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The Puppet Toolkit is devised by artist Siobhán Clancy, Artist in Residence on Helium’s Fireflies Project at Temple Street Children’s University Hospital and a Lead Artist on Helium’s Two Suitcases community film project.

Puppet Toolkits

Siobhán Clancy

The Puppet Toolkit is devised by artist Siobhán Clancy, Artist in Residence on Helium’s Fireflies Project at Temple Street Children’s University Hospital and a Lead Artist on Helium’s Two Suitcases community film project. Siobhán was one of the artists on the Puppet Portal Project, our first hospital residency programme (2009-2010). Children in seven hospitals across Ireland created puppets and shared their stories, performances and short films with peers in other hospitals via an online live video-link facility.

A puppet can be any inanimate object. It is up to the puppeteer to breathe life into it to make it seem animate and capture the attention of the onlookers. A puppet can be made from any material. For tips on materials and equipment when working in healthcare settings, check out ‘What’s in the case?’

Accessibility and Healthy Processes


Issues around access are more likely to be physical because when it comes to puppetry, it is easy to adapt activities around needs. Helium Arts subscribes to the social model of disability with regard to how we address disabling conditions experienced by our participants.

For an insight into social accessibility issues and how to deal with these, check out ‘Connecting with Patient Experience: Participation – The Basics.’ Some participants will have restricted mobility and/or movement. Choose objects or set ups that can accommodate these restrictions. Remember that through performance and play, puppets can offer a very effective means for the puppeteer to address the experience of these restrictions, to imagine opportunities for their accommodation, subversion or solution and to celebrate progression on the journey of recovery and wellbeing.

One of the participants on the Puppet Portal Project was undergoing neurological rehabilitation: he was in a wheelchair because his mobility was temporarily impaired, he found it hard to speak and therefore, express his feelings verbally, his understanding of language was impaired and he was suffering from short-term memory loss. At his first Puppet Portal session, his puppet didn’t speak but it communicated by nodding and waving at the other puppets on the video link and at the end of the performance his puppet started singing softly. At the second session, he created another puppet and this puppet was shy but was able to whisper sentences. By the third session, he had created a puppet with more mobility and this puppet lived Under the Sea. In session four, his speech had improved and he created a puppet with superhuman powers who was able to fly made from latex gloves. By session five, he was recovering well and his puppets were getting more mischievous.

For participants that have reduced strength, select light materials that they can move easily e.g. muslin on a coffee stirrer or string. Another option is for the facilitator to supply light puppet material and create the puppets according to the directions of the participant, then rig the outcomes to a structure which the participant can manipulate easily by pulling strings (see below).

The puppet performance area can be built on any surface that is most convenient for the participant to play or perform on e.g. a bedside table on wheels, a tray that can be placed on a wheelchair, an easel etc. We once built a puppet stage for the surface of a trolley table using a self-assembled goalpost.

Alternatively, the facilitator can ‘build’ a puppet on their hand or foot directly using a sock, glove or slipper, adding all the features of a puppet according to the input of the participant and interact as the puppet develops. The puppet can be removed and replaced as and when the participant decides they want to play. This works especially well with bed or wheelchair-bound participants.

We also recommend incorporating medical implements into puppet-making. We have found these can be positive for a number of reasons. In many children’s hospitals, paediatric staff have found it beneficial to indulge in this kind of ‘animation’ of inanimate objects to reduce anxiety around the use of equipment. For example, the Hickman Line which is inserted into children’s bodies prior to chemotherapy treatment is called ‘Freddie’ and the staff chat to children about their Freddies and how they are helping. Beaumont Hospital has a handmade book created by a play specialist that describes the role of ‘Freddie’ through photos in a story format.

In Helium Arts, we incorporate medical implements all the time for these reasons:

– To make young people more comfortable handling the implements, talking about their purpose and asking questions if they have any

– To acknowledge young people’s knowledge of what the implements are and to recognise their expertise in how best they can be used

– To nurture the sustainability of creativity by facilitating modification, story development and imaginative play with objects around them

– To make medical equipment feel like everyday objects and to support the relaxation of young people in their presence

The sterility of medical implement design can intimidate young people who are used to softer textures, brighter colours and appealing shapes. How they encounter these implements is usually part of a power dynamic in which they are the medical subjects of authoritarians such as nurses and doctors. The best bedside manner in the world does not change the fact that children experience these encounters as having things done to them which can be disempowering even when it is comforting. By putting the implements in their hands and allowing them to be repurposed, we aim to subvert this power dynamic in the mind of the young person and give them a sense of agency in the usage of the implements. This approach can facilitate humour and critique, all of which reinforce the intellectual authority of young people and helps to build their resilience, making them feel more confident and relaxed when they encounter the implements in other, less creative tasks.

