All children experience pain. Effective treatments exist, but this evidence is not translated into practice, resulting in undertreated and preventable pain. For example, hospitalized children experience an average of six painful medical procedures every 24 hours – over two-thirds of which are done without any pain management even though many simple, cost-effective, evidence-based solutions for procedure pain exist. Only one in four parents reports knowing how to use evidence-based pain management with their children and veterinarians receive five times more training in pain management than their physician counterparts. Poorly managed pain leads to negative short- and long-term health outcomes for children and families and detrimental impacts on the healthcare system. 

Solutions for Kids in Pain (SKIP) is a knowledge mobilization network based at Dalhousie University and Co-led by the Children’s Healthcare Canada (CHC), SKIP seeks to bridge the gap between current treatment practices and available evidence-based solutions for children's pain in Canadian health institutions. Dr. Chambers will review the evidence around the importance of children's pain management and provide examples of evidence-based pain management interventions. In addition, this webinar will introduce SKIP and explain SKIP’s role in supporting evidence-based interventions to clinical practice.

Participants will be able to:
-Demonstrate understanding of the impact of pain relief on children’s medical experiences

Suggested Domain: Intervention

Hospitalization can be stressful for child patients and their parents, and stress during hospitalization is associated with longer recovery times and negative outcomes post-discharge. As a result, families need psychosocial support to cope with hospitalization. Child life specialists in children’s hospitals are trained to address this need, and there is empirical support for many of the techniques used by child life specialists. However, there is limited empirical support specific to child life services. In the current study, the authors examined differences in child anxiety and distress, parent stress, and parent-child relationship quality between families who received child life services and those who did not. Participants included 31 children between 3 and 15 years old who were admitted to a children’s hospital in the United States and their parents. Children completed a drawing task and responded to a visual scale, and parents completed a survey. Results indicated children who received child life services tended to exhibit lower anxiety, but there were no differences in parent outcomes based on receipt of child life services. Overall, the study provides promising preliminary evidence for the efficacy of child life services in improving children’s psychosocial experience of hospitalization. Implications for practice and future research are discussed.

Value proposition statements are an increasingly common means of marketing the unique skills, traits, and outcomes associated with specific products and services –both in and beyond the healthcare industry. This free member webinar will examine the five value drivers of child life services as articulated by the Association of Child Life Professionals’ 2020 statement, “The Value of Certified Child Life Specialists: Direct and Downstream Optimization of Pediatric Patient and Family Outcomes.”Participants will delve into the often extensive, and other times still emerging, evidence base supporting the individual, familial, and institutional value of child life services and interventions. In addition, participants will encounter examples of the impacts of the value proposition statement on patient care and program development, while considering future opportunities for demonstrating our worth as a psychosocial healthcare profession.

1.Attendees will understand the concepts behind, rationale for, and process of the Association of Child Life Professionals’ value proposition statement. 

2.Attendees will examine the key findings of the value proposition statement, with attention to applications for clinical practice and program administration.

3.Attendees will learn practical methods for using the value proposition statement to drive quality improvement for patients, families, and healthcare institutions.

Suggested Domain: Professional Responsibility

Previous research has demonstrated that medical play intervention is associated with decreased pain, fear, and anxiety in children undergoing surgical procedures; however, these studies have typically examined one-on-one, adult-directed, and preparation-focused uses of medical play. Therefore, the purpose of this mixed-methods pilot study was to examine the impact of a group medical play intervention on children’s self-reported fear and observed anxiety in the pre-operative waiting area, and determine the feasibility of group medical play as a research intervention while balancing clinical care. Twenty children (ages 5 to 10 years) scheduled for a sedated surgical or medical procedure in the pre-operative services waiting area of a children’s hospital in the Southeastern United States participated in a 30-minute group medical play session facilitated by a Certified Child Life Specialist. At the conclusion of the group activity, participants used a pictorial scale to rate their level of fear about surgery at two distinct time points: prior to and after the medical play session. In addition, they responded to three open-ended prompts about their perceptions of the activity. Participant fear ratings were analyzed using a two-tailed, paired-samples t-test, revealing that the group medical play activity was associated with a statistically significant decrease in participant fears about surgery. In conclusion, group medical play as a research intervention was both clinically feasible and effective in reducing children’s fears about surgery, highlighting the value of group play opportunities for children’s coping in health care settings.

The ever-changing ethnic and cultural landscape of the United States drives the need to better understand diversity in its workforce. The purpose of this study was to conduct an equity audit in a midwestern children’s hospital’s psychosocial department to assess the perceived culture of the diversity climate. The goal of the equity audit was to uncover ways in which the department could identify needs and strengthen awareness towards the development of an inclusive environment. The equity audit was conducted in the form of a questionnaire addressing four main themes identified in workplace diversity research: physical environment, matching, communication, and leadership. Results showed that the culture of diversity appeared to be an optimistic one with many opportunities for growth and change. Overall, the questionnaire proved helpful in assessing the culture of diversity among professionals at the Midwestern Children’s hospital and identifying opportunities for awareness and inclusion.  

