by Thomas Hobson
Child Life Director

Several posts back I mentioned the importance of positive reinforcement within the realm of disciplining children.  After writing it, I was struck by just how much positive reinforcement is used at Le Bonheur Children’s.  It seems only appropriate that we are using the same advice that we are giving families.  So, I thought I would take the opportunity to tell you about the role that positive reinforcement plays in the hospital.

As is no big surprise to most people, the hospital can be a scary place. To a child that doesn’t understand what is happening around them, the experience can be even more terrifying.  It is this fear that can lead the child into behaviors that are out of character and, at times, defiant.  (By the way, that last sentence felt a little like Yoda talking about the Dark Side.)

 It’s a natural reaction for many children to become scared or defensive when placed in a stressful situation. Our goal, as the treatment team, is not to focus on all of the negative things that a child is doing, but instead to build trust and understanding by praising the positive behaviors.  When we praise a child for an appropriate action they then know more about what is expected of them and are more likely to continue that behavior.

A great example of this is when a child is getting an IV, and they begin to become uncooperative.  Instead of getting frustrated and threatening punishment if the child does not comply, the associates will focus on praising the child for what they’re doing correctly.  The child may be crying, which is a coping technique, and keeping their arm still.  The Le Bonheur Children’s staff will focus on praising the child for keeping their arm still, and not focus on the fact that the child is crying.

I would also remind you, that positive reinforcement goes hand and hand with teaching the child about the process and giving them a “job” during the experience.  By teaching about it, you are preparing the child for what to expect, and by giving them a “job”, you are actively involving them.  When these are coupled with positive reinforcement, it is amazing how different the experience is for everyone involved.

Remember what Mary Poppins taught us, “a spoon full of sugar helps the medicine go down.”  Well, at Le Bonheur Children’s, a kind word and praise helps the procedure go by.

by Thomas Hobson
Child Life Director

Following the trend of yesterday's post, I thought I would share some information about all of the construction. It is hard to believe, but in just a few weeks, the grand opening will be held for the new Le Bonheur Children's!  It is like watching a dream come true, and I simply can't underscore how excited the associates are about it.  Everyone is looking forward to getting to peek inside and see all that the new building has to offer.

Recently, Child Life Services got to take a tour of the construction, and much like with the Family Partner Council, I thought I would share the pictures.  If you look at the previous post's pictures and then these, you can't help but notice how many changes have occurred.  There are still several things left to complete, but at this point, it is more finishing touches.

I've included in the comments what you are looking at, and I'll apologize in advance for some of the fuzzy pictures.  Needless to say, the parts of the new Le Bonheur Children's that you are seeing today are small by comparison to the overall size.  However, I'm sure just seeing these pictures will help to get you even more excited about the completed project.

Enjoy!

by Thomas Hobson
Child Life Director

In another sign that Le Bonheur Chldren’s need hospital is almost complete, there has been a new addition to the building, and needless to say it’s an extremely visible one. What could be more visible than a 12 story building on the corner of Poplar and Dunlap? It’s the new hearts that have been added to top of the east and west sides of the building.

That’s right, if you are driving up or down Poplar Avenue, you will get to see the new letters and giant hearts. Considering the size of the hospital, the letters and hearts have to be huge. Specifically, the hearts are 28 feet tall and the lettering is 9 feet tall, and the hearts and letters are covered with a vinyl.

Placing the letters was relatively easy; however, it took a great deal more effort to place the hearts. After all of the planning, the first attempt happened. It was an amazing attempt that required a helicopter, special rigging, and a quick moving construction crew.

The first attempt, around 11:20 a.m. CST, drew the attention of several crowds. A few folks even set up picnics, and you could see kids playing games. However, once the helicopter started its assent, it was all eyes on the new building. It was an amazing sight to see one of the giant hearts get lifted about the hospital. However, the wind kept the crew from installing the hearts, but have no fear, around 4:30 p.m. CST, the crew got them in place.

I hope you enjoy the pictures that were taken by various people at the event. Additionally, I would like to give a couple of thanks to a few groups: Mangan Holcomb Partners of Little Rock designed the logo, heart and signage; Innerface Architectural Signage, Inc. of Atlanta, who is developing signs for the new hospital; and H.A. Balton Sign Company of Memphis who is installing the signage.

