I’m the senior child life specialist at a children’s hospital. I’ve been here for almost 20 years.
We help children and families understand and cope with a child’s hospital experience. Hospitals can be overwhelming, especially for a child and for the parents or family of a child. To support a child, we might encourage play or self-expression; for parents, it might be education or emotional support. We assess what the child and family need and then fill the gap between their medical care and their everyday lives.
Support looks different for everyone. In the case of, say, an infant patient with a 2-year-old sibling, if the baby is in ICU [intensive care unit], he or she won’t need the playroom—but the 2-year-old might. And the 2-year-old will be missing Mommy, who’s with the baby in ICU. We help families think through these scenarios, help plan for them, and provide support.
We’re often the first person they meet. We also work with a social worker and chaplain, and we determine who needs to be the first to meet the family. For example, if there’s abuse, it’s the social worker. Other families come in asking for the chaplain. If the patient is awake and scared or if siblings present are overwhelmed, support from a child life specialist is the priority. Sometimes, it’s all three of us. There’s a lot of overlap.
We don’t often get a heads-up before we see most patients. We’re not developing long-term relationships with everyone, but we can try to prepare for new patients by figuring out what kinds of stressors the child or family is facing.
We ask questions to try to minimize their anxiety: “What are you most worried about? Is it staying overnight in the hospital? Needles? Being surrounded by strangers?” As we identify stressors, we can work to mitigate those.
Sometimes, the hardest things to figure out are not necessarily what we think will be the most difficult. Our knowledge of child development may help us anticipate what helps children in general, but we don’t know what will help a particular patient. In the moment, as we assess patients and their needs, we make a plan to support their coping.
Child life specialists may have a lot of administrative duties, depending on the size of their program. In really large programs, there may be a specialist who handles all the donations, special events, and trainings. In smaller programs, they could be doing all of that plus things like keeping the toys clean.
We also sit on committees to discuss topics such as pain management, quality improvement, and bereavement. Doing other work—email, mentoring, staff meetings—all takes time, too. And our professional association has continuing education requirements for maintaining certification.
Hospital-based or facility-based child life specialists do a lot of running around. There’s very little sitting. You’re moving all the time.
Full time is 40 hours a week, which is a challenge, because we also have to chart everything we do. Hospitals are open 365 days a year. Some child-life programs are open Monday through Friday, but more and more are going to 7 days a week.
The size of a program depends on the size of the hospital: 60 beds versus 4, for example. Patient load dictates what you can do.
When I was 14, I worked as a counselor at a youth camp for patients of a children’s hospital. I met a child life specialist at camp and watched how she interacted with the kids. I thought, “I want to do what she does.”
Our background is [often] in child development, and we’re using that to help children understand what’s happening to them. Communication skills and listening skills are important. I have a bachelor’s degree in human development and family studies, with an emphasis in child life. Many people have a master’s degree; they might have a bachelor’s in a child-development field and a master’s in, say, recreational therapy.
Child life specialists also need practicum hours or an internship. Internship programs are more competitive than when I started because the field is more competitive now. I don’t think some people realize how hard it is to get into this field.
[The Association of Child Life Professionals offers certification to people who have earned a bachelor’s degree in any subject, taken courses in child development and other topics, completed a practicum, and passed an exam.]
People who are interested in medicine or nursing don’t often become child life specialists. There are benefits to having that background, but we don’t do the medical stuff, and we don’t present the medical information. We have a basic knowledge of medical terminology and anatomy, but the rest you learn as you go.
The loss of innocence. No longer can you ignore that terrible things happen, because you’re helping people deal with it. We feel like every kid has cancer. It’s not true, but you feel that way sometimes.
My favorite part of the job is also the most important: Helping adults be honest with children in these difficult situations. I remember a family with a 5-year-old who was dying, and the parents disagreed about what to tell the older siblings. The mom wanted them to understand what was happening, but the dad didn’t. I was able to ask Dad a series of questions that led him to realize why telling the truth wasn’t avoidable.
You’re in a position to impact those people in a positive way. It doesn’t mean you’re fixing it, but something you did made something about the experience better. You’re not just a bystander; you’re able to offer relief.
Volunteer, volunteer, volunteer! As with any career, you should learn as much about it as you can before you go into it to help figure out if it’s for you.
Interview by Kathleen Green, "Child life specialist," Career Outlook, U.S. Bureau of Labor Statistics, April 2018.