More than Tricks and Treats

Child and Adolescent Life Department at Duke Children’s soars, thanks to Spirit of Children philanthropy

By Miriam Sauls
Photography by Eamon Queeney and Shawn Rocco
Published as part of the Summer 2024 issue of Duke Children's Stories 

We put the “fun” in “funding,” declares Spirit Halloween, the country’s largest Halloween retailer. And signs of both fun and funding can be found at Duke Children’s — not just at Halloween, but year-round.

Spirit of Children, the philanthropic arm of Spirit Halloween, has been supporting children’s hospitals for more than 15 years. Spirit of Children has raised more than $127 million dollars in the U.S. and Canada through the generous support of Spirit Halloween guests, associates, and business partners, and nearly a million dollars for Duke Children’s.

“Our motto is to make hospitals less scary for children and their families while supporting the critical efforts of Child Life Departments,” says Nikki Balles, corporate director of PR and communications for Spirit Halloween. Through supporting the often-unsung members of Child Life, Spirit of Children is helping bring a spark of hope to families during their most difficult times.

Girl in a Halloween costume


The Duke Child and Adolescent Life team strives to ensure that every child’s medical journey is a positive one, providing support for coping with medical procedures and offering opportunities for play to help children understand and navigate their health care experiences. 

Child Life specialists have degrees in child development, human development, or early childhood education. They must complete an internship under the direct supervision of a certified child life specialist and sit for a test to become certified. Duke Children’s has 13 child life specialists: five who work in outpatient clinics, two in the emergency department, and six with inpatients.

Studies show that children respond better when they can see and understand what’s going to happen to them, and they develop better coping skills. “We work with medical dolls and show them equipment and walk them step by step through what to expect,” says Renee Hunte, MA, CCLS, manager of Child and Adolescent Life Programs at Duke Children’s.

When Child Life specialist Susan Budziszewski, MS, CCLS, was in college, she knew she wanted to work with kids, but the classroom wasn’t the right fit. One of her professors suggested she consider Child Life. Despite knowing little about the field, Budziszewski went to an interview and secured an internship. “After the first day of my experience in the hospital, I walked out realizing this was the work I needed to be doing.”

“I feel like I’m at my best when I leave at the end of the day and I’m tired because I’ve given 100% of myself to a patient and their family,” Budziszewski adds. “That’s what feeds me, knowing that I’ve done everything I could do for them, no matter how small.”

“It is gratifying when a child you have been working with says with great pride, ‘I was brave today,’’’ says Child Life specialist Grace Kirven, MS, CCLS. “It takes time for kids to build these coping skills, but it’s great to see when they achieve mastery over their situation and can advocate for themselves.”

Sometimes making sure children understand what is happening to them involves clarifying misunderstandings. Some of those misunderstandings are alleviated when a child learns a stretcher is a bed on wheels and that they are not “being stretched” or that there will not be an actual cat involved in their “CAT” scan.

Or it may be eliminating a more serious misconception such as when the anesthesiologist tells the child he is going to put her to sleep for surgery, and the child is alarmed because of a recent experience with a family pet being “put to sleep.”

“Sometimes our work is portrayed as the ‘play ladies’ just bringing toys or blowing bubbles, but all of those interventions have a purpose behind them. It’s great that Spirit of Children recognizes the importance of what we do and that we’re not just blowing bubbles for fun,” says Kirven.

It is gratifying when a child you have been working with says with great pride, ‘I was brave today.’ It takes time for kids to build these coping skills, but it’s great to see when they achieve mastery over their situation and can advocate for themselves.

- Grace Kirven, MS, CCLS


The funding from Spirit of Children has enabled Child Life at Duke to acquire sensory, educational, arts, and crafts materials, which are used to teach coping skills during medical procedures. Additionally, funding supports staff salaries. A Child Life specialist position was recently increased from part time to full time thanks to Spirit funding, and they fully fund one activities coordinator. Duke Child Life also uses Spirit of Children funds to assist with continuing education and conference attendance, as Child Life staff must recertify every five years.

