Melanie Cole (Host): Welcome to Healing Heroes PDX, the podcast series from the specialists at Shriners Hospitals for Children in Portland. I’m Melanie Cole and today, we’re discussing building coping skills for large and small life events through recreation and leisure time. Joining me is Caroline Scott. She’s a Recreational Therapist at Portland Shriners Hospital. Caroline, it’s such a pleasure to have you join us today. What a great topic. There’s so much going on in the world today and it can be so stressful for our kids. However, stress can manifest in children’s lives in a number of ways, whether we’re talking about something as big as a global pandemic or the everyday stressors that occur in many kid’s lives with their friends or with school. Tell us what that means and why it’s so important.

Caroline Scott, CTRS (Guest): Yeah, absolutely. So, my focus is generally on the use of recreation and leisure as a buffer between stress and its effects on an individual. So, we look at kind of immediate coping strategies through rec and leisure and then largely improving a child’s capacity to cope with life stressors in the long term. So, in terms of immediate coping with rec or leisure; sometimes we’re looking at just an immediate diversion from daily life stressors, a distraction from life. Sometimes, we’re looking at activities that can improve your immediate mood. If we’re not improving the mood, just helping tolerate uncomfortable feelings that might arise throughout experiencing life stressors.

So, in terms of long term in rec and leisure, increasing self-esteem through rec and leisure can act as a barrier in general, between stress and how it affects an individual. So, opportunities for social interactions, feelings of belonging, all those things that you get from recreation or leisure based activities can kind of serve as a barrier in general to lifelong stress throughout life.

Host: Well that certainly is true and it can help build that resilience. Help us to understand how times of stress like these unprecedented times we’re in right now, affect our kids.

Caroline: There’s obviously so many different dimensions to it. We have the destruction of routine. All human beings crave structure in their days and kids in particular and oftentimes kids are typically having most of their days entirely structured and now that they are at home or often pretty unstructured time throughout the day. Additionally, there is a general understanding that things are off, that things are different but not necessarily having the emotional maturity or the maturity in general to understand exactly why and then all the feelings that arise with it, being able to cope with those in an emotionally mature manner. And like you said, there are those day to day life stressors that can accumulate and then there’s the larger stressful events. In the case of this larger stressful event, it kind of adds, it builds onto the day to day stressors from the uncertainty to the lack of structure to the inability to interact with peers, the general sensing of stress and anxiety of the adults around them.

Something that I kind of stress for healthcare providers in a field working with kids that we work with is that our patients and families, they might already have more daily life stressors that they’re experiencing in their life in general. Whether that’s due to social stigma, due to disability or special needs. Whether it’s accessibility, accessibility physically or in the school or with peer groups. I think it’s important to keep that in mind when we’re working with our patient populations that not only is this current stressor stressful for them but they might already have had a lot of day to day life stressors that we weren’t considering.

Host: Well that’s certainly true and we can all hear that information. So, how can parents foster this environment of recreation and leisure to help our children with coping? Because I know as a parent, as you said exactly, their routine is different now. Everything has changed. They go to bed later. They sleep later. They don’t have school. They’re not doing much. It’s difficult sometimes to get them motivated to do things which would help their mental health and would help them to cope. Give us some suggestions Caroline.

Caroline: My recommendations might be different now than they typically would be because we are restricting close physical interaction, but we still have lots of great options. Like you said, we might be having trouble with motivation and lack of structure. Sometimes it’s important to have unstructured leisure time and recreation time, but for a lot of kids, it is important to create structure in your day to day lives. Whether that’s with a physical schedule that you make together and post on the wall or whether it’s just with individual activities that we structure. But a few things that I’ve been recommending to patients and their families is one, we all know this but time in the outdoors, preferably in nature. Here in Portland, we have access to a lot of city parks and trails. A lot of them are pretty accessible. We have different websites and I am happy to share with my patients to get more information about the level of accessibility of these trails down to the specifics of whether they are hard packed gravel or cement, what that might be in terms of physical accessibility.

In addition to that, a lot of my patients have been working with – get either bicycles or tricycles, whether they need adaptations or just a typical bike so that they are able to use those in their community because we are spending time either more isolated or outdoors. That can be a really great resource for physical activity for some independence and mobility and just a general great recreation activity. Additionally, an important thing to think about and I know it can be more difficult right now, is finding opportunities for your children to socialize with their peers. Like I said, I know it might look different but maybe that means a scheduled playdate on Zoom so that kids can spend time with their friends.

