Marisa Paolillo, Children's Counselor

In the outpatient clinic at Bellevue Hospital Center, Child Life  Specialists staff a playroom used by children while they are waiting for doctor appointments. By engaging the children with games, blocks, pretend play, and art, Specialists may observe potential development issues or concerns to be addressed with a child's parents and pediatrician.
  
Children two-months to four-years old who exhibit developmental delays may be referred to the Early Learning Group. This weekly playgroup for parents and their pre-school-aged children provides a school-like routine of play, art, music, and snack time that participating children eventually internalize, helping them prepare to enter the school system.
  
Marisa Paolillo is a Children's Counselor who joined Children of Bellevue's Child Life team about a year ago after graduating from the School of Visual Arts with a Master's degree in Art Therapy. "I wanted to work in an environment that supports children's growth and self-expression, one that emphasizes listening to their voices in determining what they need".
  
Up to ten families participate in one of two weekly sessions. Each session lasts for an hour and a half, and a typical ELG session begins with "free-play", using puzzles, building toys, animals, cars, the doll house and the play kitchen. This is followed by an art session, music time, and snack time. This simple yet structured routine encourages the children to share their space, work together in a shared environment, learn from one another, and build social skills so important to success in school.
  
Most children are referred to the group because of speech delays, so language skills are developed through questions Marisa asks when engaging the children via play. During the art session, for example, Marisa lays large sheets of white paper on the floor and gives the children their choice of paint colors and brushes. One child, Joe, was initially overwhelmed when asked what color he would like. He didn't possess the words he needed and hadn't had the experience of being asked for his input. "Now, I don't even need to ask!" said Marisa. "He loves art time and is the first to tell me when he wants red, or blue or green paint."
  
One of the most rewarding aspects of the ELG is the transformation seen in the parents. "With our subtle support and advice, they become more confident in their skills as parents," said Marisa. Joe's mom, Joanna, helped his language development by modeling full sentences for him. Instead of "red", she demonstrated for him, saying, 'I want the red paint.' The parents learn how to appreciate their children and be more aware of their children's needs. They are the ones really doing the work!"
Adolescent Parents Group
Mothers Supporting Mothers  
Susana Torino, Creative Art Therapist and Child Life Specialist
Being a parent is one of the hardest jobs a person can ever have.  The new stressors parenthood places on the mind and body of the mother can be overwhelming, especially to first time parents. For pregnant teens, the stress can be even greater, as they are still going through their own developmental growth.
  
The Adolescent Parents Group, held weekly in the outpatient clinic at Bellevue, helps provide support and guidance to adolescent mothers. Child Life Specialists, working with a team of pediatricians, social workers, and nursing staff, provide teen mothers with psychoeducational support and developmentally appropriate information for both their babies and for themselves.
  
Susana Torino, a Creative Arts Therapist and Child Life Specialist explains that the group is designed to provide guidance, support, and modeling of behaviors. "Parents have different objectives that the group tries to help them meet by offering a variety of developmentally appropriate play activities for children, helpful strategies for discipline and limit setting, feeding, potty training, and preventing and coping with sleeping issues. We also like to encourage parent/child bonding through unique methods like art, music, and even yoga!"
  
"All of the work we do as a group helps build support systems among each other and helps them all learn different conscious parenting choices from one another. We also help them learn to trust their own voices as parents even in the face of negative feedback from their own parents and family members." These different strategies are vital in helping the mothers stay in school so they can complete their high school educations, go on to college and other educational opportunities.
  
Marie was sixteen and pregnant with her second child. New to this country, she wasn't sure where to turn. Her sister, Julia knew of Child Life services at Bellevue and encouraged Marie to schedule her doctor's appointments at Bellevue and meet with a Child Life Specialist. At twenty weeks pregnant, Marie joined her first pre-natal group. After giving birth, she joined the Adolescent Parents Group.
  
"When her son turned two he truly came into his 'Terrible Twos.' With help from Child Life Specialists and other members of the group, Marie was able to learn to manage his tantrums and enter him into a Head Start Program to address speech delays that had started to manifest. We were able to give her the tools she needed to overcome her doubts and fears of being a bad mom."
  
Thanks to the support she received and the tools she learned in APG, Marie finished high school, enrolled in culinary school, and started working to support her family. Marie and her son have 'graduated' from the group, but remain grateful to the team and still come in routinely to visit Susana and all of the other friends who they made along their journey.
Music Therapy
Where Words Fail, Music Speaks
by Jennifer Davidson, Board Member
Angel Park, Creative Arts Therapist
Music can inspire and energize listeners of any age. Music also has the power to help heal.
 
Angel Park is a licensed Creative Arts Therapist and a Board Certified Music Therapist, who works with patients to manage their individual challenges. "Music is all around us, and the act of listening or singing to music can trigger different parts of us emotionally, physically and mentally," says Angel. She helps the children sing and write songs, and observes them as they select and explore new instruments. "We provide a wide variety of instruments that produce sound easily. There are no right or wrong notes, and this encourages our young patients to explore musically while building their self-confidence."  
 
Some of the more common goals she has for patients include decreasing their anxiety, developing healthy bonds between children and parents, and building healthy coping skills for kids who are hospitalized or scheduled for difficult procedures.
 
Following surgery, twenty-three month old Carlos was having difficulty breathing, unable to cough and loosen the congestion in his chest. The therapy for this is a technique called percussion - hitting the patient's chest to loosen mucus so the patient can get it out by coughing. To avoid injury, the technique is done with a cupped hand. The air that is trapped in the cupped hand is what hits the chest wall and shakes the mucus loose.
 
But imagine how frightening it would be to a toddler to have a nurse pounding on your chest! Angel wanted to prevent Carlos' heart rate from escalating and to help him cope throughout the procedure. She selected, "Wheels on the Bus" as a familiar song that his father often sang at home. This helped the toddler feel in control and provided familiarity in a potentially traumatic situation. The nurse was able to collaborate by using the rhythm of the song for the chest percussions. When Carlos began to cry, Angel was able to re-engage him with the song and turn his tears into smiles.
 
Angel is a New York native with a Bachelor of Science in Music Therapy, a Bachelor of Arts in Flute and Psychology, and a Master's of Science in Music Therapy. She was excited to find a career that uses music to help others.
 
"I notice patients engaging, exploring and connecting through music. Music gathers everyone together to listen and focus as much as they can, and the beauty of music therapy is that no prior experience is needed from the patient."
In This Issue

Children of Bellevue's 2015 expense budget includes more than $400,000 for Child Life and Development.
  
 
Sometimes it's the little things that make a big difference. Pacifiers, infant toys, and rattles that can be easily gripped by sick babies too weak to hold larger items, are greatly appreciated. These items cannot be re-used so they go home with the infants after discharge.
 
And cheerfully decorated Band-Aids are not standard fare on the inpatient unit, so donations of cartoon character Band-Aids put big smiles on small faces!

These items are a great idea for school group or scout troop donation drives. If you would like more information on making this type of donation, please contact the Children of Bellevue office at 212.562.4130. 
Click to Make a Donation!
Children of Bellevue, Inc.
(212) 562-4130
 462 First Avenue ME-15
New York, NY 10016