The Final Stretch | Yuko Okabe, ’17 BFA Illustration

Ideas, Ideas, Ideas

The last couple of weeks brought a huge wave of brainstorming, sketching, creating, and discussion with Jason and the team.  As of last Friday, I have spoken to 48 different patients, still keeping up a wide age range.  The more I spoke with patients, the bigger the game world within the Neuromotion platform grew in my head.  What world should they encounter?  What sort of problems?   The original plan was to have the player go to different cities around the world during the game, but I kept thinking that the metagame could be a great opportunity to imbue something more engaging and creative, while still keeping the experience cohesive.

When I brought up this thought to Jason, he thought of how aside from the biofeedback component, helping children with emotional regulation often means teaching them necessary executive functions.  After a thoughtful pause, he pondered, “What if each place the character could go to could teach different executive functions?  It could be a good chance to teach some psychotherapy in the game.”

I ruminated on this thought for a few seconds, but the cams and cranks in Jason’s brain were already flickering a small light of inspiration.  Without missing a beat, he slid over to his computer and e-mailed me an article about this subject, simply called Executive Functions by Adele Diamond, a professor from the University of British Columbia and BC Children’s Hospital, Vancouver.  She wrote:

Executive functions are “a collection of top-down control processes used when going on automatic or relying on instinct or intuition would be ill-advised, insufficient, or impossible.

For her, there were three core executive functions and an additional minor one. Jason’s current idea is that the mini-games could be categorized accordingly into each function:  Cognitive Flexibility, Inhibitory Control, Working Memory, and Fluid Intelligence.  That way, the games could be more organized and this would provide a bit more cohesion.  Of course, play-testing would be the ultimate judge of this idea, but it’s a start!

To provide more brief definitions of these terms, I wrote up bullets for my own notes and for the rest of the team:  Executive Functions

Sketch— Inhibitory Control: giving into external lures, handling impulses.  Lack of:  Characters with chronic hoarding issues?

Though this metagame idea is farther down the road for the team, it’s important to think of the proceeding steps since the start-up constantly changes.  Jason had me start thinking of how these worlds could look, and that we can talk through their accuracy and accessibility.   I have to say, it made those hyper-conceptual RISD assignments have come to good use.  Project tasks like “Please Illustrate De Ja Vu” and “Create a 12-dimensional self-portrait with gouache” actually DO resurface in the non-RISD world.  This gives me hope, albeit a lasting migraine to wrap my head around these concepts while also keeping themes and illustrations understandable.

Sketch—Working Memory:  Holding information in mind and mentally working with it.  Lack of:  Some form of negligence.  Purposely getting lost and not caring?

Aside from this brainstorming around the metagame, we came to the conclusion that there should be an avatar character that the child can play as.  I would say pretty much all of the kids feel relatability and customization would be crucial to this game to connect them to the game (as well as having a large world of possibility to explore).  If the avatar could have natural dialogue with the friend (coach) as well as with other characters, the experience can play out as a story and less as a one-way teaching tool.  I think we can learn a lot when situations play out in front of us;  for some reason, we can reflect better in the third person.

So in a sense, now friend character will become secondary to this avatar character.  We’re now questioning how much the friend should intervene, and how much we can use this narrative framework to instill independence for our users.  Jason and I had a brief discussion, and he thought that at this point, the avatar becomes the main character of this game.  Thus, when I started to create final splash screens and home screen backgrounds, I questioned whether to represent an avatar as an independent traveler or have them accompanied by their friend.

Progress—Splash Screen and Home Screens.  Show mid-travel spots.  Keeping it vague, but inviting.

Progress:  Avatar customization.  Dr. Alex Rotenberg suggested that this could be an opportunity to use a VAS scale (visual analog scale) where a child can choose an expression that feels represents them.  He asked whether that could give insight into “an inherent problem” that the child perceives themselves in a certain way.

Also the team has been helping to create other opportunities to introduce the avatar and friend into the beta game.  We have a tutorial or “emotional warm-up” where players have to raise and then lower their heart-rate on the screen as well as a game-over screen where the friend, when appropriate or occasionally, could appear with advice.

It’s Not Your Fault

So it’s production mode until the end.  With one more week left, I still plan to see more patients.  I think this last week would be a valuable opportunity to ask some final big thinking questions.  For some of the patients I met, I asked, “What would be something that we should definitely do in this game?” Then followed by, “What is definitely something we shouldn’t do?”  One older boy thought that there should be a main lesson in the end, so there’s a working goal.  A couple of 7 year-old girls both said that it would be important to have your character travel around and help other characters because that would help them feel better about themselves.

If I can share one response that resonated with me these past couple of weeks, it would be one experience in the Inpatient Unit with a teenage boy.  He was the only person I interviewed that afternoon, mostly because I had to leave early to see another patient in the Outpatient Clinic.

“The g-game should teach you how to…get better…and …get out of the hospital.” I noticed the “Welcome to the [Inpatient Unit Name]” notebook on the table in front of him.  He also said that the character you play as has to have a motivation, an ultimate goal to reach at the end of this game.  “Also teach…skills, like coping…skills.”

He was a very soft-spoken person, but his face was very physically scarred and his eyes very tired.  He was also shaking the entire time.  Each time he had to stop to cough, he apologized.  A couple of times, he was shaking so  violently that he couldn’t verbalize his thought.

During a particularly strong episode, he tumbled through his words. “I’m s-sorry…it’s my med-medication tha-that’s…ma-making me…shake”

“It’s okay, it’s okay.”  At that moment, his quivering head slowly turned towards me, and I knew I had to look him square in the eye.  It’s not your fault, I thought to myself.  It’s not your fault.  In a weird way, I thought he could hear me.  I let him speak for about 40 minutes until I had to leave.  Each time he coughed, I waited.  Each time he needed to collect his thoughts, I waited more.   In the beginning, I contemplated whether or not I should have turned to one of the nurses there to see if they needed to help him.  But after those first couple of minutes of speaking with him, I realized that this boy was trying so so hard to get his thoughts across. He was very thoughtful, gave great critical feedback, and really valued the importance of having a character give you advice during the game, not a disembodied voice.

Very politely, he shook my hand at the end of the interview.  “G-good luck.”  I think he smiled a bit.

I smiled back.  “Thank you so much.  G-have a good day.”  I nodded my head, thanked the nurse, and walked out with another nurse.

Should I have said ‘good luck’ back?  Should I have even said ‘have a good day’ even?  These phrases are so casual in day-to-day life, but in an inpatient unit, it’s just irony.  I thought about this on my way to the Outpatient floor where I realized my patient cancelled and I had another hour or so until my next expected patient.