Editor's Note: Recently, the media has put a great deal of attention on the food that children eat.  From news reports to television shows, you can't help put see it everywhere.  However, if you're the parent of a "picky" eater, you may feel overwhelmed because your child wants nothing to do with these foods.  It is for all of those parents, that we've invited Carolyn Vaughn, RD, LDN, a clinical nutritionist at Le Bonheur Children's, to share some advice for parents with picky eaters.  If you missed part one, click here to read it.

by Carolyn Vaughn, RD, LDN
Clinical Nutritionist

Kids want to please their parents and they like attention; use these natural tendencies to shape their behavior.  For instance, when your child doesn’t like something, just ignore it; making a big deal out of it teaches them that not liking food gets them attention.  It begins to define them the more you draw attention to it. 

Additionally, speak in terms of expectancy.  Try saying, “You just don’t like it yet.  You just aren’t old enough.”  Kids want to feel big and using this wording suggests to them that someday they will.  Now they have a motivation for liking it because you have attached the idea of being older with liking the new food. 

When kids try new foods, give them permission to just lick, put it in the mouth and politely spit it back out in a napkin, or putting in mouth and swallowing.  These are all tastes that are not necessarily associated with eating.  They will be much more likely to try a new food if they know they don’t have to eat it. 

When they do try a new food, praise them.  When my daughter was a toddler and tried a new food, I would do the “you tried a new food” dance.  She would laugh so much and would try a new food just to watch me make a fool out of myself.  Now I realize this isn’t for everyone, but at 8 years old, she is in the habit of trying new foods even without the dance. 

Do not cook a meal based on what you know your child will eat.  Give what you want them to have.  If they don’t eat it, that’s okay.  Children do not starve themselves.  Just don’t let them munch on a snack within another 3 hours.  Hunger is a big motivator to try new food.  Make sure that next snack is a healthy alternative to the meal food. 

The goal is to develop a child who wants to try and like a variety of foods.  If you can achieve that, the variety will take care of itself.

About the author:  Carolyn Vaughn has worked at Le Bonheur Children's Medical Center as a clinical nutritionist for 15 years and is passionate about preventative nutritional care in children.  Prior to working at Le Bonheur Children's, she worked at Baptist Memorial Hospital's HeathPlex Nutrition Center providing nutritional counseling for adults and children and conducting weight management classes.  She is a mother of two children ages 3 and 8 who love to eat and eat well.  

by Thomas Hobson
Child Life Director

There are many exciting aspects of Le Bonheur Children’s new hospital building, and one of my favorite parts is all of the art going into the building.  If you’ve never had to be part of a team that has to find appropriate artwork to fill a 600,000+ square foot building, it is no small task.  Considering the number of rooms and what we know about the impact of environment on healing, it can seem overwhelming.

However, Le Bonheur Children’s has a wonderful team of people that are helping to make art in the new building a reality.  They have worked tirelessly to find artist and pieces that fit perfectly for the feel of the hospital.  I’ll revisit in a couple of weeks and talk more about this team, but trust me when I tell you that there will be a lot of exciting art.

Most recently, Le Bonheur Children’s welcomed Carol DeForest to help Le Bonheur Children’s create an art project call Mapping Our Lives.  The finished product will be an approximately 21-foot mural that will turn along several walls. The piece examines the individuals’ paths of lives and how they intersect at various points on the map.  It is a wonderful way to honor the relationship between patients, families, and staff, with the road leading to Le Bonheur Children’s.

Ms. DeForest is working with patients, families, staff, and people in the community to “capture” parts of their lives in clay.  People participating in the group have a wide variety of options of what to create.  It could be their own house, a self-portrait, a garden, pet, or school.  However, they could create plants, trees, special signs, or other things along the path to Le Bonheur Children’s.

The following pictures are from the first workshop help in the hospital, last Friday.  For the Le Bonheur Children’s staff involved, they loved expressing their art, and with Ms. DeForest help, it was more amazing than what anyone expected.  Be on the look out for the finished product because it will simply be amazing.

