Babies with her condition rarely live past infancy. Her prognosis - even her next surgery - is unknown.
"She was trying to figure out how to fix his 'heart' condition. She's not sure how the doctors are going to deal with hers," said Hilary Phillips, a child life specialist at Children's Hospital of Philadelphia, after Alyia's half hour of "medical play."
About 35 staffers help patients conduct such play at Children's Hospital. The program is one of more than 400 similar efforts in the United States and Canada, according to the American Academy of Pediatrics.
The idea is to lessen the terror that kids may feel before a scary procedure. Research shows that structured play can reduce stress.
"Play is a child's work," said Elana Tenhuisen, child life director at Children's Hospital. "That's how they learn about the world that they're involved in."
Kids make puppets out of tongue depressors. They play a version of bingo in which O stands for nurses and N is for X-ray. They put bandages on dolls and wear sterile "bunny suits" before an operation, just like the surgeons do. A 1998 study of 100 hospitalized preschoolers found that blood pressure and pulse rates were lower in children who participated in individualized puppet shows about their coming surgeries. The mothers also reported that those children had less anxiety after surgery than the control group.
In the short term, specialists say that working with a petrified child before a minor procedure can help avoid sedation.
For kids who are hospitalized over long periods, guided play can promote natural growth and development, and make their world a little more normal.
A lot of play is largely undirected (although closely observed). Give a doll and a box full of medical paraphernalia to a 6-year-old diabetic who is continually getting pricked, and the child will likely make up a story line in which he is the doctor and the doll has diabetes.
