Child life specialist

Child life specialists are pediatric health care professionals who work with children and families in hospitals and other settings to help them cope with the challenges of hospitalization, illness, and disability. They provide children with age-appropriate preparation for medical procedures, pain management and coping strategies, and play and self-expression activities. They also provide information, support, and guidance to parents, siblings, and other family members.

Background
A child life specialist in North America is a professional traditionally employed in the hospital setting. He or she focuses on the psychosocial development of children, and encourages effective coping strategies for children and their families under stress. Child life specialists recognize individuality in patients, and use a range of developmentally appropriate activities, including play, preparation for a medical procedure, education, self-expression, and family support to help cope with hospitalization, illness, or death and dying. Child life specialists are trained to take into account the cognitive, emotional, and physical development of each child in order to encourage optimum development of children facing a challenging experience, particularly one related to healthcare and hospitalization.

History
The field of child life began to flourish in the United States and Canada in the early 1960s through the pioneering work of Emma Plank who trained with Maria Montessori and used the principles of child development to promote appropriate care for this special population in the hospital. Prior to this time, it was not uncommon for parents to be excluded from the pediatric wards of hospitals except for brief visitation hours, sometimes just on weekends. Today, hospitals acknowledge the special emotional and educational needs of children by providing a child-friendly environment, as well as programs which facilitate the primary role of the family, and support which encourages adjustment to the hospital and to health care through the child's growing years.

Services
Child life specialists collaborate with parents and other health care professionals to meet the distinct needs of children in managing the effects of stress and trauma. Because children may feel overwhelmed, child life professionals help children gain a sense of familiarity and control of their environment through play and exploration inside the healthcare facility. Understanding that a child’s well-being depends on the support of the family, they also provide information, support and guidance to parents, siblings, and other family members.

Services that a child life specialist provides include:
 * Psychological preparation for tests, surgeries, and other medical procedures
 * Support during medical procedures
 * Therapeutic medical and recreational play
 * Sibling support
 * Support for grief and bereavement
 * Emergency room interventions
 * Hospital pre-admission tours
 * Outpatient consultation with families
 * Coordinate special events, entertainment, and activities for patients and their families
 * Educate caregivers, administrators, and the general public about the needs of children under stress.

Child life specialists work with patients and families in many settings, such as inpatient units, surgical areas, outpatient clinics, the pediatric intensive care unit, the emergency department, and the neonatal intensive care unit. Although child life specialists typically function in the hospital setting, their skills and training are often applied to support children and families in other settings, such as hospice, dental care, schools, specialized camps, funeral homes, or wherever children experience stress or trauma. In each of these areas, child life interventions focus on the individual needs of the child and family.

Interventions and pain management techniques
There are many physical, emotional, and cognitive stressors that accompany a hospital stay. Child life specialists use child-centered interventions and pain management techniques to work with the patient and family members to help them cope with hospitalization and medical procedures.

The interventions include: encouraging parent presence and participation in care; showing parent(s) how to participate and be involved; talking and communicating frequently with patients in a calm manner; advocating for pain management strategies to prevent child discomfort or pain; providing choices when appropriate; being realistic and truthful with children and adolescents; and providing "age appropriate" activities that foster a sense of accomplishment. Some of the pain management techniques child life specialists practice involve sharing music, favorite toys or objects, encouraging words and statements, singing, videos, comfortable positions and places, and using humor.

Education and certification
Child life degree programs at the bachelor's and master's level incorporate a variety of coursework, including child health systems, child life, the role of the child life specialist, the meaning and development of play, child life methods and materials, issues and processes, and alternative applications of child life. Many programs also include a practicum or internship. Some colleges and universities offer programs in child life, but other acceptable majors include child and family studies, psychology, child development, recreational therapy and early childhood education. Undergraduate coursework focuses on child psychology and prepares students for clinical work, post-baccalaureate work and certification. Internships and volunteer opportunities often are included as part of the curriculum.

A graduate program in child life, such as a Master of Science in Child Life or a Master of Science in Family and Child Studies, can further prepare an individual for a career as a child life specialist. Studies typically include advanced coursework in medical issues and coping strategies, as well as supervised internships. Those with a graduate degree also might find work as researchers or teachers.

The Child Life Council, a nonprofit professional association for child life specialists, issues the Certified Child Life Specialist (CCLS) credential. To achieve the CCLS credential, each candidate must attain a minimum of a bachelor’s degree, with a total of 10 college-level courses in child life or a related subject area, complete a 480 hour internship, and then must demonstrate an acceptable level of knowledge by successfully completing the Child Life Professional Certification Examination. Certification is maintained through the documentation of 50 or more professional development hours, which are reviewed at the end of every 5-year certification cycle.

Becoming a child life specialist
Employers vary in their requirements, but nearly all positions require that applicants hold the Certified Child Life Specialist accreditation from the Child Life Council. The CCLS credential currently is the only one in the field.

The number of child life jobs continues to rise. Virtually every children's hospital across North America has child life staff. Most children's hospitals are in large urban areas. The Child Life Council posts job opportunities in the Career Center section of its website and there are usually 15 to 30 jobs posted. To find a job in child life, it might be necessary to relocate to a different state.

Earning potential
Results from a child life salary survey in 2000 indicated that, "on average, child life professionals earned $35,593 but this varied based on the region of the country, position held, number of years of experience in the field, education level, certification status and size of the child life program. On average, individuals who were certified in child life earned $36,256, which was about $5,510 more than those who did not have the credential."

Changes in the field
Child life specialists are breaking through barriers every day to make the profession known to coworkers and community members. New and alternative ways continue to arise to help children cope with many different types of challenges that are associated with being treated at the hospital. More professionals are learning and acquiring this new vocabulary, known as "child friendly language", and are using it to effectively communicate with children and their families.