Editor's Note: Recently, the media has put a great deal of attention on the food that children eat.  From news reports to television shows, you can't help put see it everywhere.  However, if you're the parent of a "picky" eater, you may feel overwhelmed because your child wants nothing to do with these foods.  It is for all of those parents, that we've invited Carolyn Vaughn, RD, LDN, a clinical nutritionist at Le Bonheur Children's, to share some advice for parents with picky eaters.

by Carolyn Vaughn, RD, LDN
Clinical Nutritionist

Pickiness begins at an early age and many times is a problem that can be avoided.  It is true that there are a few kids who are naturally extra-sensitive to textures and tastes, but the picky behaviors will not necessarily last forever.  You, as a parent, can play a large role in your child’s willingness to try and like new food. 

To avoid the picky behaviors, make sure you get off to the right start.  As they get older it is important to give your child the “want to’s.”  What I mean by that is that people who do not like a variety of foods are generally those who don’t want to like a variety.  

So, how do you give your child the “want to’s”?  This starts even in infancy.  Present food to babies and young children in a non-threatening way.  Let them direct how much or even if they eat.  Put a little taste on the lips of babies and let him bring it in his mouth.  If he decides he doesn’t want more, just try again later. 

You might be pleasantly surprised to find that babies learn to like new foods after just a few tries.  Sometimes it is more about texture than taste.   Just be patient, presenting the food in a variety of ways, realizing it could take up to 10-12 exposures to a food before a child might learn to like it. 

In tomorrow’s post, we’ll look at a look at strategies to help get your child to try new foods.

About the author:  Carolyn Vaughn has worked at Le Bonheur Children's Medical Center as a clinical nutritionist for 15 years and is passionate about preventative nutritional care in children.  Prior to working at Le Bonheur Children's, she worked at Baptist Memorial Hospital's HeathPlex Nutrition Center providing nutritional counseling for adults and children and conducting weight management classes.  She is a mother of two children ages 3 and 8 who love to eat and eat well.  

by Thomas Hobson
Child Life Director

Saturday night, Le Bonheur Children's Teen Advisory Council hosted the 3rd Annual Wacky Tacky Prom for patients and families in the hospital.  It was a tremendous success, and a lot of people danced the night away.  Personally, I'm still recovering from the dancing. 

After all of the fun, we had to share the pictures from that night.  These are only a handful from the night, and there are a ton of stories that go with each photo.  If you want a little more explanation on the Wacky Tacky Prom check out our post from last week.

When the Teen Council was leaving, I think I heard them start planning for next years prom...

by Thomas Hobson
Child Life Director

There are times that death seems like one of the most taboo topics in our society. It is one of the most difficult experiences a family can go through.  To make the situation harder, the thought of talking to children about death can be hard for parents.  Death is a topic that many feel like the have no idea what to say or which words to use.  Having children ask questions about death can be even harder when, especially if you are still processing your own feelings. 

This past Wednesday (April 14, 2010), PBS aired a Sesame Street special dealing with children and grief.  It centers on the character Elmo and the death of his uncle, and is hosted by Katie Couric.  Much like every thing else done by the Children’s Television Workshop, it is extremely well done and is a wonderful resource for parents.

I’ve included a clip from an interview done earlier this week on the special:

If you would like to see the entire episode of PBS’ When Families Grieve, the Sesame Street special click here.

There are situations in the hospital when families have to talk to their child about the death of a loved one.  Here at Le Bonheur Children’s, Child Life Services has served as a resource for families in these situations.  We work together with the rest of the interdisciplinary team to help equip families with the right tools to communicate.

Additionally, there are some wonderful resources in the community that can provide support to you and your child.  If you have a child that has been struggling to cope with a recent death, I would recommend looking into Camp BraveHearts. It is a family grief camp that is hosted by Methodist Hospice and has several of us in Child Life Services working directly with the camp.

