Child Life Helps Kids Cope with Hospital Stays

Child Life specialist Madison Dilgard with patient Yulisa

Child Life specialist Madison Dilgard asked Yulisa, 10, to write down all the things she didn't like about cystic fibrosis (CF) on a large piece of paper. Then they filled syringes with paint and squirted all the things listed.

Published in Johns Hopkins All Children's Hospital - Latest News and Stories


Not a pretty word.

But 10-year-old Yulisa, a patient diagnosed with cystic fibrosis, is all too familiar with it.

On this day, she’s in her hospital room at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, with Child Life specialist Madison Dilgard.

Yulisa is thrilled to see Madison — and she’s ready to vent a little bit — to get some feelings out.

With Madison’s encouragement, the young patient begins to make a list of all the things she finds difficult about her disease.

She reaches up to the giant spread of white paper Madison has attached to her door and, with her black marker, she pens her truth.


“What else is hard? Let’s see it,” Madison says.

Yulisa keeps writing.

Taking medicine every day.


Being away from friends.

Having pneumonia.

Being confined to my hospital room.

When her list is complete, it’s time to have a little fun with it. Conspiring with Madison, she loads several empty disposable syringes with brightly colored paint and takes aim at her woes.


In seconds, between giggles, her catalog of stressors is vanquished — buried under globs of cheerful green and blue and yellow and red.

That felt good.

“Child Life is such an important part of the care here,” says Yulisa’s mom, Diana. “Madison makes my daughter feel seen and cared for. She’s able to enjoy herself.”

As a Child Life specialist, Madison arguably has one of the best jobs in the hospital. After all, a sizeable part of her routine involves playing with amazing kids and making them smile. What could be better than that?

But there’s much more to what a Child Life specialist does each day.

“Patients and families are typically in one of their worst times when they come to us,” Madison says.

“They’re in the hospital. It’s scary and often unfamiliar, so to help them find a little happiness in that experience is what inspires me.”

The mission of a Child Life specialist is to make the hospital stay a little bit easier. To reduce fear and stress by providing interventions that help children to understand why they’re in the hospital and what is going to happen to them. And, yes, there is plenty of therapeutic play.

“Play is the language of children,” Madison says. “Rather than asking them, ‘Tell me what you are afraid of today,’ if we play a game, they can relax enough to be able to play out their feelings.”

For example, Madison may bring a toy doctor kit to a young child and learn that he or she is afraid of the blood pressure cuff. Through play, she can show the child how the cuff is really just a “hug.”

She often uses dolls and stuffed animals to help explain procedures to children, such as receiving a PICC line, getting a feeding tube placed or receiving anesthesia.

For older kids and teens, she is a friend and a listening ear. Sometimes she’ll employ artistic interventions. She recalls helping one hospitalized teen create an “anxiety tree.” She had the patient draw a tree, with each leaf representing a different anxiety.

The greater the anxiety, the higher the placement of the leaf. Then she had the teen draw pieces of fruit on the tree, each with something that can ease that stressor, such as listening to music or deep breathing.

“This is a way for them to ‘see’ their anxiety and to conceptualize the things that make them feel better,” Madison says.

Child Life specialists undergo extensive training to help patients cope and even thrive while they’re in the hospital getting well. A minimum of a bachelor’s degree is required, plus additional coursework, then a practicum and a 600-hour internship before they can apply for a position as a Child Life specialist. Once hired, they have one year to complete a certification exam.

Madison learned about the role of Child Life specialists as a senior at Eckerd College. She knew that was what she wanted to do with her career, and she doggedly pursued her goal. Upon graduation, she was a Child Life activity tech (lots of bedside play) at All Children’s for more than two years until an internship became available to her.

In January, after years of hard work and high hopes, Madison was hired as a Child Life specialist.

“I know this sounds cheesy, but it really has been my dream to work here in this role,” Madison says.

The work is not always easy, as many families are navigating difficult journeys.

Last year, Jessica gave birth to twins Emma and Grayson at 26 weeks gestation. After a month in a Sarasota hospital, the twins were transferred to Johns Hopkins All Children’s neonatal intensive care unit (NICU). Emma had meningitis and hydrocephalus and was ultimately placed on palliative care.

An intern at the time, Madison helped her instructor give the family special support and attention during their months in the NICU, assisting them with things to make their long stay easier, even creating special memories using the twins’ hand and footprints.

“They were like my little therapists,” Jessica says. “They were truly great.”

The twins were discharged in December. Baby Emma was recently readmitted for care and, for Madison, seeing the family was like greeting old friends. Only this time, she could support them in her official role as a Child Life specialist.

For these health care professionals, helping to create an environment where families can cope and where patients can heal is the ultimate goal.

Sometimes it involves teaching. Sometimes, a compassionate, listening ear.

And sometimes it involves paint. Lots of paint.

“Madison makes it fun for me here,” Yulisa says.

She is feeling much, much better.

Child Life at Johns Hopkins All Children's Hospital

Child life specialists use developmental, educational and therapeutic interventions and play to help patients and their families cope with illness, injury, treatment and hospitalization. Our team works closely with families and health care staff to support each child’s physical and emotional needs during their medical experience.