Intro to Child Life Midterm Uiowa

Play

a way in which children regulate their experiences and environment

Child life specialist

pediatric health care professionals who work with children and families in hospitals and other settings to help them cope with the challenges of hospitalization, illness, and disability

Assessment

1. Establish relationship with client

2. Gather information from various sources (coping, stressors, etc.)

3. Observe child/family interactions in different situations

Planning

1. Look at variables: family, child, and health variables differ with each case.

2. Look at variables and determine which type of intervention would work best

3. Set goals and have a plan to achieve them

Intervention

Actual child life specific intervention: Bereavement support, Animal therapy/special visitors, Medical play, Procedural support, Playroom activities

Evaluation

1. Determine if intervention has been successful

2. Note changes that you should make next time and note what you did correctly

3. Documentation: putting intervention into objective terms to communicate the Child Life intervention/goals to the rest of the healthcare team.

Child variables

mental age, temperament, fears, stressors

Health Care variables

previous hospital experiences, length of stay, reason for stay

Family variables:

how available the parents are, anxiety level, cultural beliefs, understanding of child's diagnosis

Characteristics of play

Intrinsic motivation

Orientation to means rather than ends (process vs. product)

Spontaneous and voluntary

Not obligatory

Involves active engagement

Unoccupied play

not playing, but watching what is most stimulating in the room

Onlooker play

not playing, but looking at something specific

Solitary Play

playing on your own

Parallel play

playing with the same things, next to someone, but not interacting

Associative play

playing together with the same things, interacting, without a common goal

Cooperative/organized play

playing together with a common goal (kickball)

Infants

play is exploration (mirrors, rattles, mobiles)

Toddlers

play as cause and effect (shape sorters, toy cars, push and pull toys)

Pre-school

sociodramatic play (modeling adults) (dress up, dolls/action figures, play kitchen)

School age

play as logical thinking and social acceptance (constructive paper/crayons, board games, word games)

Teens

Abstract play (journals, games with peers, movies, advanced long term art projects)

Trust vs mistrust

birth-1 year. child needs warm responsive care, confidence that someone is there to meet their needs, mistrust comes from neglect

Autonomy vs. shame

1-3 years old. Child wants to be able to control some things, parents give reasonable /free choices. Shame and doubt come when parents make children do things that they don't want to

Initiative vs. guilt

3-6 years old. Through make believe child can imagine what they want to be, parents can encourage this and create purpose and direction. Guilt is formed when children are given too much responsibility

Industry vs. inferiority

6-12 years. children accomplish tasks on their own and gain confidence. if children are not accomplishing things at the same level as their peers this may lead to feelings of inferiority

Identity vs. Role confusion

12-18 years. who am I and what is my place in society. Confusion about adult roles

Sensorimotor

0-2. object permanence, how child learns about the world through their senses, schemas

Preoperational

2-7. use language, use mental representation to think, imaginary play. limitation: egocentrism

Concrete operational

7-11. problems solving skills, logical reasoning, understanding conservation

Formal operational

11 +. abstract thought, hypothetical situations

Protest

first stage of separation anxiety when the child cries because caregiver has left, but is happy when they return

Despair

second stage of separation anxiety where the child is sad when the parent leaves but somewhat withdrawn when they return

Detachment

third and final stage of separation anxiety when the child is not happy when the parent returns (not wanting to leave daycare)

Vulnerable children

Young children, previously hospitalized children, children with sensory impairments, developmentally delayed children

Resilient children

children that have the ability to bounce back to the original psychological state, good at coping with things

Secure attachment

an attachment that shows distress when separated but positive emotions when parents return, trust parents and find comfort in them when they are sick or scared

Ambivalent attachment

considerable distress with separation, but may passively reject parent upon return. Fail to find comfort in parents

Avoidant attachment

avoid parents, suppress emotions, often a result of abuse and neglect, no emotion is shown upon reunion

Disorganized attachment

Reactive attachment disorder (unable to form attachments), lack of trust, and behavior is bizarre and lacks an observable goal

Conscious stress

things the child perceives as stressful (surgery)

Unconscious stress

things that you don't realize that are stressing you out (poor diet)

Psychological stress

deals with events and then individuals' response to them (primary and secondary appraisal: does the threat exist and can I cope with it?)

Expressive play

enable children to be able to express energy and feelings in an appropriate way (graffiti mural, and jenga with questions)

Familiarization play

children can explore and manipulate health care equipment to be more comfortable with it (band aid art, syringe painting)

Dramatic/medical play

guided role-playing that focuses on healthcare scenarios that they child may be put into. Real medical equipment is used. Play with them at their own pace, and prepare them for things that will happen to them (shadow dolls)

Playing "for" children/vicarious play

children are too traumatized or sick to play that the CLT has to play for them (playdough).

Level 1

children are assessed as being low risk, stable medical condition, well functioning family support, support networks, minimal signs of emotional distress

Level 2

Behavior, the remaining length of hospital stay, parental support

Level 3

Patients with chronic diagnosis, parents familiar with procedures and hospitals, coping well, have decent support, have future hospitalizations planned

Level 4

Potential for emotionally challenged child, persistent health care experiences, invasive and unfamiliar procedures, unexpected events

Level 5

Recent experiences in trauma, intensive care, unstable home, parents are too busy, parents need relief, experienced life threatening situations

AAA

Animal assisted activities, motivation and recreational to enhance hospital stay

AAT

Animal assisted therapy

Music therapy

healthcare profession that uses music to address the physical, cognitive, social, and emotional needs of individuals