Talking with children about death and grief can be one of the hardest conversations that you can have.  Just know that there are wonderful resources in the community to help with preparing for the discussion and providing support during the grief process.  It may not be something that you’re comfortable talking about, but it will be a strengthen experience for both you and your child.

by Thomas Hobson
Child Life Director

If you’ve been out to dinner on Friday or Saturday night any time over the past few weekends (and a few coming up), you have seen the flocks of high school students dressed up.  The girls are wearing any variety of gowns and have obviously spent a great deal of time getting their look just perfect.  The boys, on the other hand, just look uncomfortable wearing a tux.  This can only mean one thing: prom season has arrived!

Well, just because you’re in the hospital doesn’t mean that you have to miss the prom.  That’s right, we have a prom here at Le Bonheur Children’s.  Hey, we are a “Section VII Special Purpose Non-Public School” after all.  What’s more impressive is that the Le Bonheur Children’s Teen Advisory Council puts on the prom.  The Teen Council makes sure that it has that special touch to make the experience complete.

I should take the chance to mention that this is not like other proms that high school students go to.  In fact, it’s the exact opposite.  It is called the Wacky Tacky Prom, and it lives up to its name.  This year will be the 3rd Annual Wacky Tacky Prom, and it promises to be bigger than the previous two years.

Let’s face it, no one brings formal wear when they come to the hospital.  Why would you?  Instead, the Teen Advisory Council has collect old prom dresses, bridesmaid dress, and any other variety of dress-up clothes.  The goal is to dress as wildly (and ugly) as possible, which goes to match to decorations.  Patients and their families are invited to join in the fun, and once there they get to dance the night away.

Once we have the Wacky Tacky Prom, I’ll post some of the pictures from the event.  I promise it will be worth reading.

by Thomas Hobson
Child Life Director

It seems like every so often the media brings up the “S” word: spanking.  There is nothing that gets a people fired up like asking about disciplining children.  It quickly dives into what people would do with their own children and then on to their own childhood.  Whether a proponent for or against, it seems that everyone has an opinion.

On April 12, 2010, the American Academy of Pediatrics (AAP) released a study that examined the impact of spanking on 3-year old children when they were 5-years old. In a nutshell, the study found that children between the ages of 3 and 5 were that were spanked more than twice a month were more likely to show aggressive behaviors at age 5.  The complete article is far more comprehensive than my explanation, and if you would like to read it click here.

This study goes to reinforce what the AAP ‘s Guidance for Effective Discipline.  Instead of focusing on corporal punishment, the recommendations focus on a strong parent-child relationship, positive reinforcement, and removing negative reinforcement or applying punishment focused on stopping the behavior.  The guidelines were originally published in April 1998, and have continued to recommend them over the past 12 years.

The truth is that there has been a great deal of research done on spanking, and other forms of corporal punishment, and most have pointed towards negative impact.  Speaking as a parent, I realize there are times that spanking seems like the right action to take.  It is even more engrained into your parenting style if you were spanked as a child.  However, there is a plethora of research that states that you should do otherwise. 

If you struggle with whether or not to spank your child, I would recommend sitting down and reading both articles.  For that matter, if you’re just curious about what the AAP says read them.  This is a topic that people feel strongly about, but may have not ever read any of the research.  Take the extra time and see what pediatricians are saying, I promise you and your child will be thankful for it.

by Thomas Hobson
Child Life Director

Think back to some of the proudest moments in your life.  Did they involve someone telling you that you did a good job?  Perhaps they were proud of you?  Chances are many of those moments involve situations like those.

The truth is that everyone likes to be told that they’re doing a good job.  To put it in more technical terms, everyone likes positive reinforcement.  When we are rewarded for doing the right thing, trying harder, or just generally doing what we’re suppose to it makes us want to do it more often.  This is true for work, home, friends, and… children.

That’s right, your child loves when you provide them with positive reinforcement.  It makes them realize that they are doing the right thing, and helps to shape expected behaviors. Here are three simple pointers on giving solid positive reinforcement:

• Be specific: If your child has done a specific action focus on that.  For instance, “Great job sitting in your seat during dinner.”  This helps your child to know what actions we’re the ones being praised.
• Give more: A professor of mine once said, “if you think you are giving enough positive reinforcement, give 10 percent more.”  Guess what, it’s true.
• It’s about good, not bad: If you have two children, praise the one doing the right thing, and make sure not to point out that the other one is doing something wrong.  They’ll pick it up on their own.

