Recommended
More Related Content
What's hot
What's hot (20)
Viewers also liked
Viewers also liked (13)
Similar to What is child life anyway
Similar to What is child life anyway (20)
What is child life anyway
- 1. What is Child Life Anyway? Nicole Graham, MS, CCLS Amy Curry, MS, CCLS
- 2. Objectives • Introduce the history of the child life profession and educational background of certified child life specialists • Discuss the theoretical background as it relates to child life practice • Explore the implementation of theory and research in the scope of child life services
- 3. Evolution of Health Care for Children • 1900-1930 : Emotional life of hospitalized children was not researched • Mid – 1930 to mid - 1960 : Research was begun on children’s reaction to hospitalization • Mid - 1960 : Onward looking into the environment of multiple health care settings, institution of family centered care and looking at the benefits of building mastery in the hospital environment
- 4. History of Child Life • 1955 – Emma Plank created a program to address the social, emotional and educational needs of hospitalized children • 1967 - Association for the Care of Children in Hospitals (ACCH) established • 1970’s and 1980’s – Child life movement experienced rapid growth. • 1982 –Child Life Council (CLC) was formed. • 1983 – Phoenix Research Project was funded by ACCH. Its results became the theoretical framework and justification for child life practice.
- 5. Research - Child Life Programs • Clegg (1972) - Quasi experiment of comprehensive child life • Bolig (1980) - Activities based child life program increase internal locus of control • Wolfer, Gaynard, Goldberger, Laidley, Thompson (1988) - quasi experimental - Preparation activities based program • Pass and Bolig (1993) - Naturalistic study of two child life programs playroom/group vs. non- playroom/ individual
- 6. Phoenix Research Project • Experimental “model” designed for patients 3- 13 years • Quasi-experimental , phase lag design • 21 outcome measures • 18 of 21 outcome measures were significantly different between control and experimental group
- 7. Suggested Vocabulary Potentially ambiguous Suggested wording I.V. Medicine through a small, tiny tube; I.V. = into the vein “Put to sleep”, gas, Medicine to help you go to sleep, anesthesia different than sleep at night Dye Medicine to help us see your picture Urine – “you’re in” Pee – use child’s familiar term Stool Pooh, Poop – use child’s familiar term
- 8. Suggested Vocabulary CT scan, CAT scan, Pictures with a big camera, Pictures of MRI, x-ray inside of you, but the camera won’t touch you Dressing change Clean, new bandages Incision, “Cut open” Small opening Table (exam table) Bed
- 9. Confusing Phrases I’m not here to Instead of introducing the word “hurt”, hurt you. say what you are there to do. It wasn’t that Was it how you thought it would be? bad. Tell me how it was for you. Funny Different/odd smell/taste smell/taste/etc Special… Unusual/Strange…
- 10. Education /Requirements for Certification (CCLS) • Bachelor Degree • Having completed a total of 10 college- level courses within the following areas: – Child Life, Child/Family Development, Family Dynamics, Human Development, Psychology Sociology, Counseling, Education, Expressive Therapies & Therapeutic Recreation • Completion of 480 hours child life internship • Certification Exam
- 11. Scope of Service • Medical Play/Medical Preparation • Sibling Support • Procedural Support • Normalization/Developmental Support • School Re-Entry • Grief/Bereavement • Parent Education/Alternative Settings/ASA
- 12. Developmental Understanding of Illness • Causality – Piaget’s Imminent justice • Increase complexity of health concepts – Explain of illness – Understanding body parts • Stages of Health Care understanding ( Bibace & Walsh 1978, 1980) – Phenomenism – Contagion – Contamination – Internalization – Physiological – Psycho-physiological
- 13. Medical Play/Medical Preparation • Goals – Assess child’s understanding – Clear up misconceptions – Promote sense of mastery
- 14. Importance of Preparation • Increases the child’s understanding of the procedure (Claar, Walker, & Barnard, 2002) • Decrease the child’s anxiety level (Kazak, Penati, Brophy, & Himelstein, 1998, Lizasoain & Polaino, 1995) • Increases compliance with medical staff and with procedure ( Kolk, van Hoof, & Fiedeldji, 2000) • Fosters effective coping strategies(Mahanjan, Wylei, Steffen, Kay, Kitaoka, Dettorre, Smara, & McCue, 1998) • Gives the child a sense of mastery/control • Helps the child heal faster • Gives the child an opportunity to express fears/misconceptions (McGrath & Huff, 2001)
- 15. Key Elements of an Effective Preparation Program • Convey information to the child in a developmentally appropriate manner • Encouraging the expression of feeling about the information or event • Include participation of parents • Establish a trusting relationship with staff member (Wolfer& Visintainer, 1975, Melamed & Siegel 1975, Petrillo, 1972, Stanford & Thompson, 1981)
- 16. A Sample Preparation Not Ideal Preferable • Hold still • Where are your vein • Stick needle in your or blue lines? vein • Slip a small tube in • Then tape it down your vein • Draw blood • Your job is to hold still • Don’t look • What will help you? • You will get less pokes not no pokes
