Herní práce a herní specialista

“Like a stranger in a foreign land who suddenly hears his own language,

the child reaches out to play as an assurance of friendliness in a bewildering situation.“ (Anna Smith, 1937)

CHILD LIFE work with children

Child Life is the name of a field that is a natural part of care in many foreign hospitals and hospices. Its task is to help children and families go through life with an illness with as little fear and pain as possible, to make life with the illness easier for them, through play, which is the activity closest to children. In the UK, the USA, Canada, but also in New Zealand or Japan, playwork is a service that hospitals, hospices, and private organizations offer to patients.

Child Life is performed by a play specialist in healthcare , an expert in psychosocial support for sick children, or an expert in "child's play and life" (abroad, the terms child life specialist , health play specialist or hospital play specialist are most often used). A play specialist understands the needs of a sick child, can communicate with children with various types of diagnoses, is an expert in communication - and therefore can talk to children about the illness, but also about their fears and uncertainties associated with treatment. He explains everything in appropriate and understandable language appropriate to the child's age. He provides emotional support to children. Thanks to his work, children cooperate better during treatment. They know what awaits them, understand the steps, and have the tools to cope with difficult and painful moments. His main tool is the game.

In hospitals, a play specialist is available to support families throughout the entire hospitalization:

at the beginning, they introduce the family to the hospital environment, find out how the child is coping with the stay, what they are afraid of, and what they would like to know;
they help prepare the child for procedures – explaining how the procedure will take place, what the child will feel, and what the surroundings will look like;
they help the child cope with fear and pain – teaching and practicing coping strategies, and together with the child creating a step-by-step plan for managing the upcoming procedure as best as possible;
they accompany children during procedures, distracting them, explaining, and providing support to minimize stress and so-called medical trauma;
they support children’s optimal development, which is adversely affected by hospital stays – using sensory toys and tools to stimulate children and normalize the hospital environment as much as possible;
they teach parents techniques to best support their children in difficult moments (e.g. through breathing techniques, comfort positions, or distraction methods);
they work with siblings, helping them overcome fear of the unfamiliar hospital environment, explaining their brother’s or sister’s illness, and offering support during visits with the sick sibling;
if the family wishes, the play specialist helps children create tangible memories at the end of life (parents often welcome photos of joyful moments, fingerprints, letters, recorded messages, a personal playlist, etc.).

Because play is the natural language of children, the play specialist uses various play methods. Everything is explained in an age-appropriate and understandable way. They provide children with emotional and psychosocial support. Thanks to the work of play specialists, children and their families cooperate better during treatment, as they are prepared, understand the process, and are better able to cope with difficult situations.

In hospices, the child life specialist helps shape the daily program, collaborates with other care providers, spends time with healthy siblings, and transforms an unfamiliar setting into a space where play, joy, and meaningful development are possible. They speak with children and parents about their interests and wishes, and look for ways to fulfill these during their stay. The specialist may spend time with seriously ill children in the playroom, art or music studios, multisensory (Snoezelen) rooms, or outdoors. They also work alongside physical and occupational therapists in both dry-land and water-based activities.

Examples of hospice-based activities may include: arts and crafts, sensory play with adapted toys and materials, hydrotherapy in small pools, sensory-based reading, music-making, or organizing special events such as spring celebrations or winter holidays. The specialist can also gently support parents in creating a memory box with the child’s artwork or photographs. Their role is, simply put, to help make the hospice a welcoming space—one where there is room for play for everyone.

In home-based care, child life specialists visit families with specific goals tailored to their needs. Sometimes the focus is on sensory stimulation, other times on play itself. These sessions offer the child joyful moments while giving parents a brief moment to rest—or the inspiration to create their own play experiences with their children, supported by the specialist’s example.

Why we use play?

Play is the language of childhood. Time and opportunity to play are every child’s right. Play and art create spaces in which children take control of their own reality by expressing, exploring, experimenting and understanding it without fail, with the overall goal of managing their situation as best they can. The life experience of a child in palliative care is characterized by uncertainty, obstacles to normal development, potential fear and loss of control. Yet, providing time and opportunities for play for children with serious illness can be overlooked or considered unimportant, especially when adult caregivers are focused on alleviating the clinical symptoms of the illness. Play can help offset the negative impact of the illness not only on the children themselves, but also on their siblings and the entire family.

However, play is not the only tool that game specialists use - it often involves talking, explaining, practicing coping strategies, etc. Even in such moments, play is nearby - it helps motivate for practice or just gain trust and create safety so that important conversations can even take place.

What Play-Based Support Looks Like at Vlaštovka

At Vlaštovka, we are currently developing a pilot project focused on child life in children’s palliative care. The project is made possible thanks to the financial support of the Vlček Family Foundation. This support allows us to visit children regularly in selected hospitals and, at the same time, offer child life sessions to families receiving care at home free of charge.