Progress—launcher screen

Not to get too philosophical here, but it’s moments like these where it’s important to separate the body from the mind.  Though this boy had little control of his actions, his sharp, serious expression exclaimed his presence.  It takes a little longer and a bit more patience to really see it, but it’s there.  I had to give him time to speak and not impose anything which has been a constant anxiety for me when talking to patients.  In a way, this experience has become less about finding information about what motivates these children, but more-so learning to present myself as an active listener and empathetic  speaker.  How can you really hold a conversation with a child, any child, and have them know that an adult is taking them seriously?  Though I may be dressed in business casual and have a fancy hospital ID around my neck, I still want to get down to their level, which really becomes the task for any pediatric clinician at BCH. And there’s a lot more nuances than people think. Some kids have been easier to reach than others, but again, it’s part of the learning.  I didn’t study any of these techniques or terminology; at that moment I can only reach them through small questions, a bit of joking, and a handful of writing and doodling.

But sometimes simplicity is the answer I suppose?

Eureka!!! -Chris Cohoon ’16, TLAD

Eurecka!!!  Louis Pasteur forgot to close the window to his laboratory and discovered penicillin.  The pacemaker was invented when Wilson Greatbatch was working on a heart monitoring device and pulled out the wrong resistor.  And the new, hybrid, paddle-board hull was created during a serendipitous moment in a buoyancy testing session.

Our high school class gathered to discuss the scale models for their paddle board designs.  Most students created 1/10th scale prototypes while one group went with a 1/5th size.  As we talked about how the features of each form would affect the performance of the board, we decided to conduct a test in water.  The tide was out, which allowed us to find just the right tidal pool in which to conduct our tests.  Everyone set their boards in the water and weighted them with water bottles.  We knelt around our test-pool, pushing foam boards around and discussing how each reacts uniquely, but none contained just the right combination of qualities we were looking for.  The flat boards were less likely to tip but were more difficult to propel.  The v-shaped hull cut through the water but was easily tipped.

Shaping the stringer (central wooden board) to initiate the building phase!

When the focus shifted from observation to the discussion, the kinesthetic students started playing with the boards like little kids playing with toy boats during bath time.  One of the small v-shaped boards got lodged underneath the large flat-bottom board.  Someone picked it up and said, “What if we align the small board down the center and see what it does?”  Held by water tension, the boards stuck together.  They placed the new design back in the water, gave it a shove, and EUREKA!  We found the attributes we had been looking for, all along!  Suddenly, a new energy and excitement came over the group and we spent the next two hours spooling up for the full-scale prototype.While the high school class continues to rock the design process, the marine class has been less successful.  Work and duty schedules, island-wide travel restrictions for military personnel, and constrictive communication channels on base continue to inhibit young marines’ participation.   Each week a new combination of students shows up, which makes continuity difficult to maintain.  As I have pondered this development, I’ve wondered how to work around it.  Rather than an eight-week program, one or two multiple-day intensive sessions might work better.  If the program were to go all day over the weekend, and then during the next two evenings during the week day, scheduling may be more manageable.  It is difficult to say for sure without trying it.  A leader who is here long-term also has the advantage to scheduling sessions throughout the year.  Although attendance is unpredictable, good conversations continue each week, and we all continue to learn from one another.

Hank, and Airman, uses a broom to “paddle” as he checks out the size and shape of the adult class’ board

During some of my down time, I have been able to enjoy the island and local culture.  Last week, I received news that a friend would be on island.  I met him during a random pit-stop in Iowa, while on a road trip in 2003.  Two or three years later, we randomly ran into one another, again, in Mainz, Germany.  This time around, I heard through mutual friends that he was coming to Okinawa for a meeting.  We caught up over Japanese curry for lunch, where I discovered that he collects pottery.  I took him up to meet my good friend, Mitsunari Miyagi, who generously gave us a tour of his studio and 40 year old family kiln.

Miyagi-san is a master potter and long-time friend.  This awamori (Okinawan sake) flask displays his crab design, for which he’s well known. 

Miyagi-san is a traditional master potter.  His grandfather was designated as a national living treasure for helping to save the traditional craft after WW II.  When I previously lived in Okinawa, Miyagi-san was my neighbor.  Even though we spoke very little of one another’s language, we grew to be good friends through art, baseball, and cooking (he’s a fan of bratwurst).  One of my dreams is to open a gallery to show and sell the incredible pottery that Miyagi-san and other Okinawan artisans produce.

More of Miyagi-san’s amazing work in his studio

“That which I cannot build, I cannot understand”, Callie Clayton, BFA TX ’17

In my last blog post I proposed that the “involvement of art, interactive-critical thinking and processing seem[s] a key interpretive element for larger topics of access, understanding and analyzing the purpose and effect of genetic engineering experiments.

After two additional weeks of reflection, observation and visual protocol interpretation drafts, I don’t believe that the “involvement of art, interactive-critical thinking and processing just seems a key interpretive element-

I avidly believe it is.

Up until two weeks ago, high school students that are taking part in the Genspace iGEM team had been coming to the lab to do serial dilution tests (test the survivability of e.coli after different time increments of dehydration followed by resuspension and plating onto agar- essentially, rehydrating e.coli samples to see how well they grow after different amounts of time being dehydrated as a basis of comparison to be executed with tardigrades-testing this water dwelling, eight legged micro animal’s ability to survive under dehydration conditions due to certain genes. Identifying and isolating these genes for potential use in the production of vaccines- allowing vaccines to retain effectiveness in the presence of heat when traveling to high temperature countries lacking access to certain vaccines is an ultimate goal of this project). They have also been isolating tardigrades (essentially extracting them from the water and moss they live in) and considering utilization of the CRISPR technique with the tardigrades. Twice a week and beginning two weeks ago, everyday, the high school students come to work on this project during which I participate and observe. Participate to understand protocol processes, teaching methods + mediums for teaching, how students are learning and perhaps integrate another viewpoint- ex: commenting on changes in transparency of agar interacting with bacterial colony growth which results in light (when the petri dish is held up to be seen more clearly) highlighting certain “focal” points of this circular, 9 ” radial composition.

Common responses to these comments I make include but are not limited to: smiles of acknowledgement for the comment (I find these a bit funny and endearing), comments like “oh yeah! cool!” and “huhs” followed by what I have hoped to be looks of pondering, pondering alternate methods of viewing physical aspects of results/protocol steps.

I muse about ideas and reactions to my visual interpretations within the lab context of collecting quantitative data for a “what does this mean and how will it have subsequent effects in the minute steps that add up to addressing a broader exploration/topic” versus a “what is this now and how can it be understood outside its current context” mindset.