- 17. Age –Specific Medical Preparation Age Issues Intervention Toddler Pre-operational, limited time Parental presence, use doll, concept, no concept of inner talk about symptoms working of body Pre-school Pre-operational, not able to see Dolls, body outline, no blame other perspectives ,magical for condition, use make thinking believe play, rewards School Age Concrete operations, understand Body outline, doll, teach internal body parts, logical medical words, post procedure thinking appearance Teens Formal operations, implication of Body outline, talk about disease, loss of control implication of dx or result of procedure on diagnosis
- 18. Medical (Therapeutic) Play • Goals of play – Meet child’s ongoing developmental needs – Help children cope with unfamiliar hospital environment – Increase children’s understanding of their hospitalization – Promote a sense of control mastery and position self- concept – Meet children’s need to cope with separation and deprivation (Matthews 1991)
- 20. Siblings • Issues by age • Diagnosis teaching • Visits • Grief
- 21. Procedural Support • Coaching • Distraction • Relaxation • Positioning for Comfort
- 22. Research on Coaching and Breathing Techniques • Adult Command structure (Dahlquist, L.M. et al. 2001) • Breathing Techniques (Bowen, A.M. & Dammeyer, M.M. 1999).
- 23. Coaching • Specific, softened direct commands decrease child distress E.G., “It’s time to get on the table” or “I need you to…” • Vague commands and commands phrased as questions increase child distress E.G., “Get ready” or “do you want to get on the table?”
- 24. Research on Distraction and Guided Imagery • Cochrane review (2006) distraction, combined cognitive-behavioral intervention and hypnosis help alleviate pain and distress during needle related procedures. • Distraction & Guided Imagery (Broome, M. E., Rehwaldt, M., & Fogg, L. 1998; Dahlquist, L.M., Busby, S.M., Slifer, K.J., Tucker, C.L., Eischen, S., Hilley L., & Sulc, W. 2002; Fanurik, D, Kohl, J.L., & Schmitz, M.L. 2000; Kazak, A.E., Penati, B., Brophy, P., & Himelstein, B. 1998; Kleiber C, Harper DC. 1999)
- 25. Distraction Interventions by Age/developmental Level Infant/Toddlers Rattles, music, novel toys –rain sticks, bubbles, pop-up book, spinning toy Preschool Bubbles, Magic wands, Seek and Find, flap and pop-up books, play doh, singing, finger play songs, pinwheel School- age Imagery aids, bubbles, I Spy, Where’s Waldo, Sand/Water Timer, hand held electronic game Adolescents Relaxation Tapes, Music, Activity books, Stress ball, hand held electronic game,
- 26. Positioning for Comfort • Stephens, Barkey, Hall, (1999) (2) • Cavender, Goff, Hollon, & Guzzetta (2004)
- 28. Normalization/ Developmental Support • Play seen as important for growth and development • To express feeling and regain feeling of control
- 29. Play in HealthCare setting • Most research done in 1960, 1970, early 1980 • Play is one of primary method of determine children's psychosocial state (Po, 1992) • General goals are impacting knowledge about impending procedures and reducing anxiety (one -shot , 30 minute intervention do significantly reduce anxiety • No studies have been done on post -hospital, treatment behaviors or later adjustment
- 30. Play Programs in Hospital (Bolig 1984, 1988) • Wide variety in programs – from diversionary to therapeutic – focus for activities, play and relationships – Consistency with staff are available – Education background of staff – Ratio of staff to children – age ranges of children served, – variations in types of illness represented – equipment and play material available
- 31. Research in Hospitalized Play • Disruption in play patterns - at least temporarily (Cataldo, Bessamn, Parker, Pearson, & Rodgers, 1979, Isza, Hurwitz, & Angoff 1970) • No increase in aggressive play - (Veredevoe, Kim, Dambacher, & Call , 1969) • Anxiety and play material choice (Gilmore, 1966, Tarnow & Gutsein, 1983) • Presence of adult on play material choice (Bolig, 1992) • Effect of Short supervised play session or coping (Clatworthy, 1981, Lockwood, 1970, Schwartz, Albine,& Tedesco, 1983)
- 32. More Factors that Influence Play • Play environment • Parent contact • Age • Length of hospitalization • Type of illness • Gender
- 33. School Re-Entry Research • Uneducated peers had concerns and negative attitudes towards peers with cancer; education caused a significant increase in knowledge and decrease in concerns/worrying (Treiber, F. et al. 1986) • Information sharing, individual education plans, and goal setting are key for successful school re-entry for cancer patients (Henning & Fritz. 1983)
- 34. More Research • Assessment, multidisciplinary teaming, facilitation of peer interactions, are needed for successful school re-entry for TBI patients (Deidrick & Farmer. 2005) • Early intervention and close liaison with schools is necessary to enhance adaptation within the school environment for transplant patients (Wray, J. et al. 2001)
- 35. School Re-Entry • Facilitates transition back to school after extended absence or physical changes • Educates staff/peers • Creates acceptance and support for the child in the school environment • Prevents unnecessary special treatment which may hinder the child’s progress
- 36. Grief and Bereavement • Five Sub concepts of Death • Stages of Cognition – Death is not final. – Death is final, but can be avoided. – Death is both final and unavoidable • Legacy Building
- 37. Other Services • Parent Education • Alternative Settings • ASA
