CERTIFIED child life specialists (CCLS), who have advanced training in child development and developmentally appropriate interventions, work in partnership with doctors, nurses, social workers, and parents to meet the unique emotional, developmental, and cultural needs ofeach child and family. The month of March is set aside to honor these individuals, who promote effective coping through play, self-expression activities and age-appropriate medical preparation and education.

There have been several studies in which the presence of a CCLS during a healthcare procedure has shown to be therapeutic in allaying anxiety for the child, improving the experience for the child, and for the parent — whose satisfaction is often directly associated with observations and perceptions of their child’s comfort level.

Recently, a study appeared in the Journal of Pediatric Orthopaedics, examining the role of a child life specialist during orthopaedic cast procedures through a prospective-randomized trial. A total of 86 children, age range 2-10 years, were assigned to either Group I (42 children having a CCLS present in the cast room) or Group II (44 children who did not have a CCLS present). Pulse oximeters were utilized to record the children’s heart rates at four time intervals, and a behavior scale was created in an attempt to evaluate the child’s emotional state, objectively. The scale identified negative behaviors such as crying, protesting and physical non-compliance as well as positive behaviors such as smiling/laughing, playing, and calm/compliance.

Procedures included splint removals, initial cast placements, fracture manipulation, isolated pin removal and cast removal.

This study indeed demonstrated that the therapeutic presence of a CCLS in the room while a child was undergoing an orthopaedic procedure significantly affected the observed behavior score. Also a greater increase in heart rate was observed when there was no CCLS in the room.

Shriners Hospitals for Children is proud to be able to provide this service whenever necessary to support children in uncomfortable situations in the cast room as well as throughout the hospital. Samantha West, MSW, CCLS leads up a team of three child life specialists.