You will be amazed how well positive reinforcement works with children (and adults).  It is as simple as focusing on the positive things your child is doing, instead of talking/screaming about the negative things.  If you take this to heart and practice it, you will find you are far more relaxed and your children will have wonderful deposits in the “self-esteem bank”.

Parenting is a job; you are the supervisor and your child is the employee. So, as Peter Gibbons, the main character from Mike Judge’s movie Office Space, said about making a mistake, “I have eight different people coming by to tell me about it. That's my only real motivation is not to be hassled, that and the fear of losing my job. But you know, Bob, that will only make someone work just hard enough not to get fired.” 

How do you want to motivate your employees…  err, children?

by Thomas Hobson
Child Life Director

Le Bonheur Children’s is an important organization for the health and wellness of the children of the Mid-South, and as such there are groups that do things to support the hospital.  I thought I would take the time to tell you about an event that is benefiting Le Bonheur Children’s.  The event, sponsored by YALL (Young Adult Le Bonheur Leaders), is the Big Wig Ball.

If you haven’t heard about this already let me be the first to tell you about it.  This Saturday, April 10, 2010, the 3rd Annual Big Wig Ball will be held at Minglewood Hall.  The event is described as “a night where guests will adorn themselves in wigs of every style, size and color.”  There will be live music by MissUsed, so plan on dancing your feet off.

Oh, did I mention that you ticket will cover food and beverages for the evening?  The food will be from Memphis area restaurants.  Wondering which ones, here are a few: Mesquite Chop House, Muddys Bake Shop, Chick-fil-a on Union, LeCole Culinaire, Spindini, Pa Pa Pia, The Margarita Guys, The Rendezvous,Café Society, Just for Lunch, Kooky Canuck,Daylight Donuts

So, if you can’t tell, there is truth in advertising.  If you attend, the event starts at 8:00 p.m., and you’ll need to wear your favorite wig.  You can either dress party cool or whatever best compliments your wig.  Half of the fun is to see the wigs that everyone wears, and after last year, I’ll tell you that there are some crazy ones.

Come and hear some great music, taste delicious foods from Memphis area restaurants, and help support Le Bonheur Children’s.  I promise that you’ll have a fantastic time, and will have lots of great stories to tell your friends.  Oh, did I mention that you can order your tickets online?  Well you can!  So, buy your tickets now or buy them at the door!  Just make sure that your there.

by Thomas Hobson
Child Life Director

Picture this scene in your mind:  It’s the season for a major holiday.  Everyone is cheerfully making plans with family and friends, and taking all of the necessary steps for the wonderful family traditions.  Parents of toddler age child think that it would be great to go to the mall and have their child’s picture taken with the holiday mascot.

The family gets the child excited about it, and loads up to have the memorable photo taken.  The child chatters and plays in line, only to cry, scream, and yell when the time actually comes.  That’s right, this previously happy, playful child is now a screaming ball of terror simply because someone is in a mascot suit.

My guess is that lots of you have seen this, and have thrown your hands up in exasperation.  The truth is that this is a completely normal response.  In the minds of these young children, they know that what they’re seeing isn’t right, and can’t figure out why everyone else isn’t scared.  It doesn’t matter if it is their favorite cartoon character or a beloved figure, when confronted, it can be scary.

The advice I would give to parents is not to force your child to take the picture or interact with the character.  In just a couple of years (or even months), your child will be running up to the character.  However, when they’re screaming and crying is the time to “rescue” you child.  Remember that in the end, they are children and sometimes need rescuing.  Let them be children, and take them somewhere else to distract them from the experience.

I realize that as I write this that it may seem like it is about two or three weeks too late.  However, in my experience you can never be too sure.  Just ask my daughter, who 2 ½ years old at the time, was surprised by a mascot character at a restaurant.  While the rest of us enjoyed our meals, she coward under the table and wouldn’t let go of my leg.  Up to that point, I think it was the most stressful meal of her life.

So, as you plan trips to theme parks, go to sporting events, or event an occasional birthday remember they can all have mascots.  Remember the advice, and a little planning can help to make the experience more enjoyable for the entire family.