Editor's Notes
- P:Amy T: Introduce the history of the child life profession and educational background of certified child life specialists ﾊﾊﾊﾊﾊﾊﾊ Discuss the theoretical background as it relates to child life practice ﾊﾊﾊﾊﾊﾊﾊ Explore the implementation of theory and research in the scope of child life services
- Presenter: Amy Tie- in: Understanding the pediatric hospital environment, show the environment and the need that child life was to fill as related to greater understanding through research 1900-1930 – Emotional life of hospitalized children not research Parents visit were deemed disruptive, to time consume to consol patient, staff counseled parent not to tell Mid – 1930 – Research was begun on children’s reaction to hospitalization Demonstrated children are vulnerable to and have adverse emotional reactions that persists over time
- P:Amy T: Out of the hospital environment and developmental theory (for previous century and early this century) child life evolve not just as a diversion but as way to prevent and correct those issues in the hospital environment - collaboration has always been important to child life. The first organization create by cls was ACCH a multi-disciplinary organization not strictly child life
- Clegg (1972) - quasi experiment of comprehensive child life - significant reduction in anxiety level (o control group) Bolig 1980 - Activities based child life program increase internal locus of control Wolfer, Gaynard, Goldberger, Laidley, Thompson (1988) - quasi experiment - positive effective coping adjustment and recovery variables Pass and Bolig 1993 - naturalistic study of to child life programs playroom/group vs. non-playroom/ individual no difference in frequency and complexity of play a trend toward significance therapeutic and educative play occurring more in the playroom-focused setting
- 83 bed program , want to go to a child life program Experimental “model” designed for patients 3- 13 years eight components a) admission orientation and assessment, b) stress vulnerability assessment, c) ongoing assessment and activity planning, d) development enhancement, e) psychological preparation, f) post procedural medical play , g) family involvement, h) supportive relationship Quasiexperimental , phase lag design ethical and logistical reasons control was 8 months of rudimental child life – one person playroom little psychological preparation, those that were excluded experimental 6 month of implementation and 10 month to gather adequate sample baseline data included nursing staff organization, patient ratios, policy changes, numbers and types of patients changes - three CLS and two child life assistants Outcome measures Emotional distress and 2) coping for three procedures 3) pulse- before exam , resting, before proc 1 and after proc 1 4) overall coping adjustment rating Understanding reason for hospitalization rating, understanding procedures rating 7 surgical recovery – 9 sub variable, post hospital adjustment, parent participation in care rating, parent self rating of anxiety 11 post hospital recovery rating by parents
- P: Nicole T: Our diverse background created certification
- P: Amy T: Understanding of the main theoretical base , give us a jumping off point in which to discuss the service that child life specialist provide
- Most all children understand contagion but younger expand understanding of contagion to non contagious illness younger children more likely to think that misbehavior cause accidents or illness; self responsibly for negative events is greater than self belief in positive events Increase complexity of health concepts Younger children define illness as vague, non localized feeling older children included diagnoses, alternation in role behavior Body part increase complexity is related to child age level, parent education level, sex of child males are higher Phenomenanism, - illness caused by remote phenomena Contagion, illness caused by proximity (4 years 72%) contamination, illness caused by contact (7 year 75%) internalization, illness locate in the body ( 71% – 11year 1978, 1908, in physiological, -illness due to vulnerability psycho physiological -illnesss caused by psychological factor
- P: Nicole T: Two of the most distinctive services of child life are medical play and preparation. I think that we all understand that children at different developmental stages will understand healthcare experiences in different ways, so making sure that they have a truthful expectation of what is going to occur is extremely important. For example, I once worked with a 9 year old who was having dual nephrectomy. The first time I met him He was in the surgery area shaking with both hands tightly gripping the blanket up to his face. As we began to talk about what was going on, I just casually said, that it was ok for them to take his kidneys out b/c he would have dialysis to do their job and keep him healthy. Almost immediately his hands relaxed, he stopped shaking, the blanket got pushed down from his face and he was much more calm. No one had thought to mention this to him!!! Another example is children who here the words “take blood” and think we’re taking all of their blood instead of a small amount. Primary goals of preparation are to decrease fear and anxiety and to promote long-term coping and adjustment to healthcare experiences. So what does the research tell us about preparation?
