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Sheila Palm vividly remembers a 5-year-old boy who was scheduled for a tonsillectomy. When she asked him to use his teddy bear to show her where the operation would take place, the little boy pointed to the bear's feet.

"He thought his toes were going to be taken off," says Palm, the child life system leader at Children's Hospitals and Clinics of Minnesota.

"He was probably confused by the 't' sound in 'tonsils' and 'toes.'"Palm and her staff work with young patients to avoid such misunderstandings. They also strive to minimize the stress children and their families feel during hospital stays, in the emergency room, before surgery or during clinic visits.

Kid-Friendly Explanations

One way they do this is by translating medical information – such as the meaning of "tonsils" – into terms that kids can understand. "Children experience life and healthcare developmentally," Palm says. "A 3-year-old doesn't have the same understanding or coping skills as an older child."

To prepare children for surgery, child life specialists at Children's conduct group tours for young patients and their families. "We introduce them to the hospital environment, the equipment and the people they will see," Palm says.

On the day of surgery, a child life specialist works one-on-one with the child, using teaching puppets, dolls or photographs to illustrate the procedure. Children also engage in hands-on play with medical equipment like the anesthesia mask, which dispenses "special medicine air."

Competence And Autonomy

During prolonged hospital stays, child life specialists find ways to help children maintain confidence and self-esteem. Participation in games and activities, such as painting or making a treasure box, helps kids feel functional and competent.

In conjunction with other members of the healthcare team, child life specialists help children with chronic illnesses learn how to care for themselves. For example, a 7-year-old with diabetes might be taught techniques to help him relax during blood tests or coached on packing supplies, such as a snack and a glucometer, which he'll need at school. "Our goal is to help children grow up to become autonomous individuals," Palm says.

Education, Earnings And Outlook

Certified child life specialists must complete a bachelor's degree program that includes a minimum of 10 courses in child life, child development, child and family studies, or closely related subjects. In addition, students must complete a 480-hour internship under the supervision of a certified child life specialist and pass the certification exam of the Child Life Council.

Palm notes that many employers prefer candidates with a master's degree. Employers are also encouraging current staff members to return to graduate school.

A 2000 survey done by researchers at the University of Alabama for the Child Life Council found that child life professionals had annual earnings of about $35,600. This varied, however, by region, position held, years of experience, education level, certification status and size of the child life program.

Due to cost containment measures, the market for child life specialists remains tight. Most child life specialists are employed by pediatric centers and children's hospitals.

Learn More

• Child Life Council, www.childlife.org.