How can alternate forms of interpretation such as poetry, process and visual similarities with patterns in literature, bee flight paths, people’s tracked habits, etc. patterns allow one step in an experiment, one petri dish, be appreciated and understood outside of the exclusively quantitative? However, that being said, one could argue the opposite- that all patterns are only able to become recognized as patterns due to their calculable, repetitive nature which allows us to quantify the image, action, anything; thus patterns fundamentally are the summarization of quantification? and can identified repetition ever be completely fixed? A habit, predicted flight behavior of bees, predicted and actual growth rate (number of colonies predicted for growth) and cell behavior with the uptake of certain plasmids, etc. exist as predictable as a pattern due to quantification but within a statistical range. I’ve come to better understand and believe in the idea of maximum 99.99% accuracy. Results and protocols in the lab are treated meticulously and done in repetition in order to set up conditions for accuracy however innumerable factors such as the nature of the human hand confirming human error, changes in environmental factors and the constant changing responses of living organisms means that prediction maintains variability, quantification exists within a range of error thus meaning pattern (summarized quantification) must be expressed through a range in order to be represented/explored/interpreted “accurately.” How do we interpret range in this context? I think of it as integrated multiplicity of interpretations. Multiple translations outside of numbers and observational text capitalizing on the 0.01% bias. So let me rephrase: How can considerations of quantification (pattern) be expanded to regularly necessitate interpretations besides numbers and observational text? In order to be “regular and intelligible form or sequence” as described by one definition in Oxford Dictionary, a pattern must undergo multiple forms of translation to be understood. Translation, interpretation and the infinite concept of languages, my friends.

–

During breaks in setting up experiments- waiting for new agar plates to cool and set, solutions to dehydrate, etc. I’ve asked a number of high school students about how they understand and interpret content taught in the lab- tardigrade anatomy, CRISPR basics, 3A Assembly protocols, etc and what “type” of learners they perceive themselves to be. One student noted the importance of color in cognitively differentiating content within written and drawn information. “Writing becomes a blob of lines and color that mixes together” in an undefined way in that student’s opinion. Intentional color and alternating use of visual and written content she agreed may help her better interpret what is being taught. Upon my suggestion of “icon” visuals to piece together protocols with, in conversation with a small group of students, one student acknowledged that while icons could potentially simplify protocol building and interpretation, icons = another language such as hieroglyphics which adds an additional step of time and translation. Additionally, protocols are different lab to lab (similar to cooking- similar or same end result, minute differences in protocol peppered throughout) – meaning standardization is difficult. Work initiated and being done by the Synthetic Biology Open Language, a project and initiative funded by the NSF, federal agencies and other sponsors, started a readable visual simplification of genetic parts, devices and systems. While the symbols facilitate interpretation of certain genetic parts well, they don’t address the next step of ‘protocol’ and piecing a protocol together. (below from http://sbolstandard.org/visual/)

I had a great talk with one of the cofounders of the lab around the evolution of interpretation and languages in synthetic biology. Essentially it’s all about the development of “languages” he said (as I have come to understand myself as well). In order to expand rate and quantity of not only synthetic biology lab work, but also any lab or “hand-crafted” work as he said, languages for facilitating this work must be expanded upon. With hand manipulation of a majority of elements in an experiment comes human error, problematic experiments, confusion on what went wrong and decreased rate of results. In order to increase accuracy and efficiency, attempts through standardization have resulted in the recent development of many programmed operating languages developing to be read and carried out by a computer. The day when a protocol can be electronically sent from one computer to another to then be carried out by that computer seems to be approaching. This development of automation points to potential increases in productivity, thus allowing not only for expansion of biotech companies and more engagement in the DIYBio realm due to decreased necessary time investment, but at a fundamental scale- this allows people to spend more time ideating, conceptualizing than carrying out repetitive protocol steps in the lab. I find these developments of programmed languages for synthetic biology exciting however potentially limiting? Will understanding of actions being carried out from a protocol by the computer and the meaning / effect of those actions be hindered by the ease of technology’s commanding role? And how does this type of development affect the public without extensive understanding of science least synthetic biology, their process of learning in the DIYBio, Synthetic Biology communities? Could these communities become perhaps commercialized in unwise ways because the language containing the knowledge about what’s happening to those cells is encrypted in a code that makes executing protocols concerningly easy (touch of a button). With generally ok national public engagement / understanding in the sciences, does this engage or disengage people? I feel the simultaneous development of visual languages is imperative to address educational aspects of the Synthetic Biology community- facilitating understanding while efficiency is increased.

While at Genspace, I’ve come to recognize difficulties it and other community bio-labs face as nonprofits- similar to familiar challenges for all nonprofits. A wonderful yet potentially difficult aspect of a space in which everyone interested in taking a class and becoming involved in the community is welcome, is that unsurprisingly multitudes of collaborations, projects and ideas come out of this space each year. However, as is such with “personal projects,”and funding challenges at times, the completion and documentation of ideas/projects sometimes lacks. A really exciting project started by Genspace’s 2014 iGEM team is Open Lab Blueprint, a site for aiding the creation of community bio-labs, including a proposal for a lab protocol platform. While started, it was never completed due momentum slowing after the competition deadline. I’m excited to be talking with a designer next week about the platform called “Bioglyphics” and plans for its future development.

This week’s title “That which I cannot build, I cannot understand” was heard in the lab and is a take off of Nobel Prize winning physicist Richard Feynman’s quote: “What I cannot create, I cannot understand.”More insight on this quote to come in the next post.

Plans for upcoming week:

Continue protocol drawings and equipment use standards to make a booklet for beginners in community biolab classes such as the beginner biotech class at Genspace.

Write interpretations of lab protocols- free verse poetry.

Consider questions, prompts, topics to be considered as alternate methods of interpretation and integrate them in booklet.

Obstacles and Opportunities in the Creative Journey -Chris Cohoon ’16, TLAD

Change is the only constant in the life of service members and their families.  Major moves (often transcontinental) occur anywhere from yearly intervals up to four years.  The span between moves is often interrupted by multiple deployments which range from training missions, to humanitarian aid, to combat.  A friend of mine, who is a former pilot in the Air Force, averaged  310 days worth of deployments in the calendar year – and that was during peace time.  From the transient environment, come sarcastic colloquialisms, such as: “Home is where the military sends me,” or “Home is where I store my stuff.”  One learns to not ask a military kid, “Where are you from?” unless one wishes for a look of confusion and/or disdain.  A former student of mine had moved 14 times before her 13th birthday.

Amidst the flurry of brainstorming

The military is known for being regimented.  When I ask marines what they do at work, training nearly always comes up in their answer.  The Marine Corps ensures that each of its members knows their job backwards and forwards.  It makes sense that, in the chaos of battle – or even in the transient lifestyle – one needs to know their job by rote.  The means to this end is simplification and efficiency – even at the expense of the simplest, most efficient solution.  Job descriptions and policies are often written by what seems to be a good solution at the time.  The training criteria is then disseminated and leaves little room for questioning or interpretation.  Another oft uttered colloquialism is that “if the military wanted your opinion, it would have issued you one.” So, while one’s job differs greatly from location to location, and times change quickly, the slow grind of the bureaucratic structure and the unflinching culture of tradition, duty, and authority severely limit the potential for more efficient solutions.