- P: Nicole T: The research tells us that children who are prepared for procedures experience significantly lower levels of fear and anxiety as compared to children who are not prepared. Children who receive procedural and sensory information demonstrate less emotional distress. Children who had the chance to ask questions and express concerns prior to the procedure spent significantly less time “delaying” and seeking information during the procedure. These children and their families express greater levels of satisfaction with their hospital experiences when compared to children and families in other groups.
- P: Nicole T: So how do we go about actually accomplishing the preparation of a child? We as CLS need to take our training in child development (Piaget, Erikson, etc) and assess what developmental level that child is at. The way I like to do this is to begin to establish some rapport with the child and family by interacting or playing briefly and not talking about the procedure at all…..it allows me to sound out the child and the parents and for the child to feel safe with me. I always encourage the parents and child to tell me what the child has already experienced, how that went, what they did to cope with it, any coping mechanisms they already have in place, etc. I also like to ask the child if they’re the kind of person who like to know a lot about what’s going to happen or only a little….and I like to let them know that they can stop me at any time as we talk if they’re done with the conversation. Being truthful is paramount, but being truthful in a gentle way and encouraging kids to talk about how they feel about what’s coming really makes things easier and makes the child feel like part of the experience instead of the victim! Let’s run through and actual example….
- P: Nicole T: On the left are things you may commonly hear as healthcare workers describe staring an IV. These words are pretty harsh and very scary. The child is left with the impression that they have to keep still for who knows how long, that a needle is staying in their arm when in actuality it is not (and they don’t have any idea when it might be coming out), and that we’re trying to hide something from them because we’re telling them they can’t look even if they want to. On the right is a much gentler way to approach this – I like to show kids their blue lines and explain that veins are like roads that take blood all over their bodies. If they are old enough (about 5) I show them the plastic “straw” that will go in their vein and let them touch it and the tourniquet and the alcohol swab so they have the whole sensory experience. We might also engage in play by starting an IV on a doll. Giving the child a job (staying still, pretending to be a statue) allows them some mastery over the situation, something to be praised for. Also, offering choices about coping – deep breathing, distraction, etc allows them some control over the situation.
- P: Nicole T: How does preparation differ across age/developmental groups? Toddlers are frequently the most tricky because they have the most simplistic understanding…..they are generally prepared in a very basic way (I’m going to touch your tummy now, It’ going to be a poke now) as events are occurring and always in he presence of their caregivers. Pre-schoolers can definitely benefit from medical play and respond well to rewards. They typically are prepared shortly before the procedure and also in the presence of their caregivers. School-agers are so smart and need to be prepared a little earlier because they frequently want to ask a lot of really specific questions about what it’s going to feel like and if it’s going to hurt and how long it’s going to take, etc. They can really put you on the spot and you have to be prepared to be very honest with you – their favorite question is “am I gonna get a shot???” Teens need time to think about and process information and can be prepared for thing early….they are more focused on outcomes, physical appearances, modesty concerns…more long term implications….. Not sure we need this slide……
- P: Nicole Medical play is another tool that CLS use to communicate with children about their experiences in the healthcare environment. Let’s take a look at this model to see the scope of play before discussing further… T: So returning to goals of medical play, First and foremost we know that play is how children grow and develop. We know from Piaget and other theorists that play allows children to assimilate experiences into their existing schemas and to master situations….therefore playing doctor both allows us as CLS to understand what a child might fear about the MD and allows the child to conquer their fears. The more we know on the front end about what a child fears, the less damage control we need to do on the back end to make sure that child continues to cope well into the future. Play is prevention!!! One example is a 7 year old who needed a G button. She and I had been playing with cloth dolls with the medical kit in a very open way….little direction on my part. I noticed that she was drawing something on the doll’s belly. It was the letter G. In this way we discovered that she believed that the MD was going to sew a letter G button on her belly and she was confused b/c she didn’t know how that was going to help her eat. Knowing this let us prepare her better for her procedure, prevented a possibly negative experience for her through misunderstandings, and allowed her to gain mastery over the situation by learning about what was really going to happen.
