When children are hospitalized for a long period with a serious illness, missing out on school and playing with other kids can have a big impact on their development.

To help such children acquire age-appropriate social skills as well as formal education, many medical facilities in Japan have begun establishing teams of specialists like nursery teachers and clinical psychologists to work together with doctors and nurses.

At a Tokyo hospital operated by the National Center for Global Health and Medicine, head of pediatrics Hiroyuki Shichino said it is not unusual for child patients suffering from cancer, for example, to be hospitalized for months and sometimes even years.

But while advances in medical technology have allowed more kids to be treated at home, those who have experienced long hospital stays face a number of challenges, including interacting with other kids when they go back to school. In the worst cases, they cannot attend class, Shichino said.

Under these circumstances, a group of patients’ parents began calling for the hospital to create a system to support children with mental and developmental problems.

Since hospitals can charge the cost of operating a playroom staffed with a nursery teacher to the central government as part of public medical service fees, they began responding to the calls.

On Nov. 10, Shichino’s department opened a kids’ playroom named Waku Waku no Mori (Forest of Thrills).

On the first day, about 10 patients played in the 64-square-meter round room surrounded by windows.

Attending to the children was Miki Saito, who has been certified as a child life specialist, a professional who helps reduce fear and anxiety that child patients might have over medical treatment. The profession has been recognized since the 1970s, first in Europe and the United States and now in other parts of the world.

A method introduced by Saito as a way of reducing children’s fear is a role-playing game in which children pretending to be doctors examine a doll using a toy stethoscope and syringe.

According to Saito, some children repeatedly jab the doll’s arm with the syringe.

“That’s an expression of anger and fear over unwanted treatment being applied to them forcibly,” Saito said. “I tell them it’s OK to be afraid. Children know they have to receive treatment. What’s important is to help them accept it.”

Also helping the children was nursery teacher Mayako Watanabe, who was teaching the patients basic daily activities such as how to use the toilet and dress themselves, skills usually taught at home but difficult to learn under hospital care.

Watanabe showed the children how to do these tasks, step by step.

She also cited the importance of finding what they like to do or are interested in doing. Helping children learn something new can help them grow significantly, she said.

“I would like to treat them as children, not as poor, sick kids,” she said.

In the pediatric department, information on each child’s condition and treatment plan is shared by all staff, not only doctors and nurses but also clinical psychologists.

These staff members have agreed on the extent to which each child patient should be informed about his or her ailments.

“If all of our knowledge and expertise covering various fields is mobilized, we can find the problems and the anxiety gripping each child,” Watanabe said.

Mizue Tanaka, a pediatrician in the department, welcomed the newly introduced system.

In the past, she said, doctors and nurses sometimes helped child patients with eating and playing.

“But I’ve always hoped to have help from other staff” in daily activities, she said.

Because doctors may have to administer difficult and painful treatments, they need to keep a certain psychological distance from their child patients.

“When there is someone who would never do anything painful to them and to whom they can turn, it will help children face treatment positively,” Tanaka added.


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