One of the reasons that I chose to work with marines for this project is because of the general lack of creativity within Marine Corps culture.  In the last two weeks of classes, this point was  highlighted as we learned about brainstorming and ideation.  The creative dichotomy between the high school class and the marine class is palpable.  It has taken much longer for the marines to warm up to creative ideation, even though they are only one or two years older than the high school students.  I feel that the heart of the matter is one of permission.  In many ways, the straight forward direction and rote training of the military makes sense.  In certain situations, repetition and muscle memory will save your life.  It is difficult for young marines to feel the freedom to think outside of this context, even when not at work.  It has even been a challenge for my marine participants to call me “Chris,” rather than “sir.”  We are getting there, slowly.

Hydroelectric generators, coolers/seats, hoods to keep your feet dry, sonar, PET bottle construction material, so many creative ideas!!

The fluctuation of personnel constantly transitioning in and out still has its effects on policy, despite the attempts at standardization.  On my way out here, my supervisor had secured a building on the Marine Corps base for a classroom studio space.  By the time I flew out, the commander who had approved the space transitioned out, and his replacement decided that there were other priorities that demanded the use of that site.  My supervisor quickly worked to find a workshop off base.  Being off base makes it more difficult for young marines to make it to class, as they are not allowed to drive.  At the same time, however, this turn of events created a greater opportunity to recruit local Okinawans to participate in the design project with us.  What better way to learn about empathy than by working with people from other cultures?  Unfortunately, the language barrier has proven greater than my hopes, so far.  Translators are difficult to come by, as are English speaking Okinawans.  With four weeks left, I’m still hopeful that those connections will happen.

My Maharam Fellowship experience in Okinawa is challenging, as I face systemic and cultural barriers.  But a good challenge provides good opportunities to design solutions to meet those challenges.  The shape and tempo of classes change (sometimes weekly) to meet the needs of participants.  And with each class, we have had great moments of synapses connecting and lightbulbs turning on over our heads.  In one such moment, one of the marine participants returned to class after a research/survey assignment.  The assignment was to survey as broad of a population as he could, in order to gather information about potential “customers” in the base population.  It was clear that his samples all came from his peers.  When I probed as to why he didn’t survey others around him, he informed me that the other people around him are sergeants, and he doesn’t like sergeants.  The conversation turned back to the data he collected.  It was apparent that his peer group is unable to purchase a paddle board from our mock-business at a price that is sustainable.  The logical follow-on question was to ask who, then, is a better customer target?  He concluded that sergeants earn a considerably higher salary and would likely be a good target.  He quickly realized why it might be beneficial to empathize with sergeants though he might not sympathize with them.

One of the young marines joined with the high school class to help shape prototypes.  

The conversation then took a turn toward the importance of empathy in leadership.  The marine admitted that he didn’t like sergeants because they doll out extra work and discipline arbitrarily.  Sergeants, in his mind, don’t deal fairly with subordinates because they don’t know them.  So, perhaps, a lack of empathy leads to poor leadership.  Pressing on, we discussed that in may also be that the views of the subordinate marines are also skewed because they don’t understand the experiences of their superiors.  The eureka moment, however, hit when he realized that, if all goes well with his career, in a couple of years, he will be one of those sergeants.  This thought had never been within his grasp in his short tenure.  Together, we concluded that empathy is a very important part of leadership, and a dose of humility to recognize that we aren’t superior to other peoples is a great first step to being a good leader.

The past couple of weeks have been perplexing, and even frustrating, at times.  The Marine Corps culture and the circumstances here on Okinawa don’t make promoting creativity any easier.  In the midst of it all, however, there are still great moments with the marines and the high school students that I feel utterly privileged to be able to work with.

Students working to bring their ideas into the tangible world

Searching for Meaning in Their Faces: More Interviews, the Inpatient Unit, and a Little Green Notebook | Yuko Okabe, BFA Illustration 2017

Meeting New People and Interviewing Like a RISD Student

“It’s very important to get down to their level, and ask them if they know about the center and what it’s about.  Sometimes, parents don’t fully explain why kids are brought to places like ours.” -Dan Cheron, Ph.D, Judge Bakers Children’s Center

Since my last post, I was able to interview many more patients and clinicians. I have contacted 9 therapists and prescribers (clinician who assigns medication) on the outpatient floor so when and if appropriate I can interview any of their patients for a few minutes.  So far, I have interviewed 28 patients and with more to come with ages ranging from 6-20. Jason and I spoke how though the game would be primarily directed towards 6-12 year olds, getting insight from older teen patients would be vital. In a way, I think that teenagers would have a better understanding of what they need over what they want out of therapy, particularly if they have been going through it since childhood.  Having spoken with a few, they talk very much like veterans and they have so much dignity and awareness of their situations.  They’re honesty and sincerity has been great to see and the energy and curiosity of the younger children has been amazing to experience.

For a little bit, I would use a notebook and pen to write notes.  But then I realized, “Hey,  I’m not a therapist and I’m from RISD so what am I doing?”  It didn’t feel natural.  So instead I started using drawing/note taking on a large sheet of paper so that kids can see what I’m writing.  This proved to be so much more effective, especially kids with low focus or low verbal skills, this stimulated our conversations to a great level each time.  They sometimes draw with me, too!

Got really into this one.  We had to extend to a couple more sheets.

Just to share some clinical insight form these past couple of weeks, I spoke with the Assistant Director of the Center for Effective Child Therapy from the Judge Baker’s Children’s Center, a center dedicated to improving children’s lives by empowering their emotional, intellectual, and developmental well-being. The Assistant Director, Dan Cheron, Ph.D and I had a conversation about his methods and practices as well as his thoughts about our biofeedback game.  He related how he always introduces himself to a new child first before the parent.  “It’s very important to get down to their level, and ask them if they know about the center and what it’s about.  Sometimes, parents don’t fully explain why kids are brought to places like ours.”  I appreciated the thoughtful considerations he has towards communicating with children, especially what he said about keeping conversations on a first name basis, so kids can call him “Dan” instead of Dr. Cheron.

“It keeps our conversations more casual,” he explained.

He also shared how he would keep language developmentally appropriate, a method which ended up coming in handy during my patient interviews, particularly if someone is very young or has certain cognitive disabilities.

We treat kids like human beings, not their diagnostic. -Miranda Day, Creative Arts Program, Boston Children’s Hospital

“Younger children understand emotions better than terms.” he said.  “So instead of saying, ‘oh, so your parents brought you here because your anxiety got worse,’ you would say ‘what makes you feel sad?’ or ‘do you feel scared and mad sometimes?'”

But on that note, the older kids seem to appreciate my interviews more when I don’t beat around the bush and I flat out say that this is a “therapy” game we’re making, particularly for kids who need to learn how to stay calm and focused.  I have to asses each situation separately and be careful about language and wording each time.

Going back to Dr. Cheron, for the encouraged that we should include a tool box of skills that a child can refer at crucial times.  He also said that, as much as possible, we should make opportunities for children to feel like an expert.  He said this would increase parent/guardian/caregiver engagement and the experience would become more collaborative.  To an extent, this gives children a sense of control and agency of their experience.

