Isaiah Garner was afraid to be at the hospital. The 7-year-old’s appendix had burst, leaving him hospitalized for over a week after surgery.

His stay at East Alabama Medical Center in September 2022 came right before flag football tryouts. He wouldn’t be eligible to play at all during the fall season.

“He was down, not like gave up, but he wasn’t happy at all to be there,” said Monique Garner, Isaiah’s mother.

Other than an issue with his umbilical cord when he was a baby, Isaiah had never had surgery before. His family didn’t know what his recovery would require.

“I broke down thinking he’s not gonna get better anytime soon and was just losing hope,” Monique said.

But soon EAMC’s child life specialist, Monica Ard, entered Isaiah’s room to help him acclimate to life at the hospital.

Child life specialists are pediatric healthcare professionals who help children and families navigate hospitalization and cope with illness. Specialists use therapeutic play and education to reduce anxiety and fear, and are clinically trained in childhood development, psychology and how to explain death and bereavement to children.

Three colleges in Alabama – Auburn University, the University of Alabama and the University of North Alabama – offer child life programs.

Most child life specialists in the state work out of Children’s of Alabama hospital in Birmingham.

EAMC introduced the role in 2019, allowing families to receive holistic pediatric care without traveling far out of their communities.

Children’s of Alabama alone has 27 specialists that see about 40,000 patients every year. Statewide, the last publicly available count in 2013 listed 47 specialists.

Ard began as a child life specialist at EAMC in 2022 and helped the Garners during Isaiah’s stay.

Ard is the sole child life specialist at the hospital and works with children of all ages – including babies in the NICU – who are hospitalized for short-term and long-term stays.

When introducing herself to patients and their families, Ard explains that the main facets of her job are teaching and playing. She helps children understand what’s happening around them and helps them find ways to enjoy themselves.

“I’m kind of like a teacher because then the kids can make that connection of, oh, I can ask her questions, or we’ll kind of teach about if they want to know what an IV is or if they have this upcoming procedure, we can kind of talk through what an X-ray looks like, or what [feeding] tubes are, or walk through what their plan of care is,” said Ard.

“And then I say my second part is we get to do all the fun things. So that’s where they really enjoy my job. I’ll start asking them what do they like to do at home or what are their favorite activities? And then we’ll start working through about oh, you like to play basketball? Well, we have a little basketball goal that we can bring in or we have arts and crafts or movies.”

Because Isaiah liked sports and competition, she made him a bingo card of activities to get him out of bed and walking.

“We had 16 squares, and it had random things like go check out the fish tank or walk to the end of the hall, or have a dance party. Different things that would motivate him to get up and move by giving him choices on what he could do when he could do it,” said Ard.

Whenever Isaiah got four boxes in a row, he won a prize, which motivated him to finish the board quickly.

“He went from couldn’t walk, to the IV came out, to he didn’t have to hold on to anything to walk, so that really brightened him up and gave him motivation,” said Garner.

According to the University of Maryland Children’s Hospital, child life specialists help reduce the need for sedation and other pain management therapies in children and help children be more accepting of medical treatments, allowing for great staff efficiency and lower medical costs.

Ard knows firsthand the impact of not having a child life program.

Ard’s father had a rare genetic brain disease. While her father was undergoing treatments and surgeries, Ard and her brother underwent testing to see if they also had the condition.

Throughout the ordeal, Ard never had anyone to explain what was going on and make her feel more at ease.

“It was very scary to see our dad go through this and then thinking, am I going to have to go through this too? Or I have a headache, why is this happening?”

Ard learned importance of communicating with kids who are going through medical treatments and are hospitalized, and helping to give them control in scary situations.

“So I always say that the child didn’t choose to come to the hospital,” Ard said. ”But we can give them the control of like, would you like to color or do you like to play with this? Would you like to use the pink pen or the red pen and kind of giving them back control and that they have the choices to make.”

In the next few months, Ard hopes to start sibling support groups so that they too can understand why their sibling is hospitalized and help them cope with and navigate hospitalization.

When Isaiah’s siblings came to visit, Ard taught them about the feeding tube he had in, what it did and why it was there. She also brought in video games for them to play together.

“They made us feel welcome and took away the worry,” Monique Garner said.

Isaiah’s fully recovered now. And even though he missed flag football, he plans to compete in basketball this winter.

“We’re very cautious because we don’t want anyone bumping into his stomach, but we’re very grateful he has this option now,” she said.