[RSimmons]

Perfectly reasonable questions. I'll try to answer them for you.

We use a cord material that is a little less than 1/16 inch in diameter and appears to be almost indestructible. It can be tied and retied many, many times. Each child enters the program with a 3 foot strand of cord and their first name spelled out in letter beads. Beads get added to the strand as they progress through treatment.

One of the aspects of treatment is that there are long periods of boredom, along with varying degrees of feeling crappy. Many of the kids will unstring, re-sort and restring their beads just for entertainment value. Some don't use the strings and keep them in boxes or special bags. One thing, though, is that no matter how they are strung (or not) they can generally tell you in detail what they got any individual Courage bead for and when they got it. The strings of beads often become a point of pride with them as they can show you very directly just how far they have come. When they see other kids with longer strings it is actually an encouragement - sort of 'if they can do that so can I'.
When one string fills up, they get a new one. The strings get worn, strung up on IV poles, strung around the room and are displayed in all manner of other ways. Many of the caregivers wear bead strands as well, so there is a strong bond and an identity built along the way. I always wear mine when I go on a site visit and the kids notice right away. I make an extra bead for my own strand when I fill a special request as a link to that child. It's a very special thing to go to visit kids who have one of my beads or when I recognize a bead made by someone that I know. I can tell them something about the artist and let them know that there really are special people out in the world who are making the beads for them.
Good questions - thanks for asking them.

Robert