On that note, I also spoke with the Director of the Children’s Hospital’s Creative Arts Program, Miranda Day who also believed that children should be given as much control and customization in the game as possible.  A quote that stuck out to me during our interview was, “We treat kids like human beings, not their diagnostic.”

Miranda’s job is essentially to lead and organize music therapists, artists in residence, and a multi-media studio in the hospital called Seacrest Studios (created in partnership with the Ryan Seacrest Foundation).  Music therapists are fully trained staff in a clinical setting who use either singing and/or instrumentation to help children heal.  Artists in Restidence are not fully trained in therapy but instead come from either educational and/or professional backgrounds in fine arts or design practices.  They share their creative skill-set to children through writing, illustration, printmaking, digital media, etc. and in turn, patients can experience these creative projects and even continue to apply them when they leave the hospital.

Visiting the Inpatient Unit

Before our conversation ended, Miranda said that she could connect me to the Inpatient Psychiatry Unit in the Hospital since Jason and I only had luck interviewing from the Outpatient Clinic.  To expand our audience, Miranda said that reaching out to her or her other colleagues about the inpatient unit would be a great asset to our research.

“They’re a very creative bunch over there.”  She related how much the patients valued having the arts program visit them since it keeps them stimulated and excited about their projects.

This past week, I went to inpatient twice with the expressive arts therapist group.  I have to say the reason this experience was very meaningful but moreso relieving, and it may have been relieving for reasons different from what other people would feel.  For personal reasons, I’d like to save some exposition until after the internship ends because I can better collect my thoughts and I’d like to reflect on the experience as a whole in that way.  But what I can share right now is that having the opportunity to visit the inpatient unit was initially both very exciting (because seeing new patients is always exciting) but also very worrisome.  In  a way, I knew what I was going to see but I also had no clue what I would actually experience, especially emotionally.

If you can ignore the ambiguity of that description for now, I’ll sum up my experience at the present as, yes, “relieving.”  And I say this because a lot of my preconceptions were wonderfully proven false.  I expected to see lifeless, bare walls and ceilings but I saw colorful paintings and carpeted floors.  I expected to see barred windows but they were large and hopeful with sunlight streaming through.  I expected the space to feel like a cold tight space, like a prison, but there was a communal kitchen, a beautiful art room with a stereo and a Shrinky Dink, handwritten nameplates for patients’ rooms, and a decent amount of space to walk around.  And the best part of all was seeing the patients.

I wouldn’t generalize anything, especially with gender.  It’s easy to put a strong male character, but we should show that anyone can be strong.  Also show real-life problems.  -Girl from Inpatient

Of course, not all the patients wanted to speak with me, but the ones I got to speak with were really great. Some were reluctant at first, like this one 11 year old boy, but the open-note taking/doodling method had them open up to me a lot more.  I wasn’t trying to jip them of anything:  I really wanted to hear their thoughts and really find meaning in their words and faces.

The patients there, as well as the patients in the outpatient clinic, highly believed that customization, having multiple characters are vital components to engage children. For the friend/coach character, they should be somewhat androgynous, if not explicitly, as well as be expressive and fun while also calm and “coach-like” when timely.  When I asked one teenage girl in inpatient, What is something that this quote-unquote therapy game should definitely do or definitely not do, she said, “I would not generalize anything, especially with gender.  It’s easy to put a strong male character, but we should show that anyone can be strong.  Also show real-life problems.”

With just a few weeks left (ack!) to interview patients and create design/illustrations based off this research, I’m in early stages to develop a character.  I’m seeing the current iterations as plans rather than drawings, thinking through what elements of each kids respond to the most and then continuing to reiterate as frequently as possible.  I’m thinking through the subtleties, such as body language and how the character introduces themselves.

“Coach” character thoughts.  Expressive, outgoing, but can still be serious and calm, especially when sharing coping skills.  Can be a little older though.  Also thinking through having two characters (a coach and a friend) to see them interact with each other.

Concept sketch for outer game world-journey, creative places to explore.

Concept Sketch for outer game world

Thinking about the Audience:  The Little Green Notebook

What is it?  Is it going to taste bad?  -“Mikey” reacting to new medication

Before signing off on this post, I wanted to reflect on this project on the perspective of the audience that Neuromotion is addressing.  Of course, this game will initially target younger kids, particularly ones with emotional regulation issues often associated with anxiety and ADHD, but the audience we need to also reach are the parents of these struggling children.

I’ve been making my own sort of assumptions about how these parents must feel having gone through so many therapeutic and medication options to help their child, and I could only imagine how tired these people must be.  But one of the clinicians who I approached about interviewing their patients thought that before I interviewed someone, I should sit-in on their prescriber meeting.  I mentioned this aside in the beginning of this long post, but basically unlike therapists, prescribers help decide what medication would suit a client, in this case, a little boy.

We were all in one office:  the prescriber, the two parents, the child, me, and I think another clinician or intern who sat in the corner.  I first met the parents and their child (let’s call him Mikey) in the hallway with the prescriber, and we both explained what my project was about and how I’d really like to interview their son. They were a really nice couple and Mikey was a little shy, but I liked them a lot.  There were just a normal family.  But then when we were all in the office, the prescriber began to discuss more official business about the son’s prescription amount, how many milligrams they increased and if they need to add more milligrams or try out a new medication.  The Zoloft wasn’t working, the mother shared with a deep sigh, saying that his son had repeated outbursts and was taken out of school twice.  The prescriber then proceeded to make other suggestions and look back at Mikey’s medication history on his computer.  All the while, Mikey was sitting in between his parents, fidgety and anxious.  He only focused when he pulled out his 3DS and played, seemingly blocking out what his parents and the prescriber were discussing over his baseball-capped head.

At one point though, when the prescriber suggested  a new medication to the mother, Mikey, without looking up from his game, demanded, “What’s that? What’s that?”  He repeated it over and over.  After a little bit, he looked up to his father and asked, “What’s that?  Is it going to taste bad?”  His father shook his head and tried to calm him down, but Mikey then turned to his mother:  “Is it going to taste bad? Is is going to taste bad, mom?”  Intently listening to the prescriber, the mother didn’t respond so Mikey dropped his face to his game, defeated.

I was overwhelmed, but I did my best to sit there and contemplate whether I should nod  sometimes or just mostly look at the prescriber.  A few times, I’d make eye contact with the mother, seeing her worried even desperate exhaustion.  I found myself nodding reassuringly, but I have no idea why.  I wasn’t qualified to reassure anything, but I didn’t know what to do.

I’ve never heard so many medication names within a span of 15 minutes. Aside from Mikey questioning the new medication, what affected me the most was a little green notebook that the mother wrote in during the meeting.  As the prescriber listed different medications and their milligrams, she wrote down all his words.

