Child-life specialist Melissa Deifer Hicks, CHEP '88, says that children often have mistaken ideas about the cause of their serious illnesses. For example, she says, some children think they are sick because they misbehaved.

In her work, Hicks helps children change mistaken impressions, which can have an impact on how well they cope with and progress through their illnesses and their lives. She works with children and their families through initial diagnosis, prognosis and the pain of disease, its treatment and its outcome.

Child-life specialist is a relatively new profession, one that Hicks didn't know existed when she was a student at the University of Delaware.

After graduating from high school in Whitehall, Pa., she says her intention was to become a pediatric physical therapist. It was something she had thought about doing since she was a child. "I remember watching the Jerry Lewis telethons on TV, and all I wanted to do was help those children walk," Hicks says.

She entered the pre-physical therapy program in UD's College of Arts and Science, but a course she took in her sophomore year changed her life. Taught by Dene Klinzing, professor of individual and family studies, "The Hospitalized Child" was a course for people planning to become child-life professionals but was open to anyone who would be working with children in a hospital setting.

"When I heard Dr. Klinzing describe what a child-life professional does, I realized that was exactly what I wanted to do," Hicks says. A volunteer placement, and then a position as a child-life assistant, at the Alfred I duPont Hospital for Children that affirmed her decision.

She changed her major and immersed herself in learning the things she'd need to know to work with children and families in medical crisis.

"Children have so many things to cope with when they're hospitalized, and the child-life professional is there to bring some normalcy back to their lives," Hicks says.

As a child-life specialist, Hicks had to learn the way children respond to illness and hospitalization and what factors guide those responses before she could help allay their fears. She needed a working knowledge of the medical terms used in discussing children's health care, and she had to be able to put those terms in language simple enough for a child to comprehend.

She had to learn what developmentally appropriate coping mechanisms could be used to help children alleviate the stress of hospitalization, the psychological and emotional needs of parents who have a hospitalized child and how to best help them help their child. Culture and ethnicity would have to be studied to work with people from a variety of backgrounds.

The summer between her junior and senior years at UD, Hicks had a chance to put what she was learning to work in a special setting.

She spent six weeks in London at the Charing Cross Hospital as a child-life intern, working directly with children and families in the general pediatrics ward.

Hicks says her biggest problems were trying to work within an unfamiliar socialized medicine system and interpreting the language. "They would call diapers 'nappies,' and I'd have no idea what they were talking about."

It was at Charing Cross that she had her first encounter with a child dying from cancer. "He was 13 years old and knew he was dying. We built a very close relationship, and when it was time for me to leave, he thought it was because it was too hard for me. He thought I was leaving because he was dying. I finally convinced him that wasn't the reason," Hicks says. That relationship helped her decide to work with cancer patients.

Klinzing arranged an internship for Hicks at Johns Hopkins Hospital Children's Center during her last semester at UD, and, after graduation, she went to work there.

She was part of the child-life team in the pediatric oncology inpatient and bone marrow transplant unit. On a typical day, she would meet with the unit's medical staff, then put together a plan for each child about to experience an invasive procedure.

"When children are getting an invasive procedure, they sometimes are so frightened, it gets out of control," she says. Hicks had to decide the best way to help them before, during and after the treatments. The plan for each child included how to explain what was about to happen according to each child's age and stage of development, what kind of diversionary play to use, how to get them to express their feelings about what was happening to them and how to provide emotional support for their families. In some cases, the team needed to formulate the best method for working with post-treatment dying children and their families.

Three years after joining the child-life team at Johns Hopkins, Hicks had another mind-changing experience. Belinda Ledbetter, the child-life supervisor at Hopkins, was one of the first child-life specialists in Operation Smile, an organization that sends teams of plastic surgeons to developing nations to operate on children who have facial abnormalities. Ledbetter convinced Hicks to volunteer.

In 1991, she was sent to Kenya, where, during a three-week tour, she worked with more then 100 children. "People came from hundreds of miles away for screenings. What I found difficult was that the team couldn't operate on everyone, and some had to be turned away," she says.

"It was one of the most valuable experiences of my life to see how limited their resources were, yet they made do," she says. "It readjusted my outlook. Now, I don't sweat the small stuff."

When she returned to Johns Hopkins, she began teaching seminars–on child development, child-life philosophy and interventions–to students and other professionals. She worked on a team to formalize a school re-entry program for children returning after diagnosis and treatment, and then she co-wrote and produced a video about it.

In 1995, Hicks moved to Georgia to work for the AFLAC Cancer Center at Children's Healthcare of Atlanta, the largest single pediatric cancer institution in the Southeast, which also treats children for such hematologic diseases as hemophilia and sickle cell anemia. One-third of the beds are dedicated to bone marrow transplant services.

As coordinator of child-life programming there, she was responsible for providing psychosocial support for hematology and oncology patients and their families and for supervising the child-life staff, interns, fellows and volunteers. She also formed and conducted a support group for adolescents with cancer and for siblings of children with cancer, and she was a member of the patient and family education and bereavement committees.

Hicks also went back to school, earning a master's degree in professional counseling from Georgia State University.

Last year, she was elected president of the Child Life Council for 2002-04. The organization promotes child-life education for its 1,800 members and offers voluntary certification for child-life professionals.

She was also a founding member of the board of directors for Front Porch of Atlanta, a program for bereaved children, and served, over a 10-year period, as a counselor for summer camps for children with cancer and diabetes.

Last year, she left AFLAC and moved to Austin, Texas, when her husband, Henry, took a senior management position with Dell Computer Corp.

In Austin, she became actively involved with the Childhood Cancer Survivorship Network's, programs for children and families who have just had treatment for cancer. She also facilitates a support group and has begun a small private practice working with children who have a chronic illness and their families. Recently, Hicks and a colleague were awarded a grant to initiate a pilot support group for children who have a parent newly diagnosed with cancer.

In addition, Hicks has been working on a series of children's books that use everything she's learned working with hospitalized children. The books deal with such topics as the death of a childhood friend, pain and how to manage it and cancer–from diagnosis to returning to school.

No matter where her expertise takes her, Hicks says the children and how she can help them are her bottom line. And, while she remembers all of them, one in particular remains vivid in her memories.

"He was a 10-year-old diagnosed with cancer. When he first came to the hospital, I had to spend a lot of time helping him understand the disease and then coping with the treatment. He had a difficult course of treatment but never lost his will to fight. We focused on expressing his emotions and maintaining some normality in his life. When his cancer returned, and he knew the end was near, he wrote letters to important people in his life and made things to give people. He made me a bracelet, and I will always cherish it. That little boy taught me valuable lessons about life and living."

--Barbara Garrison