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About MAD Magazine. MAD Magazine. Collective name for "the usual gang of idiots," the various creators, authors, and illustrators of MAD Magazine. Many compilations of MAD Magazine parodies have been published, and individual author and illustrator credits are sometimes difficult to find. Books by MAD Magazine. Trivia About Mad Clowns Around. The game with the music box had been developed and elaborated upon during several admissions. The tinkling notes played by the child always induced yawns and sleepiness in the clown, as her head slowly subsided onto her arms.

When the music stopped, she sleepily raised her head and opened her eyes, only to subside again when the music began. There was always an expectant silence before the clown, eyes closed, became transformed and launched into her new persona, followed by gales of laughter from both the child and his father.

After about three transformations, the clown was allowed to wake up. The clown always left the room commenting on how refreshed she felt, and how restful it was to play with this child. Clearly, in a child's relationship with a clown, in this play space, the rules are different. The clown is a master at manipulating status 3. A clown, clearly an adult, can be hypnotized by a music box, and a child can require her to do silly or incomprehensible things.

The child feels superior, and is empowered: a very tidy turning of the tables for a patient who must cope with rules and regulations that could seem arbitrary and incomprehensible. Therefore, the continuing evolution of this play scenario encourages the child to take control in a situation where little control is possible. This story also illustrates the vulnerability of the clown.

The clown mask requires that we unmask , that we drop all our other masks and increase our sensitivity to others 17— Many clowns have commented on the necessity of enhanced antennae as they travel from room to room in the hospital. The experienced therapeutic clown will understand the careful balance he or she must achieve between true skills—whether in music, juggling or improvisation—and the need for qualities of innocence and the willingness to relinquish control to the child.

The therapeutic clown, in her interaction with a child and his father, uses gentle play and humor to relieve the stress of treatment for cancer. Both therapeutic clowns and clown doctors, create opportunities for humor and laughter in the health care setting. Many claims have been made for the physiological and psychological benefits of humor. Dr John M. Children don't understand these things, but they do understand the reassurance and fun that the CCU provides.

When a child begins to laugh, it means he's probably beginning to feel better. The clown's presence in the hospital setting adds yet another layer of incongruity. Both therapeutic clowns and clown doctors benefit from the humor they create by simply being there. Therapeutic clowns are out of place altogether. Clown doctors create humor by joining together the idea of the clown and the idea of the doctor, a concept that Arthur Koestler 22 calls bisociation. Central to the concept of fun, and an important prerequisite for the enjoyment of humor is a playful frame of mind For the child in the hospital, the clown comes to embody the spirit of playfulness.

When she is invited to step over the threshold, the space is changed and charged with possibility. The room suddenly becomes a playground, and the child is invited to come out and play. Building supportive relationships with patients and families is an essential part of the work of the therapeutic clown. As the music box story shows, the therapeutic clown and the child have played together over a period of several months, thereby establishing a trusting and supportive relationship.

The child and his clown friend have developed ways of playing together that are comforting and predictable. The therapeutic clown will always bring certain toys and the play will often unfold along familiar paths. It may be said that the therapeutic clown exists only in a state of potential, waiting to be fully realized in a relationship with a child or young person. Despite the fact that the therapeutic clown is a health care professional, he or she is perceived as coming not from the world of medicine but, as the family does, from the world of biography, the world of story In these ways, with bubbles and giggles, with face paints and wind-ups and pure play silliness, meaningful and supportive relationships are forged between the child and the therapeutic clown.

As a member of the health care team, the therapeutic clown is aware of the needs of other staff members as they work with the child. When it is appropriate, the clown can be a helpful distractive presence during medical procedures. In order to address some of these issues, therapeutic clowns tend to present with minimal make-up and costuming. A red nose and a hat, and a visually pleasing costume are enough to communicate the clown's identity. Therapeutic clowns learn how to approach babies, children, young people and their parents, and the staff, sensitively—for all of these are their clientele.