Healthy Processes

As with any creative process, opportunities for self-expression can often bring forward very personal insights. Puppets are very particular because they allow the puppeteer to project their emotions and ideas and animate them. They also facilitate total fantasy and escapism. We recommend simply observing how a young person plays/performs and not reacting immediately to the outcomes, bearing in mind that the line between fantasy and reality in this artform is very blurred. For example, the very fact that puppets can be brought to life inevitably means they can be put to death and many murderous scenes will play out for no more sinister reason than a young person’s desire to explore themes of power and their own agency in very simplistic terms. Professionals are advised to discuss your observations with staff who work closely with the participants according to a pre-agreed report process, particularly if you have any cause for concern. Parents meanwhile are encouraged to use your judgement and discuss any questions you have with your child after the experience before pursuing professional support.

Hygiene and Infection Control

It is critical that materials used in workshops with participants whose health is compromised adhere to the highest standards of quality and safety.  Feathers, felt, fabric and other fun materials can easily spread bacteria through the accumulation of dirt or dust or simply through contact with naturally occurring oils from the body that become absorbed. Even paper is a concern because of its absorbency potential.

Follow these basic steps to avoid infection:

– Limit access to materials and tools by multiple users.

– Advise users (including yourself) to wash hands and use a sterilising hand gel before and after using tools.

– Wipe down tools with sterilising wipes before and after use.

– Thoroughly clean your storage for materials at the beginning of every day before use.

– Replenish art material stocks frequently. As this is likely to eat into budgets, it is advisable only to remove from packets as much as you feel is needed per interaction and not much extra.

– Where possible, return tools to containers that are cleanable such as jiffy bags and use them as little as possible in non-sterile settings.

– Use a vacuum or, for sensitive items, a handheld air pump to remove dirt or dust particles.

– If a tool cracks or breaks, place tape over the area to prevent cutting/scratching risks. Replace the tape after each user. Replace the item as soon as possible.

– Wash any cloth-based materials immediately after use.

– Bring materials in unopened packages into isolation wards and leave them behind to avoid cross-infection.

Puppet-making & storytelling techniques

Puppets are centuries old and have delighted many inter-generational audiences. Neither the humour nor the performance style needs to be limited to youth audiences. After all, Punch and Judy shows were originally intended for adults but later adapted to be more appropriate for children in the Victorian era. Spitting Image was a British television series that modernised puppetry as an effective form of political satire. Sesame Street used puppets as a means to capture the attention of all ages in the development of literacy skills and is one of the most successful examples of educational entertainment.

Reminiscence is an approach to work with older participants that draws on memory and historical narrative. Puppetry is useful in this field as a means of connecting to the past through personification, costume and the oral arts such as singing, storytelling and poetry. Reminiscence also might incorporate the use of old photos and other media, memorabilia, souvenirs, recipes and more. Karrie Marshall recommends the use of puppets in dementia and gives strategies for using puppetry in daily care and step-by-step instructions for making puppets in her publication, Puppetry in Dementia: Connecting with Joy and Creativity (2013).

Puppetry is an artform that is incredibly close to play and as such is provides a very fitting entry point for a lot of children into the arts.  One of the differences between puppetry and play is that where play is free-form, puppetry is usually more structured and involves repetition through rehearsal and performance. The use of props and prompts in performance support the memory skills required in story-telling. The rituals of performance like curtain up, the traditional placement of audience and the bow at the end provide a structure for learning about and subverting traditional artistic formats. For older children and teenagers, puppetry for film tends to interest them most. They seem to get most enjoyment from tabletop puppets or stop-motion animation puppets.

Whoever the audience may be, puppetry offers a great medium for self-conscious participants (and their parents) as it shifts the focus off the story-teller(s) and places it instead onto a puppet(s). In health contexts, this can be helpful for anyone self-conscious about the effects of their condition on their bodies, with these temporary or long-term attributes positively integrated in the characterisation of a puppet to entertain and educate. Storytelling methods can be combined with rehearsal techniques to build confidence in performance and draw in audiences with compelling narratives.