Hunte points out that although Child Life does not charge directly for their work, they can save money when their interventions eliminate the need for extra services, sedation, or medication.

“For example, when a kid has an MRI, sometimes they have to be sedated,” says Hunte. “Our Child Life staff can prepare that child to have the MRI and avoid anesthesia, which also eliminates the time and money you would need for the anesthesiologist and a nurse.” This means they may be able to add additional patients to the schedule.

Through Spirit of Children funds, the program has been able to enhance its offerings, from purchasing materials to supporting staff; however, Hunte would love to see the Child Life program continue to grow so it can meet the needs of every single patient at Duke Children’s.

Spirit of Children hosts an annual Halloween Festival for their partner hospitals, including games, crafts, and a costume boutique for patients. Spirit Halloween representatives take a moment to celebrate with Duke Children’s Child Life specialists and a member of the Duke Health Pet Therapy team.

Tommy Atkinson, far right, local Zone Manager for Spirit Halloween, celebrates with members of the Child and Adolescent Life Team while presenting a $118,550 check — Spirit of Children’s 2023 fundraising for Duke Children’s.

Cami Polfuss, MS, CCLS, Duke Children's Child Life specialist and recipient of the CMN Hospitals 2024 Child Life Specialist of the Year Award, works with a young patient in a play room at Duke Hospital. Spirit of Children support funds Child Life activities at Duke Children's and other pediatric hospitals. 


One of the most poignant uses of Spirit of Children funding is the annual Pediatric Day of Remembrance. Parents who have lost a child in the last two years while in the hospital or after they have returned home are invited to spend a day together. After using different venues over the years, last year the event was held at the Museum of Life and Science in Durham and was a tremendous success, so it will return again this year.

“We found that families didn’t necessarily want to feel like they were going to another memorial service for their child. They had already done that,” says Budziszewski, organizer of the event along with a multi-disciplinary committee. “They just wanted a chance to reconnect with the staff who had become their community, their second family, who knew their child the way they did, and to be with other parents who have experienced the same devastating loss.”

The Museum of Life and Science was an excellent partner, according to Budziszewski, and the response was outstanding. Spirit of Children funding enabled the team to purchase museum tickets so that families could explore the museum after the program, which featured hospital staff and parent speakers and a generous array of food and arts and crafts.

A butterfly release in the museum’s Butterfly House in memory of the children ended the event. “It was really powerful, and we couldn’t offer such a great experience without the help of Spirit,” says Budziszewski.


Spirit of Children recognizes that many kids in the hospital miss out on normal childhood milestones, and that an easy way to combat that is to bring the milestones to them. Each Halloween season, Spirit of Children organizes Halloween parties at their 159 partner hospitals. Spirit Halloween stores send store associates to assist with the festivities and loads of costumes for kids to keep.

Spirit of Children hosted a Halloween festival last October at Duke Children’s, a fun and visible example of Spirit of Children’s impact and care for kids; but the support for the tireless Child Life work that goes on behind the scenes at hospitals like Duke Children’s is the driving force for their philanthropy.

Spirit of Hallowen 2

“We could never have imagined the impact Spirit of Children would have when we first started this program, but through the incredible efforts of our team and guests, we have seen many magical moments shine a bright light on what’s often a dark time in children’s lives,” says Spirit’s Balles.

“We are honored to provide critical Child Life resources for Duke Children’s and other pediatric hospital partners,” says Tommy Atkinson, local Zone Manager for Spirit Halloween, who recently visited the hospital as part of presenting a $118,550 check representing Spirit of Children’s 2023 fundraising for Duke Children’s.

“As a father of two boys, and like many parents, my biggest fear is something happening to them,” adds Atkinson. “I can’t imagine what these kids and families are going through, but being a part of a company that does so much for them during a scary time evokes a lot of pride.”

As a father of two boys, and like many parents, my biggest fear is something happening to them,” adds Atkinson. “I can’t imagine what these kids and families are going through, but being a part of a company that does so much for them during a scary time evokes a lot of pride.

Tommy Atkinson, Spirit Halloween


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