Pediatric patient populations are changing and healthcare environments are becoming increasingly more complex. Child life professionals must adapt to the realities of today’s healthcare spaces if they hope to make a difference in the lives of hospitalized children and their families. This paper explores some of the challenges associated with the current ways of thinking and theoretical orientations, which can impede professional growth and psychosocial care as a whole. For example, practice and scholarship continue to be guided by developmental theories, with little regard for how race and other social determinants may affect child health outcomes. As a way forward, child life professionals must consider engaging in a paradigmatic shift whereby new theories and approaches can address the realities of racial disparities and reject the antiquated views of childhood embedded within established developmental theories.

There is much variation in the way child life specialists implement and document their interventions and services, especially among practice arenas. This variation includes the methods child life specialists use to set individual goals with pediatric clients and families, as well as to evaluate the effectiveness of their interventions and services. The purpose of this paper is to highlight how goal attainment scaling (GAS) could and should be integrated into the daily practices of child life specialists working in a pediatric rehabilitation setting. GAS is a widely used individualized outcome measure, designed to assess whether individuals have achieved the goals of intervention by quantifying their progress (Kiresuk & Sherman, 1968). As there is currently no literature on the integration or utility of GAS as an outcome measure for child life specialists, this paper will critically examine the available peer-reviewed literature to demonstrate how and why GAS is currently being implemented in pediatric rehabilitative settings by other health care practitioners. Recommendations for the transferability of GAS in child life practice will subsequently be discussed to not only address this gap in knowledge but to further emphasize the benefits of using an individualized outcome measure in clinical practice.

Certified Child Life Specialists are a well-documented component of family-centered care; however because they typically work as members of multidisciplinary teams, it can be difficult to immediately recognize the scope of their contributions to health care research and practice. As the field continues to grow and evolve, it is even more essential that health care practitioners recognize, implement, and evaluate empirically supported child life services for patients and families across settings. Although the importance of scholarship for practice is well-recognized, there have not yet been any systematic analyses of the child life literature base. Therefore, the purpose of this study was to complete a scoping review of Certified Child Life Specialist authorship, participation, and presence in peer-reviewed journal articles published from 1996 to 2017. Results demonstrate statistically significant increases over time in research that is driven by and focused on Certified Child Life Specialists, as well as emerging trends in populations and interventions studied and the publication outlets in which these articles can be found. These findings highlight that although child life presence in research is increasing, there is more work to be done to improve academic and clinical training related to research, to expand the literature base as it stands, and to advocate for the inclusion of Certified Child Life Specialists in collaborative scholarship to improve psychosocial care for children and families.

Certified Child Life Specialists (CCLS) work within a complex medical system, comprised of multiple interpersonal relationships including those with their immediate supervisors, peers, and non-child life medical staff. The job demands of a CCLS often place them in situations that involve high levels of stress and anxiety, placing them at risk for burnout and job turnover. This study examined which types of work relationships are associated with levels of burnout. The study included a sample of CCLS (n = 214) working a minimum of 20 hours a week in clinical settings in the United States. Participants completed an online survey containing the Caplan Social Support Instrument, the Maslach’s Burnout Inventory, and an open-ended question related to burnout. Multiple linear regression was used to identify factors associated with burnout. Having a positive relationship with one’s direct supervisor, a positive relationship with peers or positive relationships with non-child life medical staff were associated with lower rates of burnout. Age, years of experience, exposure to trauma and bereavement, and exposure to chronic or terminal illness were not found to be significant predictors of burnout. Qualitative analysis identified additional stressors that participants considered contributors to burnout including compensation, workload, and respect and understanding of the child life role by other medical professionals. 

Certified Child Life Specialists (CCLSs) have been engaged with other health professionals to provide care within international short-term medical missions (STMMs). However, there is minimal research describing the care they provide, their professional roles, and the impact of their services on the beneficiaries, as well as the volunteer CCLSs. This exploratory, survey-based, descriptive study reports findings regarding roles and experiences of 55 CCLSs who volunteered to provide psychosocial care for children and families on STMMs. They reported providing play, normalization, psychological preparation for medical procedures, and emotional support, resulting in an observable reduction inpatient and parent anxiety. Nonpharmacological pain management and education for capacity building regarding psychosocial care were not routinely provided. Using Campinha-Bacote’s cultural competency framework and Knowles’ adult learning theory, we explored the reciprocal impact for CCLSs volunteering on STMMs. CCLSs reported improvement in their own cultural competency, professional skills, and child life competencies. Findings suggest providing psychosocial care on STMMs benefited patients, families, and the CCLSs. A brief commentary on children’s rights and ethical considerations for those in a child life role on STMMs is included. Practice and research implications are provided to enable a greater understanding of the child life role in STMM contexts and to inform prospective CCLS volunteers of this opportunity, as well as to educate STMM organizations about the role of child life.