Facilitating performance development

There are many different ways to devise stories collectively. Good warm up activities include:

Two Truths and a Lie
Each participant in turn tells everyone 3 things about themselves. One of these things is a lie and the others must guess which one.

Wally’s Wallet
Everyone donates one thing from their pockets/bag to put into Wally’s Wallet. In turn each participant draws an item and builds on a story about Wally and what he has done with each item.

A variation on this exercise is ‘What’s in the Bag’ where each participant draws something from a bag of random objects and must continue a story told by the person before that incorporates the new object.

In turn, each participant starts a sentence with fortunately or unfortunately that is a continuation of a story told by the person before.

A Day in the Life
Participants describe the events of an invented character’s life hour by hour over the course of one day.

Toss the Dice
(similar to how Rory’s Story Cubes work)
Participants can draw symbols onto each of the 6 facades of one or more cubes. Then in turn, they must roll the cube(s) and tell a new part of a story inspired by the symbols on the top face of the rolled cubes.

Retell a Classic
Participants choose a well-known fable, fairytale or myth and retell it as it might have unfolded if it were set in a different location, time or with alternative characters.

Prompt Cards
Each participant can write one word on a card(s). They then take turns drawing a card and using the word to inspire the next part of a story.

We also love to use the exercises in Augusto Boal’s ‘Games for Actors and Non-Actors’ to create performance content for puppets. Our favourites include ‘The Hannover Interrogation’, ‘Allegory Rehearsal Style’ and ‘Long Beach Telegram’. Forum Theatre techniques developed by Boal offer great starting points for critical reflection on social themes related to health, identity, power and autonomy.

Merits of puppets

Puppets provide:

– Fun physical exchange

– Play and self-expression opportunities

– Humour, originality and spontaneity

– Real and online interaction (via live streamed or documented performances)

– Enhanced perception

– Channels for creative energy

– A forum for artistic expression and production

– Enhanced memories

– Opportunities to develop relationships

– Promotion of diversity

– Broadening of knowledge (of self, abilities and artistic processes)

– Prevention of feelings of isolation

– Enhanced experience of transitional spaces

Types of puppets

Over the years we have made many different puppets using lots of materials. Our favourites involve found materials from the environment around us. Here are our top ten puppets:

  1. Rattle puppets – insert beans or seeds inside a container and decorate with a puppet face. Use the rattle as a mode of communication.
  2. Rod Puppets – build a puppet that can be placed on the end of a long rod at a right angle and moved across a stage easily.
  3. Glove Puppets – build a puppet on a sock. This one will require fabric glue or another strong adhesive. Be careful when choosing your adhesive in case of toxic fumes.
  4. Stick Puppets – this is a smaller version of a rod puppet using upright lollipop sticks and felt or card. They are handy for ‘Punch and Judy’ type stages where they can pop up and down.
  5. Finger Puppets – take a piece of card and cut out two holes to fit index and middle fingers to be the legs of the puppet. Outline the shape of a puppet around the holes and decorate. These puppets are especially good for football and dancing-themed shows.
  6. Marionettes – create a jointed puppet operated by strings from above the performance space. Light materials are recommended for these puppets.
  7. Wrist Puppets – these puppets are great for any performer with limited mobility in their hands and/or fingers. Part of the performance can be building the puppet on the participant, following their directions on what decorations to use.
  8. Giant puppets – these puppets are similar in size to the performer and might incorporate the performer’s own body e.g. the arm or feet of the puppet is the performer’s arm or feet.
  9. Tabletop Puppets – these are like stick puppets or card puppets that are placed flat against a backdrop on a horizontal surface. The action is viewed from above looking down. The backdrops, which are two-dimensional, can have skewed perspectives or use layers to give the illusion of space and three-dimensionality. This works especially well when recorded on video.
  10. Shadow Puppets – these puppets consist of cutout shapes in card that typically perform behind a paper or cloth that is back lit so their shadows are projected onto the performance space.
Rod puppet & glove puppet (Puppet Portal Project)
Finger puppet (Puppet Portal Project)
Wrist puppets (Puppet Portal Project)
Shadow puppets (Cloudlands Project at University Hospital Galway)