I kept looking at that notebook, and I had several thoughts then and after.  I wonder if she bought that notebook specifically to write down Mikey’s medications.  I wonder how she feels pulling the notebook out of her purse each time at these meetings or when she’s picking up medication at a local CVS.  I wonder if she hates that notebook, that she’s imaging the day that she doesn’t have to take it out of her purse anymore.

Afterwards, Mikey and I were able to go to the waiting area and I think it was a relief to both of us that we could just talk about games and characters.

“He [character] should be a hero!” Mikey flashed a large grin and he drew a Luke Skywalker outfit on one of my doodles. “Can he have powers?  He should defeat a bad guy, like how Luke defeats Darth Vader.”

What I gleamed from Mikey’s interview as well as from all the other interviews so far is that these children, these teens, these people want to have a sense of choice and strength.  This want freedom to explore, to discover, to have fun especially considering their situations where they very little choice in deciding their therapist, their prescriber, their medication.  They want to see themselves in the game, they want to be Luke Skywalker or Batman or Superman or a fairy or a princess in a pink dress…and they want to defeat the forces that scare them the most.

There’s a lot of promises I feel like I’m making with this game.  Some higher forces might come into play unfortunately, like budget, time, budget, staffing, budget… a start-up can only accomplish so much. But at least for now, I’d like to put that away from me.  I’m not about thinking about financial practicalities because that’s only going to hinder any progress.  And it’s not fair to the kids if I just write off everything they shared with me so far.  So my goal is to get as much done as possible and to record everything I find.  The ultimate goal is to increase patient motivation and see what these kids want as well as what they need from this game, and I have to say I think I have a very strong idea of what that should be.

Until next time~

Cheers,

Yuko

to Navigate “Contributing” : making & research flows – Callie Clayton / BFA TX ’17

Patience.

Plainly, what is research? and what does it look like for a visual learner, thinker?

Observation, writing, sketches, proposals

and patience.

What is the most effective and needed method, interpretation, translation I can provide in a community bio-lab? Thinking, sketching, proposing, and the key element; starting over has occupied a majority of my time these past few weeks.

The message and purpose of Genspace and most community bio-labs is to teach lab techniques and concepts surrounding the creation and evolution of the biotech movement to the public. In a past survey, a majority of Genspace class attendees would prefer taking a hands on class versus exclusively lecture + discussion. “Hands-on” or kinesthetic learning represents the body acting out motions, eye-hand coordination and not only physically, but also visually understanding processes.

And so, recordings or translations of these physical motions (pipetting, vortexing, etc) in visual 2D forms seems imperative to connect

1. written lab procedure with the

2. physical execution and finally

3. effect of the protocol (purpose and “expected” results of the experiment/protocol)

While participating in a beginner biotech class, my notes have consisted of understanding the details associated with teaching processes such as DNA Isolation and PCR (polymerase chain reaction- process of amplifying extracted DNA to create many copies of a specific sequence of DNA in order to look at the nucleotides/amount in the DNA sequence) and transformation (occurs naturally when e.coli bacteria bond with other e.coli to transfer plasmids through hair-like protein tubes called pili) this process allows for the alteration of a cell through the transfer of genetic information by a plasmid artificially and in the case of this class- we made an e.coli culture that expressed red fluorescent protein meaning it glowed red and ampicillin resistance. Focus of observations to work with have included:

• What are the teaching methods?
• How do class attendees absorb this information?
• What are the key details to include in effective visuals outlining a lab protocol?

(Such as touching the pipette tip to the side of the tube when pipetting out a very small amount of liquid, such as 1 microliter, due to the surface tension of the liquid preventing it from easily exiting the pipette tip)

• What metaphors seem to expound and explain processes?
• What questions are class attendees asking?

An iGEM project completed in 2014 by students attending the University of Paris-Saclay revolved around the representation of objects- questions of reality brought up by Rene Magritte’s painting, “The Treachery of Images.” This painting displays a painted pipe and the words, “Ceci n’est pas une pipe” under the pipe which translates as “this is not a pipe.” The project consisted of genetically modifying e.coli to produce the

“fragrance of a lemon and simulate the ripening process of a lemon by changing its color gradually from green to yellow. A mixture of bacteria and solid growth medium will be moulded in a lemon shape: it will smell like a lemon, ripe like a lemon and look like a lemon, but “ceci n’est pas un citron” – this is not a lemon… or is it?” http://2014.igem.org/Team:Paris_Saclay

This example project utilizing genetic engineering was brought up and briefly discussed in one of the classes. The response from class attendees was engagement of curiosity in a scaled out form. While it seems a majority of questions during classes revolve around specific techniques, ethics of all different types of GMO’s, CRISPR and press, this involvement of art, philosophical questioning seemed a key interpretive element for these larger topics considering genetic engineering.

Can art facilitate removed, wide- perspective processing of technology and ethics?

Is science able to quantify art is some form?

Suggestions for classes I’ve been thinking about and proposed include:

• Including more examples of the effect of genetic engineering techniques such as transformation through plasmids by talking about art/design related genetic engineering work in order to facilitate better understanding of the effect and possibilities of what class attendees are learning on a basic scale. Art perhaps serves as a neutral ground between the realms of research and product.
• Including teaching tools that physically represent the idea of biology as building blocks. Utilizing more hands-on tools to fill in steps of kinesthetic learning; content that is:        1. orally presented 2. written 3. drawn out 4. absorbed through visual diagrams (a key aspect I’m working on) 5. enacted with hands-on “building blocks” 6. procedure executed in lab and then repeated in opposite order to ensure understanding of the role of all reagents and organisms.
• A “Question” page on the Genspace website and social media pages that stores questions to be answered on community nights such as the PCR + Pizza night. Questions could revolve around misconceptions of synthetic biology in the media, genetic modification processes, etc. After questions are answered on those community nights, icons on the “Question” page when clicked could expand with a thorough answer. This suggestion came out of the observation that people come to the lab however what do these class attendees leave with besides a series of written processes, protocols and written results in terms of learning take-aways? How can people continue to be involved with Genspace after leaving the space? and how can questions be more efficiently addressed and engage people outside of the direct lab space in a way that would encourage them to come to Genspace?
• Workshop in relation to “Interpretation and Translation”:
  Artists/Designers/Public interpreting simple lab procedures such as DNA extraction to be featured with open source written protocols on sites such as “Open Lab Blueprint.” http://2014.igem.org/Team:Genspace/Project/Open-Lab-Blueprint The course of the workshop could be slower paced and more question based in order to facilitate sketching or additional note taking for interpretative making. Essentially, this workshop could facilitate an amassing of visual and written open source lab protocol content in a variety of interpretations in order to accommodate varying learning styles.
• Workshop revolving around creative writing and designing or interpreting lab protocols and procedures, perhaps “Storytelling of Lab Protocols through Poetry; how lab procedures and experiment results manifest in a literary form.” Evelyn Reilly, an ecopoet writes free verse poetry revolving around material and chemical compositions of man made materials such as Styrofoam in a form reminiscent of lab procedures. Poetry and lab protocols could be compared / contrasted and then merged in a literary form.