- P: Nicole T: Medical Play and Preparation are not discrete entities but instead run along a continuum As you can see on the left, you have play which is completely directed by the child without constraints of time, or learning objectives, or any other imposition placed on it by anyone other than the child. At the right side of the continuum you see directed “play” which is really not play so much as what we consider preparation because it is very controlled by the CLS with specific learning goals in mind…… As you move toward the middle of the continuum, though, you progress to guided play which is really what we’re talking about when we’re discussing medical play. This can be either unstructured, where I might present the child with a medical kit and then let them play out whatever they want with it, or more structured where I encourage playing doctor or going to the hospital and try to lead the child a little more down a path of my choosing.
- P: Nicole I want to touch on siblings here briefly because they are another group of children that we as CLS frequently interact with and who benefit from preparation and medical play. In terms of coping, we see that the Issues differ by age Sibling under the age of 7 (Knafl and Dixon 1983)may be the most vulnerable and the age of 4-11 (Craft 1993) may have the most negatively affects – young siblings may feel to blame for causing an illness (as many as 50%), they are more vulnerable to separation from parents while a sib is in the hospital because they have a poor conception of time, they generally have a hard time understanding why the sib is getting all the attention and they are “being ignored” Older siblings can feel guilt from a contagious illness or feel anger b/c of additional responsibilities placed upon them – having to help care for the sick sib, care for other well sibs, taking on more chores at home etc. CLS can frequently help facilitate conversations that help sibs express those feelings in a safe environment and let them know it’s ok to feel that way and to help them cope with that… We also do a lot of teaching with siblings, like we would with the sick child, to help them understand their sib’s DX so they can begin to cope and to help them understand why parents might need to be at the MD or why the sib might need more support/attention for medical care, etc. We also prepare them for what they may experience if they visit the PICU, NICU or even just a regular hospital room in the same way that we would prepare the ill child for a procedure – focusing on truthful, developmentally appropriate, sensory information. Finally we work with sibs around bereavement issues and legacy activities to help them understand death and to say goodbye to their loved one – you’ll be hearing more about this from Amy a little later….. Grief- intervention (davies, 1999) encourage sibling to participate in family meetings, if not inquire about their coping, encourage open discussion between children relationships with their peers, offer age-appropriate teaching session that help siblings understands Behavior – a similar feeling of anger guilt, anxiety as new baby Visit DX teaching
- P: Amy T: Now taking the research explain how we operationalized - good time for examples
- P: Amy T: Discuss how this relates to stress theory and sense of mastery
- Get out items now 0-2 touching, stroking, patting, rocking, music, mobiles 2-4 plays, storytelling, reading, breathing, and blowing 4-6 same as 2-4 y/o plus talking/sharing interests 6-11 same as 4-6 y/o plus counting/chanting, humor
- P:Amy T: Demonstration of comfort
- Play seen as important part of prevention ( b/c it provide integration experience, emotion, cognition as experience are occurring so that intervention is less necessary, ply is a comforting and familiar activity How children regulate environment Comforting familiar activity involving symbols and signs, on value for relationship building According to Piaget play allows children to abstract or assimilate experience into their existing schema According to psychoanalytic theory play and be catharsis, and allow child to master a situation
- Short supervised play session with materials related or unrelated to the medial setting help children cope more effectively ( Clatworthy, 1981, Lockwood, 1970, Schwartz, Albine,& Tedesco, 1983) Lockwod - medical play doll doll play did reduces children's stress scores, anxiety defense scores were lower in the experimental group Clatworthy - Control were more anxious at final evaluation than children in the experimental group play intervention did not decrease the anxiety level of children over the course of hospitalization. Experimental group anxiety was constant but control group went up. Rae, Worked, Upchruch, Sanner, and Danile 1989 short sessions of therauptic play nondirective but reflective and inpretative with symbolic objects were significantly more effective in reducing self- reported fears 5 though 12 year old than diversionalary play, verbal support or no treatment. Fosson, Martin, and Haly (1990 present a single 30 minute session with medical or a control of televleison viewing with the investigator there was a decline in anxiety in both group. Greater decline but not significant in the medical play group