Bringing a puppet to life can be done in small stages and is lots of fun. Try the following out when you have built your puppet:

  • Make the puppet perform a breathing motion, rising and falling gently with breath.
  • Make the puppet ‘wake up’ i.e. roll, move, stretch, yawn, smack tongue against teeth, open eyes/make eye contact with audience, jerk awake, shake out.
  • Make the puppet do exercises – touch its toes, do star jumps, do scissors jumps, jog on the spot, do yoga poses etc.
  • Make the puppet walk – choose different kinds of gaits e.g. stroll, canter, dash, race, sidestep, dance, drag feet, jog etc.
  • Practice different expressions/gestures and tones of voice according to moods e.g. sadness, happiness, excitement, joy, anger, despair, boredom, indignation, fear, surprise, shock, calm, impatient, giddy etc.

Planning and evaluation methodologies

For professionals, before you embark on any project it is useful to have a support system built into the delivery of your initiative focused on the wellbeing and creative development of the participants.

Previous projects we have coordinated have involved some or all of the following personnel (depending on the scale of the project):

  • Artist
  • Artist Mentor
  • Project Manager
  • Line Manager
  • Healthcare Co-ordinator (key point of contact within hospital / healthcare setting)
  • On-site healthcare staff (e.g. play specialists, hospital school staff, nurses etc)
  • Documenter
  • Independent Evaluator

Planning typically requires the following:

  • Clear statement of Project Aim
  • Breakdown of Project Objectives
  • Overview of Anticipated Outcomes
  • Details of an Evaluation Strategy
  • Details of a Publicity Strategy with key dates for drafting/design, sign off and publishing of content

Often the items listed above will need to be outlined in a Memorandum of Understanding (MOU) for the information and approval of the health partner that will co-produce or facilitate your project. The MOU should also refer to your Health and Safety Statement, Consent Process, Infection Control Guidelines and Child Protection Policy.

Reflection is a very important and useful process to develop on artistic experiences. Everyone participating in puppetry can take time to reflect and then follow up:

– Discuss what worked and what didn’t (or what was most and least fun)
– Consider what themes, ideas and processes emerged

Documentation of Work in Progress

We recommend that you document the work-in-progress and find ways to share it in order to increase the ‘moments of celebration’. Gathering feedback from observers of the process is a good way to motivate participants in their progress and to create a build up to the final performance or screening.

For more information about documentation see ‘Connecting with Patient Experience: Participation – The Basics’.

Practical resources for puppet-making and performance

We have outlined each stage of developing a puppetry performance so the process can be replicated by all interested in trying out this art format.

Stage 1: Pre-Production

  • Allocate roles and outline the responsibilities involved in each role
  • Draft a contract for participation (e.g. Listen to one another etc.)
  • Draft consent forms if the performance will be documented
  • Brainstorm a story theme
  • Outline the main events of the story through improvisation or by using a storyboard
  • Improvise or write a script
  • Rehearse the story and adapt as ideas for improvement are developed
  • Gather materials for construction of puppets, props and stage
  • Gather equipment required for documentation
  • Design and send invitations/put up posters to attract an audience
  • Perform a ‘tech’ rehearsal to make sure that lighting, stage design, sound design etc. work on cue and to ensure that all equipment is tested and ready.

Stage 2: Production

  • Perform a ‘preview’ and invite audience feedback
  • Incorporate feedback in adjustments to the performance
  • Perform again

Stage 3: Post-Production

Edit any documentary footage using appropriate applications. We recommend the following:

  • Edit photos with Photoshop Elements (a more affordable version of Photoshop). Make PowerPoints or slideshows with Google Slides. Share images online using Flickr (private albums can be created).
  • Edit audio with Audacity (a free sound editing application). Share podcasts using SoundCloud.
  • Edit video with YouTube Movie Creator, iMovie or Windows Moviemaker

You may like to burn the documented footage onto discs or copy it onto USB drives to share with participants, always ensuring the necessary permissions are in place.

You may also consider submitting the content to exhibition opportunities or festivals, with consent in place to do so.

Below are some handy links for more tips on using technology in your project!

Digital Photography

For tips on digital photography using a mobile phone or camera see:


For post-processing images, navigate to this tab on the same site:


Digital Videography

For tips on digital videography, check out the Vimeo Video School:



Good advice on using social networking tools can be found at www.webwise.ie

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