A well-trained therapeutic clown will watch for cues and react instantly if any sense of unease is present. For example, simple techniques can often reassure a patient or family member: keeping an appropriate distance, initially avoiding eye-contact, and minimizing physical presence by crouching down or turning sideways. Many therapeutic clowns use music as a way to bridge the gap between clown and patient or parent.

However, therapeutic clowning is not a popularity contest, and the clown must realize that on occasion, despite his or her best efforts and for whatever reasons, it is not possible to establish a therapeutic relationship with a patient. In this case, the clown gracefully withdraws, which action in itself can be empowering for the child or young person. Since children from all cultures play, the universality of play suggests it is an essential human function. Even in cultures where young children are expected to assume adult work responsibilities, literature provides examples of how children manage to integrate play activities into their daily work tasks Through play, children learn how to handle the world and the social roles in it.

For this reason, play becomes the predominant context in which children interface with the environment. In child development literature, the use of play as a therapeutic intervention is extensively supported where the benefits are shown to be profound and wide-ranging. Following a meta-analysis of studies, Fisher 28 concluded there was cogent evidence for the positive impact of play on child development.

Play was found to significantly promote cognitive and social aspects of development and these effects were magnified when adults participated in play with children. In pediatrics, research consistently cites the value of incorporating psychosocial care in children's health care Particularly in a pediatric context, play provides a protective factor against developmental delays, regressive behaviors and emotional withdrawal 30— For this reason, Child Life programs are essentially hospital play programs and they have become an integral part of pediatric psychosocial care.

These programs provide opportunities for hospitalized children to engage in play and to build therapeutic relationships based on these interactions. Within this context, several varieties of play can occur. For example, children traumatized by medical experiences require opportunities for both non-directive and directive forms of play.


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For the most part, child life philosophy supports a child-centered approach where the adult follows the child's lead during play, opting for more non-directive than directive experiences. Non-directive forms of play allow children to safely explore their environment at a time when they may perceive physical challenges and vulnerability. Distinctions also need to be made between therapeutic play and play therapy. Therapeutic play is developmentally- supportive and can include forms of enactments related to illness and hospitalization issues.

Play therapy , on the other hand, addresses basic and persistent psychological issues associated with how a child may interact with his or her world. Therefore, therapeutic play , in a less structured way, focuses on spontaneous phenomena as the child engages in play to aid mastery of developmental milestones and critical events such as illness and hospitalization. In particular, clowns are poised to create forms of play that tend to invite children to participate. For this reason, the presence of the clowns in this setting is extremely powerful, for clowns can go where other adults may hesitate.

Imaginary, story-filled spaces allow the emergence of play forms that may function as therapeutic metaphors for the child. A game of Hide and Seek may allow the life-threatened child to test whether or not he or she would be missed For example, the swelling and bursting of bubbles may speak to a child about the presence, growth or absence of a tumor A magic trick that transforms a small object into a larger one and back again may allow a child to express feelings about a changing body image during treatment As the play unfolds, the child's often profound concerns can be explored in a creative space that is both safe and comforting.

For the hospitalized child, playing with a therapeutic clown can provide opportunities for creative self expression as well as a welcome refuge from the stresses and challenges associated with illness, both of which support the notion that therapeutic play is indeed a form of complementary health care. Despite the growing number of clown programs, there exists a paucity of research on clowning.

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In particular, research is needed to evaluate the impact of clowning in health care settings, and more specifically how therapeutic clowns play a role in the well-being of pediatric patients, their families and health care providers. Furthermore, the few studies that have been carried out have not been widely disseminated.

Two pilot studies at Columbia University 38 , 39 , funded by the Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine, focused on the effectiveness of clowns as distractive presences during cardiac catheterization and invasive procedures in a pediatric oncology day clinic. Clinical researchers from a variety of disciplines hypothesized that humorous distraction provided by the clowns would increase patient cooperation, ameliorate parental anxiety and decrease the need for sedation. Results showed that during cardiac catheterization there were significant decreases in observed child distress, in child self-reported distress and parent-rated child distress with the clowns present.

