Child Life Heroes: Paving the Way in Japan

Child life is a fast-growing field in North America, but it’s also catching on in other countries around the world. Hospitals, schools, and organizations spanning the globe are recognizing the ways that child life specialists can help kids. Being based in the United States, we may be familiar with what child life looks like in North America, but child life in other countries has some significant differences. Eriko Miura is a certified child life specialist (CCLS) at St. Luke's International Hospital in Tokyo, Japan, and she has first-hand insight about some of these differences. Her child life story starts as a second year psychology student in college.

Eriko had always known she wanted to work with kids, but she had no idea what she wanted to do after graduation. That year, she stumbled upon an article about the child life profession that changed everything. The article brought back memories of her one week hospitalization when she was a young girl. “All I remember was the pain in my stomach, feeling extremely lonely in my hospital bed, the bad hospital food, the face of the boy in the next bed, and the comic books that my dad bought,” Eriko says. She was struck by the realization that there are children who spend months in the hospital.

After some research, Eriko found that there were no child life specialists in Japan. “Why not be a CCLS?” she thought to herself, and transferred to a college that offered an undergraduate child life program. She then started her career as one of the first CCLSs in Japan. At that time about 10 years ago, there were less than 10 CCLSs; now, there are about 50 and they’re part of a professional association called the Japanese Association of Certified Child Life Specialists (JACCLS). Japan has the largest number of CCLSs in Asia, with more cropping up in countries like Singapore, Taiwan, China, and the Philippines.

Eriko can’t even begin to explain the differences between being a CCLS in Japan and being one in the United States. “In the US, people tend to take initiative. Being independent and individualistic is valued and is recognized as a desired quality,” says Eriko. “In Japan, being humble is valued. You are expected to be a good team player, and respecting authority is very important.” The most difficult challenge for Eriko is finding that delicate balance between being assertive and being humble. Since child life is still a lesser-known profession in Japan, CCLSs are forced to be assertive, explaining to other medical teams about what they do for children. However, other healthcare workers have been supporting children long before child life specialists in Japan, so it’s important to respect their roles while also trying to help them understand how CCLSs can contribute. Japanese culture also tends to emphasize humility and emotional suppression, traits that are thought to promote better relationships by maintaining harmony with others, rather than standing out. People are hesitant about disclosing their illness which can make it hard to help, especially when it comes to telling children about their illness or a parent’s illness.

Even with the challenges, Eriko says she’s lucky to be a part of a multidisciplinary team of hoiku-shis (nursery school teachers), psychologists, and social workers that collaborate to support patients. She currently works with two patient groups in the hospital: pediatric patients and children of adult patients. In the pediatric unit, she does preparations and distractions for surgeries, procedures, and tests, and also organizes seasonal and sibling support events. With seriously ill adult patients, she guides the patient in how to talk about their illness with their children, prepares kids for hospital visits, and provides end-of-life support. “I love watching children gain strength and be who they are even in the toughest moments in their life. Just being there and being able to support in those moments is really precious,” she says.

Eriko found SpellBound while she was looking for apps that use augmented reality (AR). She knew AR would be useful in the hospital setting after Pokemon Go gained so much popularity in Japan. “SpellBound is just what I was looking for,” says Eriko. “I like that it's really engaging for children and easy to use for staff. All you need is a card and an iPad and you can engage a child for a procedure! Often times, parents can’t wait to play with it too.” She recently used SpellBound with a 2-year-old boy during an IV injection. When Eriko pulled out the Fable Journey tools, both the patient and his mom (and the doctor and nurse) were fascinated. Each time the animals appeared on the screen, the patient shouted, “Mouse! Jump jump! Elephant!” When the lion appeared, he got excited and said, “Lion!!” and made the lion stand up and swing its paws. After the procedure was over, the patient wanted to continue playing with SpellBound and started crying because he had to stop. His mother laughed and pointed out how funny it was for him to be crying for a totally different reason than you’d expect in that situation.

We’re grateful for CCLSs like Eriko who are helping children all over the world find joy in the hospital and making procedures less scary. She’s an example of how just one person can begin paving the way for the profession in a hospital, or even in an entire country. As child life grows and spreads across the globe, our team at SpellBound is proud to support CCLSs and build tools that they’ll use to help patients and their families.