As I have continued to observe progress and lab protocols/ methods used by the Genspace iGEM Competition group, introductory biotech classes each week and interact with new-comers to Genspace during a “PCR + Pizza” community night and Kombucha and Ginger Bugs Fermentation Workshop (exciting research on the health benefits of fermentation for a range of health conditions, one of which is autismhttp://www.contrabandferments.com/– check out “Missing Microbes” by Martin Blaser http://www.nytimes.com/2014/04/29/health/missing-microbes-how-antibiotics-can-do-harm.html and a crowd-sourced, citizen science based project on mapping the human gut http://americangut.org/) I’ve focused my work on sketched visual interpretations of lab protocols to be used in classes and ideas around making this a more accessible space– the latter I believe is closely linked to visual communication and aesthetic of branding and communication to the public.

Focus Questions:

1. What learning techniques / answers are not being communicated well?
2. What isn’t being talked about in relation to Genetic Engineering?

Thanks y’all- stay tuned for more thoughts on under utilized forms of visual interpretation and considerations of the “wisdom of the crowd” in relation to current events.

Callie

What is a Biofeedback /Bio-responsive Game? | Boston Children’s Hospital | Yuko Okabe, BFA Illustration 2017

Neuromotion logo

With another two weeks having flown by, I’ve encountered several enlightening, challenging, and overall eye-opening experiences.  To summarize quickly here, I was able to meet and interview two patients about how they felt about a character that could support them through this game.  I  also met with the hospital’s Psychiatry Assistant Director of Outpatient, Dr. Lauren Mednick, as well as Director of the Developmental Neuropsychiatry Clinic, Dr. Joseph Gonzalez-Heydrich (one of the co-founders of Neuromotion along with my supervisor).  I also spoke with an art / expressive arts therapist who gave great advice about unconventional therapies and how mental health therapies are perceived in society.

However, for this post, I realize I should properly illuminate some details about biofeedback games, and their place in contemporary healthcare.

Little Henry in beautiful clip-art quality.

Imagine this:  a young boy (let’s call him Henry) has a hard time coping with his outbursts associated with his ADHD and anxiety disorder.  With his parents exhausted from finding suitable therapeutic coping skills, they hear about this new intervention: a biofeedback game promising successful emotional regulation and strength-building.

Luckily, Henry has the chance to test this new game in the works.  The small group running these test pilots meets with the young boy and his mother:  they help him get set up and they give him a small heart monitor to put on his wrist.

Henry’s mom explains to his son that he has to keep calm and control his heart rate to perform well in the game.   However, not really understanding  (or perhaps not even listening) to his Mom’s advice, Henry delves right into the experience.

The platform has several mini-games to play.  Let’s say Henry chooses the first one on the list. When it opens up on the screen, it looks like any normal game—the only weird thing is that there’s a small speedometer looking image on the bottom of the screen.  It has the colors green, yellow, and red.  Right now, an arrow pointed to the green zone.

Henry’s heart under stress in detailed Shutterstock quality

The game starts off easy.  But pretty soon, as the game starts getting harder, Henry starts to get more and more flustered.  And something surreal happens.  As his heart rate rises, the game starts to spaz uncontrollably.  He thinks its glitch, but he realizes that it’s too planned and consistent to be just that.  Looking back at the speedometer thing, he sees it’s at the furthest point in the red zone.

Henry loses the first game, and he’s very frustrated.  But his mother says, that if he stays calm, the game will work normally and won’t turn against him. So Henry plays again, doing his best to stay calm.  When the game starts getting more intensive, he starts to lose control of the functions. He looks over to the “speedometer” on the screen, and it’s inching into the yellow.

So he takes a deep breath.  As best he can, he clears his mind, relaxes his muscles, and keep going.

Henry’s heart once he learns to control his emotions during play!

Henry gets much farther into the game. Though the game doesn’t get any easier, he’s able to regulate his emotions better.  He constantly glances over at the bottom of the screen, doing his best to stay in the green zone.  Here, Henry makes the connection:  he understands the relationship between controlling his emotions and controlling the game.  He can visually see his heart rate change on the screen, and this gives him agency of his experience.  As his heart rate rises, he loses control (like in real life).  When he stays calm, he can master his experience. This would be the challenge for all the other games on the platform as well.

This is biofeedback in game form. And this is the innovation behind Neuromotion.

To provide a formal definition:

Biofeedback is a technique you can use to learn to control your body’s functions, such as your heart rate. With biofeedback, you’re connected to electrical sensors that help you receive information (feedback) about your body (bio).

This feedback helps you focus on making subtle changes in your body, such as relaxing certain muscles, to achieve the results you want, such as reducing pain. In essence, biofeedback gives you the power to use your thoughts to control your body, often to improve a health condition or physical performance.

From  http://www.mayoclinic.org/tests-procedures/biofeedback/home/ovc-20169724

The Neuromotion team’s ultimate goal is to help control emotional “dysregulation” in children struggling with mental disorders and symptoms.  Genuinely, they believe that in order for children to truly gain control of their emotions, they need to train their mind and body to handle stress levels; they need a platform that helps enhance motivation and create a more effective learning experience.

On the Neuromotion website, they express:

 Children are expected to control their emotions better as they get older. If they fall behind in emotional control either due to out of control anger or anxiety, this holds them back from succeeding socially and academically as they should. We believe that focused practice of emotional regulation allows children discover for themselves how to control their emotions better and that repeated practice of emotional regulation strengthens the brain connections that control emotions.

… As a society we badly need such tools so we are not forced to rely so much on medications to dampen anger or anxiety in our children. Medications can reduce anger and anxiety but they do not teach a child the skills that might reduce their need for the medications. Our work is aimed at reducing the push to put children on psychotropic medications by providing effective, affordable, and accessible alternatives.

From http://www.neuromotion-labs.com/

2010 – original game prototype, called RAGE-control with a heart monitor connected to the pinky. Read more here.

My focus, to reiterate, is to think about the “outer” part of the game (which we call the metagame).  There, we need to find  a convincing and engaging way for child users to navigate from game to game with ease and conviction.  A character can act as a guide, coach, friend, etc. to help monitor the child’s progress and keep track of goals.  What we need to think about further is what would really draw a child to this game?  Truthfully, some kids would be reluctant to do anything that calls itself “therapy.” How do we gain their trust?   How can we be helpful as well as respectful to their age? Also, some kids with emotional issues are not even convinced they even have these problems:  we have to work around these potential scenarios to reach as much of our audience as possible.  Because of these questions circling over my head constantly, I have to be aware of the introduction, the delivery, and involvement of this character.

2015:  Biofeedback Explanation.  Read more here.