As a result, physicians found the procedure significantly easier to perform with the clowns present. Clown interventions were non-toxic, did not cause respiratory depression, sedation or gastric upset. In addition, positive changes in the behavior and mood of health care providers were observed when the clowns were around. Long-term outcomes of the research included the successful implementation of clowns into medical settings in which there were no previous clown programs.

In summary, this research showed how the presence of clowns can improve certain aspects of the pediatric experience. Authors call on the need for further research on the bio-psychological benefits of clowns with sick children in less frightening settings. In a rare qualitative study, Aquino et al.

Twenty-seven pediatric patients between the ages of 4 and 12 participated in semi-structured individual interviews. Data analyses showed several important themes. Participants found the clowns to be humorous, which allowed the patients to laugh and be happy.

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In a review of the literature on laughter and humor, Bennett and Lengacher 41 , 42 note that humor acts as a coping mechanism to reduce stress and psychological symptoms related to negative situations. Some children noted that the playfulness of the clown allowed for distraction in that some children stopped crying during their medical procedures. Similar findings were cited in a recent Italian study by Vagnoli et al.

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The aim of their study was to investigate the effects of the presence of clowns on a child's pre-operative anxiety during the induction of anesthesia and on the parent who accompanied the child. The sample comprised 40 children 5—12 years of age who had to undergo minor day surgery. The anxiety of the children and parents was measured using standardized scales. The clown group was significantly less anxious during induction when compared with the control group. A questionnaire was also developed for health care professionals in order to ascertain their opinions regarding the presence of clowns during induction.

The questionnaire data for health care professionals indicated that the clowns were a benefit to the child, but the majority of staff was opposed to continuing the program because of perceived interference with the procedures of the operating room. This study provides a valuable contribution to the literature in that it validates the therapeutic benefits of the clown in a pediatric setting. Perhaps more importantly, the study identifies key issues for further exploration; namely, the significance of supportive health care teams for the development of innovative programs. Similar findings were identified in a study by Caprilli and Messeri 44 where some staff were hesitant to fully support a pet visiting program for fear it would interfere with hospital policies around safety.

Therefore, a critical aspect associated with the development and sustainability of new forms of complementary medicine rests on whether health care staff are well-informed and collaborative efforts are maximized. Clown programs at the Winnipeg Health Sciences Centre, British Columbia Children's Hospital, and the Children's Hospital of Wisconsin, among others have surveyed children, families and staff in their institutions.

None of this research has been published.

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Other research 45 , 46 examined therapeutic clowns and clown doctors and their programs rather than the specifics of their impact on the well-being of children. In , at the Hospital for Sick Children Sick Kids , the authors conducted a survey to address the impact of therapeutic clowning from the perspectives of pediatric health care professionals and parents of hospitalized children. Ethical approval was obtained by the hospital's Research Ethics Board. The purpose of the survey was 2-fold: i to provide an informal evaluation of the program and ii to obtain pilot data on the impact of therapeutic clowning with the objective of designing a future research study.

Two quantitative surveys were created; one for staff and another for parents.

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Surveys were administered to staff and parents on five in-patient units. Questions provided participants with a variety of responses or they could indicate their own. Recently, I met a young girl who could not wait to tell me her little pick-me-up speech. I loved it so much I had her record it on my They are all used as props in some of the tried and Leslie Ann Akin is a real clown. And she knows how to paint her lessons learned in such vivid colors, making We want to know you. Whaddya waiting for?! I have done business with some of these resources but not all of them.

Please do your due diligence before deciding to buy from any of these resources. Crickits Corner—Magic and novelties www. Clown Name. Email Address. Log-In My Account 0 Items. Jest for Clowns. Learn More. Purchase Now. Watch Our Video Leslie Ann was also a jazz radio deejay for twelve years in San Francisco and in began designing CD art for fellow deejay musicians.

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