Wednesday, June 20, 2018

We celebrate 'a smile, a hand reaching out to say more'

By Louise Kinross

Shawna Perkins loves to play. The art therapist spends her days with babies and young children in Holland Bloorview’s therapeutic playroom. Her little patients may be here for rehab following a painful surgery, to recover from a traumatic brain injury, or because their parents need to learn how to care for their child's ventilator at home. The playroom is a happy place, full of bright toys, comfy mats and art supplies; tables for water play or play dough; and a ball pit and child-sized kitchen. Warm sun streams in through a floor-to-ceiling window. Shawna coordinates the playroom with three therapeutic recreation assistants and up to 70 volunteers a week. No matter what the day, the playroom is a welcome respite from hospital life.

BLOOM: What is the purpose of the therapeutic playroom?

Shawna Perkins:
It’s to provide fun activities in a safe, play-based environment, to help kids cope with hospitalization, and to offer parents breaks as needed. Parents may need to get a meal, take a rest or visit with a social worker, knowing that their child is safe and engaged and happy. We’re also part of the interdisciplinary team working toward a child’s rehab goals, but we do it through play.

BLOOM: How do you help kids cope with being in hospital?

Shawna Perkins:
In the hospital, children don’t have the same choices they have at home. They have to do things they don't want to do. In the playroom, we want to give kids a space they feel is their own. We encourage them to make choices here, and try to give them a sense of control and mastery in what they do.

BLOOM: How did you get into this field?

Shawna Perkins:
I did my master’s in Creative Art Therapies at Concordia University, and my background is as an art therapist. While at school I had the experience of being the inclusion coordinator for the town of Newmarket, overseeing all of the summer camps in the town. When I came back from Montreal I was looking for a place to work where I would be a member of a team, and where I could continue my education. I got my first position as the coordinator of our Ronald McDonald Playroom. I did that for two years, and I’ve been the coordinator of our therapeutic playroom for eight years.

BLOOM: What’s the greatest challenge?

Shawna Perkins:
We see families who have come through many difficult situations and who may be experiencing a sense of loss or grief. If their child has lost mobility, or the way they communicate has changed, parents may be unsure about how to engage their child in play again.

BLOOM: I’m sure some parents must feel in shock.

Shawna Perkins:
They’re often dealing with a lot of trauma. We work really closely with their kids to look for positive responses to what we’re doing, and to foster their participation and instill hope. Even the smallest progression—a smile, a hand reaching out to say more, is something we celebrate together.

Parents are trying to balance many needs with other family members at home and with their child here.

When we invite them into the playroom, we’ll ask questions about what their child has enjoyed in the past, so that we can build on those experiences here. Over time children get to know us and feel safe and comfortable, and that’s when we see them blossom.

BLOOM: Do you ever find parents are so focused on their child’s rehab goals that it’s hard for them to just enjoy their child?

Shawna Perkins:
They do have so many goals and so much ‘homework,’ and we’d like them to know they can leave those things behind in the playroom. We recently started a Baby and Me group with Andrea Lamont in music therapy. The intention of that group is to provide an opportunity for parent and child to enjoy music together, create a special work of art to celebrate the child, and to shift the focus to their relationship and bonding.

BLOOM: What kind of change do you see in kids?

Shawna Perkins:
When kids first come in to the playroom, they may be overwhelmed, and begin pulling everything off the shelf. Our program provides structure and as they learn the routine, they become able to participate in small group activities with children of the same age.

Kids may come in with very limited communication but, over time, they begin expressing themselves through play, by making choices and in their sense of humour. They may enjoy playing silly games and we find out what makes them belly laugh. Or who they are comes out in the art work they make.

BLOOM: What’s the greatest joy of your work?

Shawna Perkins:
Every child is motivated in some way to play, and can be engaged creatively, and that’s an amazing thing to get to do when you come to work every day.

BLOOM: What drew you to art therapy?

Shawna Perkins:
When I was younger I had an opportunity to work at a camp for girls, and I saw the potential to have a positive impact on other people. I’ve always been able to express myself through the arts, and now that I work with the therapeutic recreation team, I see how important it is for children to have a sense of belonging and a sense of community. I think all of those experiences impacted me.

BLOOM: How do you manage the emotions that come with this work?

Shawna Perkins:
As a staff member, we care deeply about our families. We feel their emotions and we feel for them. The work we do can be difficult, and it’s important that staff check in on each other to debrief, to talk about tough situations, and also, to celebrate the joys of our jobs as well. My office is a tight space that I share with five other people, and we become close quickly. We often share similar case loads and similar feelings.

On my second mat leave I started practising mindfulness, and I was so pleased to find out that Anna Marie Batelaan was offering a mindfulness meditation group for staff on Tuesdays at lunch. That gives me an opportunity once a week in the middle of the day to check in with myself and with other colleagues, and to reflect on where I am. How am I doing, what am I noticing? Maybe I can shift things a bit to ground myself better, so I’m better equipped to return to work.

BLOOM: What kind of people volunteer in the playroom?

Shawna Perkins: Everyone from high school and university students to retired people in their 70s. Some hope to develop skills to help them in particular career paths, and others just like playing with the little guys. We have people who work full-time and take time out of their work week to come. Our volunteers are amazing. We have multiple people come in every day, seven days a week, and about 150 in total.

BLOOM: If you could change something in children’s rehab, what would it be?

Shawna Perkins:
I’d like to see us better connect the system, as we talk about in our strategic plan. For example, I refer families to infant development services when they go home, and in the GTA it’s easy to connect them, but the services run differently in each region of Ontario.

BLOOM: So how you access these services isn’t equitable, depending on where you live?

Shawna Perkins:
Yes. As a health-care provider trying to do a good job, it’s challenging. Right now I’m doing some leg work to find out where the programs are in different communities, how they take referrals and what the wait lists are like.

BLOOM: What do you enjoy about working with young children?

Shawna Perkins:
I like talking to families about what their child can do when they go home. We try to expose kids throughout the week to a range of activities, so parents can identify what their child’s interests are. For some families, the way their child plays will look different when they go home.

They have questions: What supports will I need? Is funding available? Can I stay with my child in a program if they need support? Are there programs for children with disabilities? If my child goes to an integrated program, will my child be the only one with a disability? These first steps are so important for a child to be set up for a sense of belonging at home and in their community.

BLOOM: How have you changed as a result of your work here?

Shawna Perkins:
I’m a bigger advocate of inclusion and accessibility outside of work. It’s important that I pass those lessons I’ve learned to my kids, and I want inclusion to be a part of their world as they grow up.

Working here has given me perspective on what really matters. We do come across a lot of suffering, and it puts things in perspective in terms of what’s important in life. We also see a lot of resiliency in the children and families we work with, and a lot of hope. I think we need to acknowledge that there’s a lot of good in this world, and to honour our families.