Dr. Jane Aronson, President and CEO, Worldwide Orphans Foundation as interviewed by Lisa Platt, MS, EDAC, LEED AT BD+C, Director of Business and Product Development, Planetree
I recently had the great privilege of talking to Dr. Jane Aronson, the President and CEO of the Worldwide Orphans Foundation and a recent Keynote Speaker at the 2014 Planetree International Conference on Patient-Centered Care. During her presentation at the Planetree Conference she had touched on the concept of Toy Libraries and their ability to meaningfully change the developmental progress and coping abilities of children in dire conditions and those that have been orphaned or abandoned.
Being a completely new concept to me, I was struck by how this notion seemed to have particular relevance to healthcare and that often this same concept applies to patients and families finding that they are facing life altering health events without necessarily having the tools and capabilities to emotionally and mentally deal with their circumstances. The following is Dr. Aronson’s synopsis of this truly innovative approach, and how applying the concept of Human Interactions, Access to Information, and Healing Environments through these Toy Libraries can have an absolute game changing impact on creating Healthy Communities and Enhancing Life’s Journey.
I have a long history of working as an adoption medical specialist. I was introduced to the concept of the toy library when I started my work in Russia. When I arrived in Russia in the early 1990’s, I was at an early intervention institute in St. Petersburg and that had a toy library. This was a concept that this institute in St. Petersburg had originally adopted from Scandinavia. Scandinavia has, for some time, had a fairly robust network of educators and specialists that use toy libraries as a way of connecting with children with differing abilities and special needs. The purpose of the toy library at this early intervention institute was to prevent abandonment of children. The director of the institute would work with mothers of children who were disabled sometimes mentally and physically, and at risk for abandonment. This risk of abandonment was often due to the economic poverty of the family. These mothers did not have access to education about their child’s condition. The mothers-They were so afraid of their child’s differing abilities and their lack of ability and resources to cope with them that they would end up abandoning their institutionalized child. The toy library was a great tool to be able to educate mothers and care takers who visited the institute. The toy libraries proved to be a great source of prevention for abandonment while concurrently helping to improve the development of a child that had disabilities and was institutionalized. During this time I was also approached by several adoption agencies that were really concerned about how children were languishing in orphanages all over the world and becoming increasingly more developmentally delayed, depressed and traumatized by their circumstances of abandonment. My take on this was to look at the activity of play that would occur in these toy libraries as a way to moderate those circumstances.
Based on my experience and expertise, children’s well-being improves when they are busy and active. Play allows them to be in a mode of discovery and be free to be who they are at that moment in time. What I – noticed early on in my work with orphans is that they were, in a sense, disabled by their circumstances. There is a psychological diagnosis called “psycho-motor retardation.” Because of their level of depression due to their situation and lack of opportunities for individualized human interaction, orphans can experience this condition. Orphans can often lose their ability to physically express themselves emotionally. They can lose their facial expressions. They can start exhibiting autistic-like behaviors, even though they are not autistic. This includes challenges with making eye contact with others, as well as problems with engaging in self-regulating and self-soothing behaviors. All of this leads me to believe that the power of play allows these children the ability to be actively engaged and learn to better understand their inner selves . Being exposed to the concept of toy libraries and seeing the impact these programs had on children caregivers made me realize that someday I wanted to have toy libraries all over the world.
We at Worldwide Orphans are realizing this vision. Worldwide Orphans currently operates nineteen toy libraries – in Bulgaria. We have a toy library in Ho Chi Minh City in Vietnam, and we have had a toy library in Haiti for a number of years. We train parents, volunteers from the community, and many people that don’t necessarily have an educational background in child development the techniques of working within toy libraries to enhance early childhood development. We carefully interview parents and volunteers that want to work as caregivers in these settings to ensure the safety and security of the children we are serving. We also gauge their commitment, because to be successful, these individuals have to be willing to attend the classes and undergo rigorous training and comprehension testing. They also have to be willing to take continuing education that follows to receive a certificate in this course of study. Finally, we look at the coping mechanisms of the staff we train. This can be very emotionally charged work and we need to ensure that the people we are bringing in to help run – toy libraries have the ability to self-regulate and manage their own emotions. When an individual makes it through this initial vetting assessment, we then commence with the actual training curriculum. We start by using didactic methods to help these individuals understand fine motor growth, pro-social, communication, and cognitive development throughout the stages of childhood. We use the actual toy library settings to play out the therapy scenarios that we are giving to children.