- Play environment Tisaza - three days need for settled play Narvey and Hales note presence of play leaccer was necessary for settled play In outpatient setting the presences of play facilitator was found to be related to more play and less anxious behaviors Long children were in a supervised playroom the more likely they were to engage in higher levels of play Parent contact parental presence related to increase play Ages 6 months and 3 to 4 are the ages most vulnerable for upset, normative play may most critical preventative, carartive, equilibaration functions Length of hospitliztion preschooler show disprution in play at day that dimishes at day three - attibuted to a disposition not to play than distraction from novel stimuli Pass and Bolig 1993 longer children were hospitalized the they engaged in educative and rough and tumble play Type of illness -few significant finding of type of illness or treatment mode and psychological treatment, children admitted under emergency condition more likely to have upset Pass and Bolig found child admitted for surgical procedures engage in less play and than children admitted for other medical reasons Gender No difference in upset in due hospitalization ( research studies are conflicting
- Nicole
- Nicole We see consistently across illnesses that again and again the research supports school re-entry programs to help children adapt back to the school environment after illness or injury. Education for staff and peers, along with facilitating peer interaction is crucial to helping children cope with this experience. The literature discusses many different types of programs, offered by RN practitioners or other medical staff…..we’re going to take a look at how CLS offers school re-entry.
- Nicole School re-entry is not something that we do on a daily basis, but it is one of the more important things that we do, and it can be considered preparation on a wider scale. Generally school re-entry is considered when a child has been away from school for an extended period or has some highly noticeable physical changes – hair loss, dialysis catheters, scarring, amputation, etc. It can also occur at the school or parent’s request if there is just a basic need for the school personnel or children to have more information. The CLS will go into the class and give a developmentally appropriate presentation about whatever issue is pertinent, providing generic info not info specific to the child. The helps to diminish fears/misconceptions of the child’s peers and teachers, and generally the number of questions a child may get when they get back to school which may be uncomfortable for them to answer. It’s also an opportunity to talk to the class about what it’s like to be different from the people around you and how you would want to be treated and ways that you can support each other no matter what your limitations or differences might be. Finally, it gives an opportunity to prevent the school from limiting the child unnecessarily and thus singling them out in an effort to “help” by educating them about what the child can accomplish. Example – working with renal kids I had a child in elem. School who walked a little slower than the other kids b/c of bone disease and missed each M, W, F afternoon of class to come to dialysis. The teachers had created him a special rolling chair and had the other kids roll him from place to place instead of walking and had special cushions for circle time on the floor – singling him out instead of integrating him. They also believed that instead of him following our policy of homework time during dialysis that he shouldn’t have to worry about it since he was sick – and could just skip work. We had to educate them that his kidneys were broken – not his brain!
- P: Nicole T: Relate concepts of death about to Piaget’s theory Five Sub-Concepts of Death (Speece & Brent) Universality – “all living things must die” All-inclusiveness Inevitability Unpredictability Irreversibility – permanent Nonfunctionality – cessation of body functions External or observable function – breathing, eating, walking Internal functions – feeling, thinking , dreaming Causality – understand what cause deaths Some Types of Continued Life Form – beliefs in an after life or non-corporeal continuation
- P:Nicole T: There are many reasons and opportunities to provide parent education ranging from a new parent in the NICU who just needs some extra support to feel comfortable as they approach discharge and taking their first baby home for the first time to parents who are in the hospital with toddler who is clearly running the show and need to learn some appropriate guidance techniques. We are available to model basic child care, safety, guidance, educate about what to expect in terms of normal development and also to help parents learn coping strategies to get them through and to use with their kids. ASA are generally seen in the ER, although we will soon be having a position in the CAC to assist in preparing children for exams related to possible sexual abuse. Alternative settings: child life has been branching out in recent years and CLS can now be found in dentist offices, funeral homes, the court system, and in private practice. Wonders and Worries in Austin provides services to children in the community who are referred from the school or other community agencies (schools, MDs, etc) so that children who are not hospital in-patients but who are still undergoing healthcare experiences can have the benefit of CL services.