Our child life specialists — our vlaštovky, or “swallows” — work with children with serious illnesses, children with palliative care needs, children who are hospitalised for long periods of time, and children who depend on medical technology or life-support equipment. Each session is shaped by the child’s current condition, needs, abilities, mood, and the wishes of the family. Sometimes the aim is to bring calm and relief. At other times, it may be to prepare a child for a medical procedure, support communication, offer sensory stimulation, develop play, or create a shared family memory.

Child life is therefore not a fixed programme that looks the same for every child. It is a carefully guided encounter in which the child life specialist looks for the best way to support the child in what they need most at that moment: to feel less afraid, to better understand what is happening, to have a choice, to experience joy, to engage their senses, to stay connected with the world around them, or simply to return, even for a short while, to the natural playfulness of childhood.

Where Our Swallows Fly

Our child life specialists visit children both in hospitals and directly at home. They offer activities that help improve a child’s mood, support their emotional experience before and after medical procedures, strengthen communication, sensory awareness, a sense of safety, and the creation of shared family memories.

They also work with parents and siblings, helping to make a hospital stay or long-term care at home as little stressful and exhausting as possible.

Míša

Our swallow Míša visits the University Hospital Hradec Králové, where she works with families across different departments. She primarily supports children with palliative care needs, but she may also be seen with children in acute medical situations or children who are hospitalised for a longer period of time.

She works through play, creative activities, sensory experiences and theatre — always according to the aim of the child life intervention, the child’s current condition, and the wishes of the family. She uses coping and distraction techniques for difficult moments, helps children prepare for medical procedures, supports their motivation during treatment, and creates space for joy, connection and shared memories. In addition to her hospital work, Míša also provides consultations with families and professionals by phone and visits families at home “on call” for one-off interventions, for example when a child needs support before a medical procedure.

Růženka

Růženka works with children in the long-term intensive care unit at Hořovice Hospital. She visits children who often need very gentle, patient and long-term support.

She uses sensory activities, music, touch-based and sound-based stimuli, sensory storytelling and simple games that help children remain connected with the world around them. By returning regularly to the same children, she gradually supports the development of their play, communication and emotional experience.

Klárka

Klárka works at the Children’s Clinic and the Department of Long-Term Intensive Care at Hořovice Hospital. She offers children child life and developmental activities adapted to their medical condition, movement possibilities, communication abilities and current energy.

She helps create an environment in which the child is not seen only through their diagnosis or treatment, but can also experience ordinary childhood moments — play, curiosity, joy, connection and the possibility to choose.

Šárka

Šárka flies directly to families at home. In home care, she works with each family over a series of seven sessions, following the specific needs and aims identified by the family.

Sometimes the focus is on sensory stimulation; at other times, it may be on supporting natural play, communication, sibling contact, or creating a space where the child can experience joyful moments despite a challenging medical condition. The home environment makes it possible to work calmly, in the rhythm of the family, and with respect for what matters most to the child and their loved ones at that particular time.

Below, you can read more about how child life support works in home care.

Regular Child Life Sessions at Home

As part of a pilot project, we are offering free home play care to families caring for a child with a serious illness in 2026. The service is intended for children with palliative needs, their parents and siblings, and takes place directly in the family's home environment.

Families can contact us themselves, or we can be recommended by one of the organizations that supports the family in palliative care — for example, a home hospice, a palliative support team, a hospital, or another professional service. Thanks to the financial support of the Vlčkovych Family Foundation, the service will be provided free of charge to families in 2026. We currently offer it in Prague and the Liberec Region.

At the beginning, we will clarify together what the child and their loved ones need. Sometimes the family is looking for support in managing fear or pain, other times a space for more joyful moments, sensory activities, involving siblings, or help with how to play with the child in a challenging medical situation.

At the first meeting, the play specialist gets to know the child, their way of communicating, their favorite stimuli, their possibilities for movement, their fatigue, and what is important to the family. Together with the parents, they agree on what type of support will be most suitable for the child. Based on this, a simple individual play care plan is created, which is based on the child's age, health status, sensory needs, interests, and family wishes.

The goal of play therapy can be to promote joy, calm down, activate, develop communication, involve siblings, prepare for surgery, manage fear and pain, or create shared memories. However, it is not a fixed program that the child must complete. Play therapy is always adapted to the child's current condition, their capabilities, and the atmosphere in the family.

Each session usually lasts 45-60 minutes. The play specialist may offer play, sensory reading, creativity, music and sound stimuli, gentle movement activities, story work, preparation for challenging situations, or support in managing fear and pain. Sometimes the session is lively and playful, other times it is very peaceful — perhaps with just scent, sound, light, touch, a short story, or shared silence.

Parents and siblings can join the meeting, depending on the family's wishes. Sometimes we play together, other times the play specialist creates a safe space for the child and parents can just observe, relax or get inspired for the next few days.

After several visits, we will evaluate together what helps the child, what makes sense for the family, and what direction to continue. We usually offer seven meetings, but their number can be adjusted depending on the situation and mutual agreement.