Sometimes kids are comfortable just interacting on Zoom, unstructured. But you might come up with an idea for the playdate like a scavenger hunt. Maybe they are both looking for the same thing at the same time. Maybe we plan to come together and do Legos together. Maybe we’re going to come together and read a book together. Or maybe they brainstorm ideas for something to show and tell with their friends. And these are all activities that can be adapted for children who use augmented and alternative communication as well so that they really have the opportunity to communicate with and socialize with peers.

Host: Well it is so important, and these kids are feeling so much isolation and the social distancing and quarantining is really affecting our kids in so many ways. What about family members. It’s great to be able to use things like Facetime and Zoom to see grandparents and other family members. But what else can they do? What would you like to see happen with families to kind of bring them together when everybody wants to retreat to their own rooms?

Caroline: It is important to have alone time. You are spending a lot of time with your family members, usually more than they typically would but there’s been a lot of studies done about families engaging in play together and how it can result in a number of positive benefits, one of which is what we call communal coping. So, another kind of access to a coping skill. So, whether that is for instance, time outdoors on accessible trails. Maybe we do a nature scavenger hunt together. If we aren’t able to visually see things, maybe we use auditory, make an auditory scavenger hunt. Maybe we have a smell based scavenger hunt or like a different kind of sensory experience scavenger hunt. The feeling of the sun on you face. Things like that for kids who might have differing abilities.

Something like a family game night can be super valuable. Scheduling that in your day to day life, structuring that in. Engaging in your favorite board game together or if you’re connecting with family members like grandparents and things like that remotely; maybe we play an online game together and lots of opportunities for adaptations there as well.

Host: As a Recreational Therapist at Shriners Hospitals for Children in Portland, I’m sure it’s really rewarding to witness your patients developing through these skills that you’re talking about as well as their self-esteem and through your program. Tell us a little bit more about your program at Shriners.

Caroline: Yeah, absolutely. So, typically the Recreational Therapy Program provide year round programming for patients of all ability levels. So, including all of our patients here at Shriners. We do everything from adaptive rock climbing to art programs to adaptive skiing and our focus here is providing rec and leisure services that allow opportunities to improve functional ability. So, that’s physical abilities, social abilities, emotional, cognitive, those kinds of things. And then also promoting the application of leisure skills and their awareness of adaptive techniques and equipment in order to empower our patients and families to be able to engage in leisure outside of our rec therapy program.

So, sometimes it just looks like advising patients and families, helping them find resources for a community based recreation camp or something like that. Or an adaptive trike, those kinds of things.

Host: Well it is so important and as we’re talking about our kids, which is important, and for some of us, that’s really the most important thing, but we have to put our own masks on before we can take care of the ones that we love. And we know that that stress doesn’t end when you become an adult. Tell us a little bit about long term benefits for kids as they grow and if we can teach them these coping skills now and how we can cope so that our children see that we’re dealing with this okay and we’re being good role models.

Caroline: Yeah, so there’s certainly the modeling of behavior. I think compare it off to like a healthy lifestyle, healthy eating habits, healthy exercising habits kind of like modeling. If you show your kids how to develop healthy recreation and leisure patterns in their childhood, healthy outlets in their childhood; it’s more likely to carry on to adulthood. So, not only will it help them cope right now, but help them learn that there’s healthy ways to cope in the long term.

Host: Well it’s so important. It really – for us to teach our kids that. As we wrap up, what can parents do if they have questions about all of this and helping our children through recreation and leisure to cope with different times that we’ve never experienced before?

Caroline: You can give me a call at the Rec Therapy Department line at Portland Shriners Hospital. You can call me at 971-544-3304. That’s the line you can reach me at. I’m happy to chat about any of the things we’ve spoken about today or about your individual unique scenario and what you’re looking for in your community.

Host: Thank you so much Caroline, for joining us today and really telling us how we can get our kids involved in recreation and leisure to help them cope with all the stressors that they’ve got right now. And that concludes this episode of Healing Heroes PDX with Shriners Hospitals for Children in Portland. Please visit our website at www.portlandshrinershospital.org for more information and to get connected with one of our providers. Please remember to subscribe, rate and review this podcast and all the other Shriners Hospitals for Children in Portland podcasts. I’m Melanie Cole.