Celebrating Allied Health Professionals Day
Allied Health Professionals Day is celebrated annually on 14 October. To learn more about the amazing work allied health professionals do in paediatric oncology, we asked ANZCHOG members to share more about their role. Keep reading below to find out more …
“As a physiotherapist in the paediatric oncology unit our role is to help infants, children and adolescents remain as fit and active as they can during cancer treatment. Physiotherapists aim to minimise or prevent the adverse effects cancer treatment can have on a child’s body. One way we do this is by helping children be more physically active. This involves problem solving with families, and working with the oncology team to ensure children have access to opportunities and environments that encourage physical activity. Physiotherapists also have a key role in identifying and treating treatment related impairments and supporting healthy infant development. We do this through specialised assessment and treatment techniques for children who have had surgery, an acute medical episode, a severe treatment toxicity, or long-term hospitalisation. This involves hands-on therapist support to help a child walk and move, exercise and equipment prescription, and developmental intervention. Physiotherapists also provide tailored support and education to families to help them transition back to an active lifestyle after treatment has finished.
Physical activity is safe and recommended for children with cancer both on and off treatment. But without support from professionals, such as physios, families and children find it very challenging to be physically active during cancer treatment. Every member of the treating oncology team can play a role – not just physios. Moving more needs to be promoted, no matter how small that movement is. The oncology team also have a vital role to ensure physical impairments are monitored and treated as early as possible. It’s important that if a child experiences treatment effects that are impacting their ability to move, that they are referred to physio as soon as possible so these impairments can be managed as early and possible. To get the best physical outcomes for children, a team approach is vital!”
Why is physiotherapy such an important aspect of a child/adolescent’s cancer treatment?
“Cancer treatment can cause damage to the body which impacts a child’s short- and long-term quality of life. Long term survivorship studies show that children with cancer are at higher risk of lifelong chronic health problems and sedentary lifestyles. Some of the physical impairments associated with cancer treatment can be prevented or at least minimised through physical activity promotion and, early detection and treatment of physical impairments. Physical activity can help children maintain their physical function, their sense of independence and connection with an active lifestyle. Physiotherapists also manage adverse treatment effects such as fatigue, nerve damage, weakness and muscle loss, poor appetite, and developmental delay. Early physiotherapy intervention can have a huge impact on child’s function in the short-term. It can also help children get back to doing the things they love faster after they finish treatment, and improve long-term outcomes.”
What did the journey look like for you to get to your current role? Were you always interested in this field?
“I trained initially as a paediatric physiotherapist in the community and then moved to the hospital setting. Whilst working in the acute paediatric setting, I became interested in the oncology population as I could see opportunities for a more preventative approach to physiotherapy. Children in the oncology unit and ward at that time were very sedentary and many children would be referred to physiotherapy with long-standing physical impairments that were missed or identified only once they were severely impacting a child’s function. I became interested in understanding how children could be more physically active in the acute oncology setting, and exploring intervention strategies that allowed for early detection and treatment of physical impairments. This led me to complete my PhD and inspires my ongoing work as a clinical researcher in this field.”
“The role of a social worker includes psychosocial assessments, therapeutic interventions to support the patient and family, collaboration with community supports, advocacy on behalf of the family, counselling for transition from active treatment to surveillance, and anticipatory grief and bereavement support when needed.
In our hospital, the oncology social workers meet with families from diagnosis through to survivorship or bereavement – working with patients whether in person at the hospital or connecting with them at home. A typical day varies wildly: It may be composed of counselling to support how the child is adjusting to the next phase of treatment, providing crisis support to parents in the context of a new diagnosis, conducting psychosocial assessment to determine the appropriate community referrals, and attending multidisciplinary team meetings to develop collaborative care plans for our patients.”
Why is social work such an important aspect of a child/adolescent’s cancer treatment?
