Instructions for use of this template:

1. Instructions for use of this template: This PowerPoint was created by child life specialists on the Child Life Council’s Professional Resources Committee for use by professionals in the field. It may be used to educate multidisciplinary team members and students in your practice. You may use it “as is,” or you may customize it by adding graphics or photos, selecting only a subset of slides, or integrating some of the slides into your own presentation, as appropriate for your audience. Please include the next slide (slide 2) in your presentation, either at the beginning, or end. Please remove this slide (slide 1) prior to use.

2. Our Thanks to: The Child Life Council’s Professional Resources Committee, who provided a template to help in the creation of this presentation for our audience.

3. Child Life New [Medical Team Member] Orientation

4. What is Child Life? Child life specialists address the psychosocial concerns that accompany health care experiences by promoting optimal child development and minimizing adverse effects.

5. Basics of Child Life • Play • Therapeutic • Medical • Diagnosis education • Preparation • Support • Procedural • Emotional • Family

6. 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 *By 2022, all newly Certified Child Life Specialists will be required to hold a master’s degree • Minimum of 480 hour internship • Certification examination • Professional development hours to maintain certification • Adherence to the code of ethics and standards established by the Child Life Council

7. Play • Basic mechanism for learning and refining cognitive skills • Promotes supportive, therapeutic relationships • Motivation for movement therapy • Energy release • Creates an environment for formal and/or informal assessment • Reduces frustration and anxiety

8. How This Helps You • Opportunities to build rapport with child • Allows the child to feel a sense of control • Child is able to make choices • Increased level of cooperation • Allows child to experience a sense of normalcy within an unfamiliar environment

9. Therapeutic Play • Facilitates expression, coping, and mastery • Addresses a child’s need to problem-solve, resolve distress, and express feelings • Adult’s role is facilitator/reflector, not leader • Child-directed play in response to child’s own needs

10. How This Helps You • Increased coping skills • Expression of emotions • Relaxation

11. Medical Play • Therapeutic play in which children use medical themes and materials in their play • Gives children an opportunity to: • Express feelings or concerns • Become familiar with medical equipment • Increase understanding • Learn and practice coping techniques • Reenact healthcare experiences • Develop feelings of mastery • Communicate fears

12. How This Helps You • Coping • Compliance • Familiarization • Clarification of misunderstandings

13. Diagnosis Education • Child Education • Developmentally appropriate education regarding diagnosis specific information • Medical play related to diagnosis • Therapeutic play related to how the body functions with new diagnosis • School re-entry • Medical teaching dolls • Parental/Sibling Education • Provide resources • Address family issues • Medical play for siblings demonstrating patient’s care regimen

14. How this helps you: • Coping • Familiarization • Compliance • Becomes more involved with care

15. 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

16. How This Helps You • When children understand and gain a sense of control: • Increased cooperation from the child and family • Child knows his/her role for the procedure • Child knows what to expect • Choices • Cooperation is key • Child feels more in control • Only give choices when choices are truly an option

17. Procedural Support 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

18. How This Helps You • When a child has support during a procedure, he/she: • Can hold still • Has more control • Has more relaxed environment • Remains more calm • Parents feel like they are given a role and that you are including them in the process

19. Emotional Support • Allows patient to discuss previous hospital experiences • Provides an appropriate outlet for patient to discuss fears and concerns • Provides an opportunity for patient to discuss other factors that inhibit ideal coping

20. Family Support • Promotes family play and interaction • Increased family understanding • Increases sibling coping and interaction • Allows opportunity for family to discuss fears, concerns, and triumphs

21. What do these have in common? • Trach placement • New diagnosis • Amputation • Bowel resection with ostomy placement • Anoxic brain injury

22. Death and Bereavement • Provides developmentally appropriate education to family members of the deceased • Opportunities for legacy building and memory making by patient, sibling, and family • Increases sibling understanding of patient’s death through discussion, education, and therapeutic activities

23. How This Helps You • Parents appear to cope better when supported. This transfers to the patient who will take cues from parents. • If parents and patients feel supported and are coping appropriately, this makes the job of the medical team much easier.

24. Child Friendly Language 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.

25. Child Friendly Language When using child-friendly language for descriptions, keep in mind that children may not understand exact measurements. • When describing length: it’s better to describe an incision that’s “smaller than a penny” or “smaller than the length of a Barbie shoe” compared to “an 8mm incision.” • When describing time: it’s better to describe the length of a surgery as “about an hour, which is less time than it takes to watch a Disney movie” compared to “60 minutes.”

26. Developmental Responses to Hospitalization • Infant • Toddler • Pre-School • School Age • Teenage

27. InfantDevelopmental Responses to Hospitalization Common fears: • Separation from primary caregivers • Stranger anxiety • Pain • Parental anxiety, which is passed on to the infant • Anxiety due to either a lack of stimulation or over stimulation Ways to help: • Soft music • Use of pacifier • Encourage parental involvement/holding • Provide medical explanations to parent • Calming touch Developing a relationship where basic needs are met

28. ToddlerDevelopmental Responses to Hospitalization Balance between becoming independent and having boundaries • Common fears: • Separation from their parents or primary caregivers • Loss of physical and emotional control • Pain • Needles • Ways to help: • Provide choices • Comfort item • Distraction • Encourage play

29. Pre-SchoolDevelopmental Responses to Hospitalization Working on learning new skills and becoming self-reliant without being made to feel as if they are doing something wrong. Very egocentric. • Common fears: • The unknown • Loss of body function • Pain • Needles • Ways to help: • Provide choice • Participation in procedure • Comfort object • Distraction • Assure procedure is NOT punishment

30. School-AgeDevelopmental Responses to Hospitalization Feel the need to accomplish a task and be successful without feeling not good enough or considered insignificant • Common fears: • Loss of body function • Loss of control • Pain • Death • Ways to help: • Full explanation/preparation • Allow child to ask questions • Participation in procedure • Encourage play and normalcy • Create opportunities for self expression

31. TeenageDevelopmental Responses to Hospitalization Struggle to find who they are and what they are to become • Better able to understand the complexity of the health care experience than younger children, but they still have fears and needs that should be addressed. • Common concerns: • Body mutilation • Loss of body function • Change in physical appearance • Loss of control • Loss of independence • Invasion of privacy • Ways to help: • In-depth medical explanation (if desired) • Respect for privacy • Offer choices • Encourage/facilitate communication with friends and other peers • Encourage engagement in ‘normal’ activities • Provide opportunities for self-expression

32. Child Life Department • Insert contact information/unit information

33. Questions?

34. Top Reasons to Call Child Life 1. Difficulty Coping 2. Life Changing Illness/Injury 3. Death or Impending Death 4. Scheduled Procedures or Surgeries 5. Compliance 6. Little or no Caregiver/Parent Involvement 7. Development Issues 8. School Issues 9. Non-Pharmacological Pain Management 10. Sibling Issues or Issues with Adult Patient