Social Interaction is a Standard of Care
Written for Mattie Miracle Cancer Foundation Monthly Newsletter
April 2025 | Volume 16 - Number 4
It is well known that any amount of time spent in a hospital can be isolating. Many hospitals have restrictions on visitation, family members may have limited time to visit due to schedules, and certain conditions warrant extra precautions to prevent further illness. Pediatric oncology patients are among an especially vulnerable population due to their suppressed immune systems, a side effect of chemotherapy. Chemotherapy is designed to kill rapidly multiplying cancer cells but can often take healthy cells down as well. This is also why oncology patients lose their hair, as hair growth is the result of rapidly growing cells.
Many children’s hospitals that focus on treating patients with cancer have specific units with rooms designed to keep their young patients safe from exposure to germs or other illnesses that could be devastating to their immunocompromised systems. These units may also feature negative pressure or isolation rooms that prevent the spread of infectious diseases from other patients or staff. All of this is to say, being a pediatric oncology patient admitted to the hospital can be incredibly isolating. This does not even account for the unknown number of days a child may spend in the hospital over the length of their treatment.
In the field of child life, our education and training are backed by the understanding of the developmental impact of illness and hospitalization. Teens and adolescents fall into Erik Erikson’s stage of development called “Identity vs. Role Confusion.” This is the stage where teens are developing their identity, often defining who they are based on their peer interactions. They begin to answer the question of “Who am I?” as they engage with their friends and social circles. They develop their interests based on peer groups and resolve moral dilemmas through friendships, social events, school, clubs, and groups. As you can imagine, a hospital isolation room is not exactly the place for building and developing friendships. However, a hospital isolation room can be a place where child life specialists facilitate peer interaction and social connection.
During the COVID-19 pandemic, when playrooms were shut down, all social interaction among patients were shut down as well. Patients were restricted to their own rooms and were rarely, if ever, allowed to walk the hallways. This meant that patients of similar ages or interests were separated by just a wall, unable to connect or engage. One of my patients, a teen boy with a passion for video games, had been isolated for weeks as he began treatment for leukemia. In the room next door was another teen boy admitted to treatment for bone cancer. The two teens, who may have organically developed a friendship in the playroom over a shared video game on the big screen TV, now had no way to even learn about one another’s existence. That is, until I, as the child life specialist, began to make the introductions. With permission from both young men and their parents, I facilitated an exchange of phone numbers so the two patients could connect, discuss their shared love of video games, and hopefully find a way to cope together through their cancer diagnoses. The two patients continued this connection throughout their treatments.
Once we emerged from the restrictions of the pandemic, it was time to start connecting patients face to face again. The playroom, the clinic, even the waiting rooms became spaces where I could introduce patients to one another and open opportunities for connections. Our female teenage patients bonded over hair coverings, fashion, and friendship bracelets. I provided art materials for shared projects, and soon the hospital spaces were filled with giggles, music, and a sense of camaraderie.
The role of child life addresses the psychosocial needs of patients in the hospital setting, focusing on the impact of illness and hospitalization at each developmental age and stage. This understanding is essential to treating patients from a whole-patient perspective, looking beyond just the diagnosis and treatment, and recognizing each patient as a person with an inherent need for social connection. Opportunities for social interaction is a Standard of Psychosocial Care that child life specialists operationalize every day with children with cancer. Mattie Miracle has funded child life services since 2011 and understands the importance of social connections, as illustrated in their tagline......Childhood Cancer is NOT Just about the Medicine.