Also, one of the most important aspect of this game is to make sure the child feels like they have control of not only their emotions but of the experience.  We live in a society (or just a world) where children have very few choice in situations.  This becomes especially apparent when a child has sort form of disability; many schools do not have very effective policies in place to support these individuals and students and families endure through painful measures to find the best quality education.  The lack of control makes it absolutely frustrating.  Sometimes, children can’t help but contemplate why the adults in their lives can’t help them as much as they could.

But maybe that’s unfair to say.  Adults make mistakes just as children do, but older people get more backlash for negligence or missed research.  It’s just the age standard we have in society—which makes sense I suppose.  In the end, what matters is that good-even great, amazing-research has been brewing in many parts of the world and Boston Children’s Hospital and Neuromotion have been tackling some of the toughest problems and solving them with care and creativity.

This reminds me:  before officially starting my internship, I met the Neuromotion team back in May just to get introduced.  After sitting down with my supervisor, Dr. Jason Kahn, he told me this:

You’re going to fail an awful lot.  But you know, failing means you’re doing something.  I can speak from experience so don’t get discouraged.

That’s probably the most comforting advice I’ve received in a while.

I’ll follow-up with another post to talk more about research and some ponderings.

Until then, have a good day!

Cheers,

Yuko

“I’m like an astronaut who’s spent a lot of time in space but is still pondering the nature of the universe”: My Introduction to BCH | Yuko Okabe, Illustration BFA 2017

The above quote was taken from one of the responses I got from my teammates to the question, ” Would you consider games as an art form?  A narrative form? Why?”   Earlier in his answer, he also reflected:

Games are interesting (to me, at least) because they cause your mind to twist, to try, to explore places that aren’t intuitive right in front of you. They force your mind to grapple with things in ways that aren’t the default way… Maybe games can activate neural pathways that are there but underused? Maybe games can rewire behaviors? I think it’s fascinating.

I asked a number of questions like this to my internship teammates this past week, and all of the answers have been insightful, witty, and very honest- I wish I can share them all!  I think it goes without saying that I feel very baffled and grateful for such a community that has opened its doors to the likes of a curious little Illustration student like myself.

Just to provide a bit of description, for the next ten weeks (or nine now) I will be collaborating with the Boston Children’s Hospital and their Psychiatry Department’s start-up called Neuro’motion to help develop characters and narrative to accompany their mobile therapy games.  My supervisor and I came to the agreement during my Maharam application process that children would be more stimulated to engage in therapy if they had a welcoming character to accompany them on this metaphorical journey.  The point is to design someone who can be a coach and even a friend; a human or creature who can track their progress and be there to give help.  To go about this research, I will interview individual children as well as gain feedback from hospital staff regarding psychiatric practices and its sensitivities.

A First Week:  Meetings, Introductions, and Fun People

Home space for the following weeks.

To illuminate on my initial experiences, on the very first day, I met up with my supervisor at his office space a few blocks away from the main hospital.  After some quick tours and introductions, we sat in his office space which he shares with Neuro’motion’s software engineer.  Both of them asked me to think of three things 1) Deliverables to the Team for Week 1, 2) How to Interview Children to Gain their Feedback, and 3) Questions for the team.
I took these tasks and organized my answers into a Powerpoint ( selected slides below).  I explored themes around character design while also trying to apply some innate therapeutic senses into my reasoning.  I wondered how to depict the character as “strong” and how that would compare to a character that would be either “comforting” or even more abstractly “heroic.”  What sort of personality would best help guide a child through therapy?  I also wondered what sort of resistance a child could have towards a main character:  “Why should I listen to him/her?”  “How do I trust them?”  “Will they make me feel stronger?”  “Will they make me feel too dependent?”  Coming from an Illustration background, I’m interested in learning the finer and more sensitive points about creating this character, and how he/she/they can both represent and advocate for an audience of children struggling to control their emotions.

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I’m scheduled to speak with the Children’s Hospital’s outpatient adviser next week so that she could help me organize my thoughts about how to go about interviewing and speaking with her patients.  I have ideas to make it an interactive dialogue by having drawings and word associations to help the child visualize who their ideal “coach” would be like.  I guess there’s also the question to how much depth the character should have.  Should the character be 100% confident all the time?  Should the character be more attuned to a child? Should they be deceivingly weak but end up being strong?  These are my hovering questions:  it’ll be interesting what feedback the kids will have!

A selection of character silhouettes I created for my first interview stages: “Which character seems strong to you?  Why?”

Back in May, I actually met up with the team just to get introduced to the hospital setting so I already knew everyone in the room.   Nonetheless, I was both overwhelmed and fascinated by all of the high-speed and articulate business-speak that these guys whipped out onto the table.  Of course, in the foggy and looming universe we know as the “real work world,” this obviously happens all the time.  But, being the scrawny collegiate with just a summer sublet and a handful of RISD workstudies to my adult name,  I found (and will continue to find) these meetings super eye-opening and helpful.

When it came to my presentation, I admittedly felt a bit strange transitioning  the topics from marketing and product testing results to my artsy thinking around character designs.  But it was pleasant to see how interested and excited everyone became.  They also appreciated the questions I had to the team and encouraged me to ask more along the way.

There’s a lot more I could reflect on, but I’d rather not overwhelm my first post.  However, I would like to share a sweet video about Hospital Empathy I learned about from a required “High-Reliability, Error Prevention Training” I attended this week.  Though more geared towards employees in the clinical setting, it was fascinating to get some insight and first-hand knowledge and transparency of the Hospital.

A snapshot from the video Empathy: The Human Connection to Patient Care

I will update in the coming weeks about my findings after interviewing patients.  Also, here are a few Q&As from this week ( I summarized answers for my own purposes):

What are the most vital components to successful therapy? What needs to be improved upon?

• Self-efficacy
  • Seeing and celebrating progress
• Supportive environment
  • Building external supports
    1. And then slowly taking away scaffolding
  • Good relationship
  • Invested therapists
  • Difficulties
    • Hard to measure outcomes with therapy
    • Hard to tell “good” therapy
      1. How to be a successful therapist
      2. Clients become skeptical

How do you balance a child’s desires with what a parent/clinician/(teacher) says is best for them?

• Convince that they’re playing a positive role
• Kids’ desires and parents’ desires are one in the same
• Kids often realize, by being in therapy, that something is “wrong”
  • they want to be “normal”
• Sometimes, a concordance about “presenting problem” and what is “clinically best”

What are three things a child should have to be truly happy? How has this changed since you were a child?

• To feel loved
• To feel safe
• Growth
  • Intellectual
  • Emotional
  • Physical
  • The “Self”
• Freedom and space
  • Exploring interests
• Material answer
  • Blocks, legos
  • Access to water
  • Something to read
• “80s, early 90s, kids could be bored and that let them think about things. Now it’s really hard to be bored.”
• Basic necessities
  • Maslow’s hierarchy

Cheers,

Yuko