“Paediatric oncology social work is a specialty discipline that is grounded in enhancing the psychosocial wellbeing of children/adolescents with cancer and their families. In paediatric cancer care, social workers play a key role in multidisciplinary teams because we’re trained to assess the broader social and emotional challenges faced by children/adolescents and their families. We take a comprehensive approach, providing emotional support and crisis intervention, while supporting families by addressing social determinants of health such as access to resources, financial strain, or housing issues. We acknowledge patients and families as the experts of their own lives and empower them to make the best decisions for themselves. Our professional values and code of ethics guide our work, and we regularly reflect on and review our practices. We always strive to learn and make sure that our help fits the ever-changing needs of families dealing with childhood cancer.”
What did the journey look like for you to get to your current role? Were you always interested in this field?
“I’m passionate about paediatric oncology social work and I’ve had the privilege of working in this profession since 2015. I’m currently the Social Work Team Leader at Children’s Hospital at Westmead in Sydney. I manage the oncology social work service and am the senior social worker for the Blood Transplant and Cellular Therapies team. I’m deeply committed to advancing psychosocial care for children/adolescents with cancer and their families through clinical social work practice, advocacy, and program development. I am also currently serving on the committee for Oncology Social Work Australia New Zealand (OSWANZ).
My previous social work experience was in adult oncology and public schools, and paediatric oncology felt like the perfect mix of my skill set. It is humbling to have the opportunity to get to know children, young people, and their families at such a distressing and formative time, and work with them to build their resilience and capacity to cope during their experience with cancer.”
“My role as an Occupational Therapist (OT) in paediatric oncology aims to address challenges in development, self-care, productivity and leisure by assessing and providing opportunities to engage in activities of daily living while still in hospital to maintain and promote independence, to reduce the burden of care of carers with the use of adaptive self-care equipment, and prepare a child and family for discharge post prolonged inpatient stays that are a result of the oncological treatment. For children in the younger age groups, we aim to provide an assessment of development specifically in the areas of fine motor, positioning, self-care and play. Interventions aim to be provided during 1:1 sessions on the ward or in the OT department building the capacity and education of parents regarding the importance of maintaining developmental play skills and how to facilitate these skills in a hospital environment that can include isolation.
Each day varies given the large number of patients and their differing needs. Typical tasks completed during my day include reviewing children on the ward or in the OT treatment rooms for ongoing therapy. This focuses on things such as improving function (i.e. task-specific practice), adapting tasks such as pacing and planning throughout the day and energy conservation strategies, adaptive equipment such as supportive spints and wheelchairs, education and empowerment to families to help them maintain occupational/familial roles and developmental therapy.
Why is Occupational Therapy such an important aspect of a child/adolescent’s cancer treatment?
“A child/adolescents energy levels and ability to engage in activities will change throughout cancer treatment. This can lead to generalised weakness and can make it harder for them to participate in their usual activities. Childhood is also a time of rapid development where new skills are learnt. This can be interrupted by treatment for cancer which can include long periods of feeling unwell, hospital stays, and side effects which leave children unable to participate in daily activities. The primary goal of Occupational Therapy is to enable people to participate fully in the activities of their everyday life (e.g. self care, leisure, school, play). OT addresses the physical, cognitive, sensory, psychosocial and functional needs of patients along a wide spectrum of care from initial diagnoses to palliation. OT centres around patient/family goals to direct therapy, ensuring continual participation in activities that children both need to do and want to do throughout their cancer journey.”
What did the journey look like for you to get to your current role? Were you always interested in this field?
“I have worked across all roles within the inpatient setting at Sydney Children’s Hospital and the Children’s Hospital at Westmead. I took a short-term contract in Oncology and fell in love with it. I am constantly learning and being challenged and can apply skills I have gained in all my prior roles as all children present differently throughout their cancer journey. I love being able to build strong rapport with children and families given their extended time within hospital during their cancer journey. I love supporting children to achieve their goals and still participate in meaningful occupations despite the challenging journey cancer poses.”