We use ages and stages quotients (ASQ), to create a baseline assessment of developmental stages for all the children we serve. We work with the toy librarians and have them look at the data that has been compiled on the children and we help them develop prescriptions for play for the children. These prescriptive paths of play and the description of the toys that should be used for these purposes are all created in the native language of the country in which they are being developed so that they are easily understood by the parents and the volunteers that have been trained to work within them. The trained caregivers play with the children using these instructions and that is how the children start exploring their own competencies and begin to be empowered in their own development process. We also match the toy and the play with music and motion. Monitoring and evaluation are very important aspects of ensuring that children are accomplishing their goals and meeting their developmental milestones, so we also periodically test the children so we can track their developmental progress.
The environment that these toy libraries can occur in can take many forms, but it is important that they have home-like qualities, and are child friendly to encourage children in their play. It is also important that they be set-up so they can allow children to engage in individualized play. The goal is that the children and the adults working with them are using the toys in a manner that will help the children to explore and problem-solve in order to accomplish their developmental milestones. Because these are unique to each child, having an environment that allows for this is important. It doesn’t have to be elaborate, they just have to be intentional in the way they are designed and used. In fact, many of these toy libraries are relatively small but are adaptable to individualized use. We have some toy libraries that are portable and are transported from place to place in a traveling case. We actually use this portable toy library approach in our partnership with UNICEF in Romania. Portable toy libraries have the dual benefit of demonstrating our commitment to these communities, since we are bringing the toy libraries and the therapy to their specific location. Mobility of care sends a very strong message Willingness, as a care giver, to meet a community where they are to help them with their health and well-being. It changes the way a community engages with care providers.
Personally, I would love to begin seeing this model used in the US. It would be wonderful to have toy librarians certified and credentialed in several different settings of child care and enrichment. It seems to me that a concept like this would be natural fit for healthcare institutions and community health centers due to the health and well-being benefits that it provides for children and their caregivers. Play eases the tension between negative physical health conditions or disease and our emotional and mental reactions to it. It can ease the level of anxiety we experience when we don’t feel whole or intact. We know from the work we have done in other countries that we could have toy libraries in healthcare settings staffed with trained volunteers that could include retirees, parents and family caregivers. I even think of the Veterans Health Administration and some of the recent conflicts that our country has engaged in, and the ways in which it has affected the families of those Veterans, especially the children. I think that children of service personnel could potentially profit from some of the therapeutic benefits that toy libraries may offer. It would really be wonderful to see a team of veterans trained to become certified toy librarians who could use this incredible tool to improve the lives of families of fellow veterans.
We have a wonderful film that I entitled “The Birth of Altruism.” It’s an incredibly uplifting segment about how the staff and volunteers have benefited from their work in these settings. (To access this video click here.) Helping children desperately in need of tools to cope with their own circumstances has allowed caregivers to experience personal growth. It truly is a bilateral process. Toy library work ends up being very reciprocal in its paybacks. The children we are working with gain value from the therapy and education the toy libraries are providing and the people who are working with the children benefit in their own emotional, spiritual and metal progression.
I have a term that I like to use when I refer to the work we do. I like to think of us as “communitarians.” We are not just trying to do good work; we are trying to meaningfully build communities of care so individuals have the ability to continuously strengthen their skills in nurturing one another and helping each other in their on-going understanding of their children’s and their adult member’s development, and one another’s self-reliance. We have found that toy libraries have an amazing capacity to fuel this effort. Toy libraries create a physical space for the people within the community that are using them and both children and adults develop a true sense of belonging. It’s amazing to see how this sense of unity, balance, and empowerment can transform challenging circumstances and change perceptions of powerlessness to happiness and hope.
To learn more about WWO Toy Libraries, their benefits, and the process introducing this concept into your own healthcare environment or community health center, contact Dr. Aronson at Worldwide Orphans Foundation (www.wwo.org ), 515 Valley Street Suite 201, Maplewood NJ 07040 USA 973-763-9961 or email: email@example.com .