1. Child Life

2. What is Child Life?
Child Life Specialists help children understand why they are in the hospital. We do this by explaining procedures, tests, or a new diagnosis they might have. We also provide support and distraction during those procedures and tests.
You may choose to add a picture of your Child Life Team to give a visual to your audience. Pictures of the playroom and other specific areas give a good visual and can add some local “color” to the presentation.

3. Certified Child Life Specialist Professional Standards of Practice
Minimum bachelor’s degree or master’s degree with specific coursework in human growth and development, family studies, psychology, and related fields
Minimum of 600 hour internship
National Certification examination
Professional development hours to maintain certification
Adherence to the code of ethics and standards established by the Child Life Council

4. Basics of Child Life Play Preparation Support Diagnosis Education
Basic Play
Therapeutic
Medical
Preparation
Support
Procedural
Emotional
Family
Diagnosis Education
Death and Bereavement
Developmental Play
Theraputic Play

5. Additional Aspects of Child life
Patient Goals
Pill Swallowing
Schedules (long term hospitalization, behaviors)
Children of adult patients
Pediatric traumas in the ED
Sibling Support
Preparing to see siblings
NICU sibling visitation day
Normalizing Events in the Hospital
Community Events
Kids Fair
Teddy Bear Clinic
Flu Shot Clinic

6. Preparation
The communication of accurate, developmentally appropriate information prior to a healthcare experience
Includes:
Reason for procedure
Anticipated sequence of events
Sensations that accompany the experience
Preparation materials
EEG Preparation
Preparation materials include, but are not limited to: medical play kits, medical play dolls, photo prep books, surgery prep videos, pre-surgery tours
Evidence validating that most children prepared for medical procedures experience significantly lower levels of fear and anxiety compared to children who are not prepared. Preparation also promotes long-term
coping and adjustment to future medical challenges.

7. Child Friendly Language
Word
It’s Not…
In the hospital, it is:
I.V.
A poisonous plant
Medicine straw
Dressing change
Changing your clothes
Putting on a new bandage
Stretcher
Stretching your body
A bed on wheels
Move to the floor
Lying on the floor
To a different room on another level of the hospital
Leads
To take you somewhere
Stickers on your chest to listen to your heartbeat and your breathing
Urine
“You’re in”
Pee
Other examples: RN couldn’t get IV for surgical patient, told her she would get it “in the back” meaning OR patient thought she meant in her back
Tourniquet: blue rubber band
This chart is adapted from: Gaynard, L. et al (1998). Psychosocial care of children in hospitals: A clinical practice manual from the ACCH child life research project. Rockville, MD: Child Life Council.

8. Prep for an EEG Prep book reads like a book Tells each step including:
What they will feel, hear, taste, see, smell
Gives patient appropriate choices
What their “job” is during each step (if have one)
Appropriate choices:
do you want to sit by yourself or on Mom’s lap?
Would you like soda or juice to take your medicine?
Not: are you ready for your IV?
Jobs: help child feel in control, gives them something to focus on

11. Important to see if have questions, provide teach back: do you remember what your jobs are?

12. Procedural Support/distraction
Because some procedures may be lengthy and anxiety-provoking, procedural support and distraction can be utilized as a patient’s choice to engage in an activity to keep their focus on something else (such as an I-Spy book, a View Finder, or a game on an iPad) rather than the procedure alone.
Non-Pharmacological Pain Management
Sensory
Positioning, holding, pressure,
motion, rocking
Cognitive/Behavioral
Preparation
Thought stopping, guided imagery, distraction
Validate child’s feelings and words
Relaxation, deep breathing
Here is some information that can be referenced:
one voice should be heard during procedure, encourage parental involvement, prepare patient before the procedure about what is going to happen, validate child with words & feelings, offer the most comfortable, non-threatening position, provide individualized support including appropriate distraction, eliminate unnecessary people not actively involved with the procedure
Sensory
Positioning (comfortable and non-threatening), holding, pressure, motion, rocking
Cognitive/Behavioral
Prepare the patient for the procedure
Thought stopping, guided imagery, distraction
Validate child’s feelings and words
Relaxation, deep breathing
Distraction during PICC line

13. One Voice One Voice What does it look like?
One designated person speaking to patient before and during procedure (can be a staff person or parent/guardian)
When can it be implemented?
During any procedural preparation and during all procedures
How is it effective?
The child focuses on one person and more easily engages in distraction
video of "one voice" child life
Debbie Wagers

14. Comfort positioning What is it?
Positions to sit in/be supported in to promote comfort for the child as well as immobilization for success of the procedure
When/How can it be implemented?
For procedures – most commonly IV starts, NG placement, blood draws, injections
Why should we use it?
Standard of Practice in Children’s Hospitals Nationwide
Children who are calm before the procedure will react with less intensity than children who are already upset for other reasons (Korner and Thoman, 1971)
Procedures require less time and fewer staff
Parent or caregiver participates in positive assistance, not negative restraining
By letting a child sit upright during a procedure, they will feel more in control of their body, and are more likely to stay calm and compliant

15. Distraction tips Ask child what they would like to do, make a plan
Taking turns
Conversation
Ask about school, pets, siblings
Some of my favorite distraction items:
Bubbles
I spy/look and find books
Songs (toddler tunes)
Favorite video/show

16. Recent Article- April 2018 Abstract
The goal of this study was to determine the value of a certified child life specialist (CCLS) on the patient and staff experiences in an epilepsy monitoring unit (EMU). We integrated a CCLS into the EMU for all children as well as adults with intellectual disability. We surveyed families to determine the impact of child life services on their stay. EMU staff completed questionnaires to determine perceived impact to their job performance from the integration of the CCLS. All of the families (pediatric and adult patients) who responded to the survey reported the presence of the CCLS improved their hospital experience. Staff reported that the CCLS improved their daily work by allowing them to focus on their assigned medical duties. This preliminary pilot study suggests that CCLS can have a strong impact on the experience of patients and staff in an EMU.
Clinical Pediatrics
2018, Vol. 57(11) 1269– 1274
Families reported presence of CCLS improved their hospital stay
Staff reported CCLS improved their daily work, allowed them to focus on assigned medical duties

17. Questions???
Contact Information:
Bridget Ullery, CCLS, CTRS
Child Life Coordinator
WVU Medicine Children’s