Play work with children
Playwork is a professional field that is a standard part of care in many hospitals and hospices abroad. Its purpose is to help children and families navigate life with illness with as little fear and pain as possible, making life with illness easier through play — the activity closest to a child’s natural way of being. In countries such as the United Kingdom, the United States, Canada, as well as New Zealand and Japan, playwork is a service offered to patients by hospitals, hospices, and even private organizations.
Playwork is carried out by a child life specialist, an expert in “childhood and the life of the child” (commonly referred to abroad as a child life specialist, health play specialist, or hospital play specialist). A specialist understands the needs of sick children, can communicate with children with various diagnoses, and is skilled in communication — able to talk with children about their illness, as well as their fears and uncertainties related to treatment. Everything is explained in age-appropriate, understandable language. They provide children with emotional and psychosocial support, using play as their primary tool.
“As a foreigner in a foreign country who suddenly hears their own language, so a child reaches for play as a certainty in a confusing situation.” — Anna Smith, 1937
Thanks to the work of play specialists, families are better able to cooperate during treatment. They know what to expect, understand the steps ahead, and have the tools to cope with difficult and painful moments.
Where does play/child life work take place?
In hospitals, a play specialist is available to support families throughout the entire hospitalization:
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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;
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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;
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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;
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they accompany children during procedures, distracting them, explaining, and providing support to minimize stress and so-called medical trauma;
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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;
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they teach parents techniques to best support their children in difficult moments (e.g. through breathing techniques, comfort positions, or distraction methods);
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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;
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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.
Where do our Swallow’s
child life specialists fly?
Our child life specialists visit children receiving palliative care in hospitals and offer play-based activities tailored to each child’s needs and wishes. These activities are designed to improve mood, provide emotional support before and after medical procedures, encourage communication skills, offer sensory stimulation, or create meaningful family memories. They also work with siblings and parents to help make the hospital experience as supportive and minimally stressful as possible for the entire family.
Míša visits the University Hospital in Hradec Králové every week, where she provides therapeutic play interventions for children and their families. She primarily supports children with palliative needs, but also meets with children in acute conditions or those who are long-term hospitalized. She engages children through play or uses interactive theatre, depending on the goals of the intervention and the individual needs and preferences of the child and their parents. Her work includes mood-lifting activities to increase motivation for treatment, distraction techniques around medical procedures, and sensory-based games that promote healthy development. She often uses theatre as a way to foster connection between the child and family and to create joyful shared memories. She also supports siblings and caregivers to reduce emotional exhaustion and stress during hospital stays.
Růženka, our second specialist, works with children in the Department of Follow-Up Intensive Care at Hořovice Hospital. Her focus is on sensory stimulation, using music-based activities, sensory reading, and developmental play. She regularly returns to visit the same children on mechanical support, gradually expanding their play possibilities, encouraging natural playfulness, and offering emotional presence and support through play.
Currently, we are expanding our team of child life specialists so that, starting in autumn 2025, we can also offer our services to families in home-based palliative care. Together, we continue to deepen our knowledge in therapeutic play, play-based interventions, communication, and pediatric palliative care. As a team, we are also developing tailored methods and approaches that best support child life work in this unique and sensitive field.
Why we use play?
Play is the language of childhood. The time and opportunity to play is a right of every child. Through play and artistic expression, children are given a space where they can take control—expressing themselves, exploring, experimenting, and making sense of their reality without fear of failure, and with the ultimate goal of coping with their situation as best as they can.
For a child in palliative care, the experience of life is often marked by uncertainty, interruptions in normal development, fear, and a loss of control. And yet, the value of offering time and space for play is sometimes overlooked or underestimated—especially when adult caregivers are focused on relieving the child’s clinical symptoms.
But play has the power to offset the negative impact of illness—not only for the child, but also for their siblings and the entire family.