Child Life Intern
Mayo Clinic Children’s Center
When I began my child life internship, I had a significant change in my ability to hear in the months leading up to the sought-after spot. As a student in a competitive field, I had trouble deciding if I should pass up the internship opportunity because of this change in hearing. I had concerns about asking for an accommodation as a student because I knew an internship site could easily pick someone else, equally or more qualified. I ultimately decided to step into my internship as a student with a relatively new, “profound hearing loss.” I soon learned I wasn’t the only one with reservations about entering the healthcare field, individuals with a disability are greatly underrepresented in the healthcare workplace, at 4.8%, compared with the general population employed with a disability, at 10.9% (Bulk et al., 2018). Why is this?
Imagine standing in a bustling pediatric intensive care unit on the first day of your child life internship, a patient codes within hours of stepping onto the unit, and a flurry of activity follows. All you take in is a swarm of scrubs rushing into a room. Then you hear a faint, soft, disordered beeping hum. However, you can’t differentiate the sounds or detect the location of where it is coming from. Looking everywhere for a visual indicator or light to inform you of what is occurring but come up short. This was my first day of internship. I took a deep breath, and my supervisor pulled me aside to a quiet hall and explained what is happening and what I can look for during different codes on the unit. As someone who is hard of hearing, I quickly learned people running is the best visual cue things aren’t going well in the ICU, because there is no indicator light for a code.
A qualitative study, controlling for visibility and onset of disability, found a common theme in why individuals with a disability were facing barriers to entering their chosen field. Academic and clinical training programs rely on a biomedical model of disability to train healthcare professionals (Bulk et al., 2018). The biomedical model promotes that the person experiencing the illness, injury, or diagnosis is the problem that must be changed for that person to fit within society. This cookie-cutter approach lacks flexibility and disregards the nuanced and individual nature of disability and accommodation. An additional theme that was found among students and healthcare professionals was a hesitancy to self-advocate for accommodations, citing the competitiveness of the field (Bulk et al., 2018). The Americans with Disabilities Act, prohibiting education and workplace discrimination went into effect in 1990. Yet, the majority of those in the academic and workplace setting only choose to disclose their disability once they feel they no longer have “the capacity to conceal” (Santuzzi & Waltz, 2016). A move from a biomedical model to the social model of disability in academic and clinical programs could be a piece of the solution at greater representation. A social model of disability examines, what is not working in the environment for this individual to be successful? Rather than, what is not working with this individual? (Burchardt, 2004).
As a child life student, I felt similar reservations echoed by allied healthcare workers who have a disability. I wondered if I would lose my internship if I shared, that I was hard of hearing. I was luckily surprised that wasn’t the case. Instead, I met virtually with an “access coordinator” who explained there was nothing wrong with my abilities but the environment was not conducive to my abilities. This reflected a social model of disability, focusing on how we could make the environment more conducive to a new hearing loss rather than, the hearing loss. She coordinated the use of clear masks to be available for lip reading, ensured video materials would be accurately closed captioned and that supervision meetings would occur in a quiet space. I felt confident I would be successful and that communication would not be a barrier as I began my internship. I was fortunate to be a part of a clinical training that would account for my individual needs, rather than providing a list of accommodations assumed a student who is hard of hearing would need.
However, little did I know how unprepared I was for the reality of mixed staff responses making comments such as, “must be nice you can’t hear kids scream” to “do you ever pretend you can’t hear someone?” I continued to have to try to advocate for myself for the use of the communication tools I needed. I became exhausted advocating for myself. I felt a new level of empathy for the patients and families I was simultaneously working with, self-advocacy can be exhausting. While the organization and the coordinator of my internship had a social model of disability in mind, there was still growth and opportunity for individual healthcare professionals.
I was fortunate to have mentors who continued to encourage me in my child life journey despite the obstacles I faced from staff and the nature of the setting. My internship coordinator connected me with a pediatric resident who was also hard of hearing and routinely checked in with me. It was beneficial to have a connection with someone who understood the unique barriers for individuals in healthcare who are hard of hearing, specifically in a pandemic, where masks limit sound and lip-reading. She encouraged me that patients and families need to see themselves reflected in the staff serving them. The children we were working with need to see that they are also capable and able to have goals, regardless of their physical abilities. This made me wonder, how as the child life profession can we create more access for students like me? How can we create an inclusive workplace that is more representative of the children and families we serve?
Child life departments can consider how to support students of varying abilities to gain access to the profession, increasing representation within the child life profession to reflect the populations served. In my experience, I was fortunate to have an academic and clinical program do the following,
- Include a history of disability policy and rights in the curriculum for internships, and in required course materials. Consider the Harvard Implicit Association Test, this was a part of my orientation week at my internship site. Did you know there are many options to choose from to assess your biases and growth areas including, disability?
- When a student with a different ability asks for an adaptation, such as an environment modification, help the student identify resources within the organization and support them through the process to ensure the modification is made.
- Celebrate the unique strengths of team members, and don’t count people out.
- Encourage students with varying ability levels to apply, and discuss in your program how you will meet those needs before they arrive for their first day. I was fortunate my academic and clinical sites were able to coordinate this with me.
- Avoid overgeneralizations and stereotyping. Ask what is helpful for that individual, don’t assume you know.
- Consider what a student with different abilities might offer your internship program, beyond representation, might this student have…strong advocacy skills, empathy, creative problem-solving solutions, or extra tenacity because of their differing abilities?
- Stay open! Be adaptable!
Adapting is what child life specialists do best, remember to stay open to students with a different ability or background than you. While it is not always easy to stay open to promoting and ensuring inclusivity in a program or department, it is worth it.
Bulk, L. Y., Tikhonova, J., Gagnon, J. M., Battalova, A., Mayer, Y., Krupa, T., Lee, M., Nimmon, L., & Jarus, T. (2019). Disabled healthcare professionals’ diverse, embodied, and socially embedded experiences. Advances in Health Sciences Education, 25(1), 111–129. https://doi.org/10.1007/s10459-019-09912-6
Burchardt, T. (2004). Capabilities and disability: The capabilities framework and the social model of disability. Disability & Society, 19(7), 735–751. https://doi.org/10.1080/0968759042000284213
Santuzzi, A. M., & Waltz, P. R. (2016). Disability in the Workplace. Journal of Management, 42(5), 1111–1135. https://doi.org/10.1177/0149206315626269