Research has shown that music provides all of the following benefits for hospitalized children EXCEPT:
A.Decreased distressed
B.Decreased time to first ambulation after surgery
C.Increased Coping with traumatic effects of illness and treatment
D.Reduced a
Decreased time to first ambulation after surgery
Which of the following in the GREATEST stressor for most hospitalized preschool children?
A.Painful procedures
B.The hospital environment
C.Separation from parents
D.The lack of apparent routines
Separation from parents
Fundamental to an adolescent's successful coping is maintaining their sense of
A.Mastery and control
B.Physical limitations
C.Humor
D.Family Support
Mastery and control
When prioritizing child life care, what is the MOST crucial factor?
A.A child with a chronic illness
B.A child ceases play when the nurse is present
C.Hospitalization may pose a threat to the family's ability to cope
D.A child has imminent or recent exper
A child has imminent or recent experience of intensive care, trauma, or emerygency room care
When a terminally ill eight-year-old expresses feelings about death, such as despair and loneliness, during expressive play, the child life specialist should:
A.Change the subject and refocus the play on a lighter topic to avoid further upsetting the chil
Continue to support the child in play, trusting that the child will open up to others only to the extent they feel safe in doing so
A passive response to the stress of hospitalization is MOST likely illustrated by a child who:
A.Exhibits fear of needles
B. Sleeps excessively
C.Crises incessantly
D.Clings to parents
Sleeps excessively
Preparing parents for a child's hospitalization ideally should begin
A.During the pre-admission assessment visit to the hospital
B. Through a private phone call to the parents initiated by a designated pediatric staff member
C.During a scheduled pre-admis
In the physicians office as soon as the admission is scheduled
Alexander Thomas and Stella Chess were two psychiatrists who research findings determined nine identifiable traits in newborns that remain intact for life. These traits are the basis of:
A.Temperament
B. Verbal skills
C.Cognitive Development
D.Gross Motor
Termperament
The MOST beneficial play activities for children in health care settings are:
A.Emotionally charged
B.Highly structured
C.Open-ended
D.Passive
Open-ended
To prepare orientation activities for students and volunteers, it is advisable to minimize the use of:
A.Handouts
B.Audio-visual format
C.Active-involvement format
D.Lecture format
Lecture format
A definitive sign of ataxia in a child would be:
A.Difficulty breathing
B.Refusal to eat
C.Problems with speech
D.An unsteady gait
An unsteady gait
Preparation of a preschool child for a medical procedure is MOST effective when performed:
A.Immediately before the procedure
B.A few hours before the procedure
C.A few days before the procedure
D.A few weeks before the procedure
A few hours before the procedure
Qualitative methods of research
A.Are seldom used due to the medical community's preference for quantative data for complete statistical analysis
B.Are considered to be of limited value to child life specialists.
C.Refer to research procedures which produ
Refer to research procedures which produce descriptive data
All of the following, defined by James Robertson (1958) and John Bowlby (1960), describe a young child's response to separation EXCEPT:
A. Protest
B. Denial
C. Despair
D. Detachment
Denial
Which of the following statement(s) is/are accurate for school age siblings?
I. Sibling presence often enables play for the hospitalized child
II. School-age siblings who are developing normally are no longer vulnerable to the use of fantasy to explain th
I and III only
All of the following areas are essential when orienting students and volunteers EXCEPT:
A.Summarizing the philosophy and goals of a program
B.Presenting the needs and roles of the child and family during the hospital stay
C.Discussing the disadvantages of
Explaining children's developmental concepts of grief and death
Which age group is MOST likely to think that death is reversible?
A.Infants (0-1)
B.Toddlers (1-3)
C.Preschoolers (3-6)
D.School-Age (6-9)
Preschoolers (3-6)
Which of the following will BEST facilitate coping in a preschooler child who is intubated and in an intensive care unit?
A.Regular multidisciplinary teaching rounds
B.Opportunities for dramatic play
C.Practice that increase environment predictability
D.V
Pratice that increase environment predictability
The term "correlation"
A.Refers to change in a dependent variable as a function of manipulation of one or more independent variables
B.Refers to one variable consistently increasing or decreasing in unison with another variable.
C.Generally implies causat
Refers to one variable consistently increasing or decreasing in unison with another variable
To hold, rock, and pat young children, give massage, and return hugs initiated by patients are examples of
A.Positive positioning
B.Physical Conditioning
C.Vestibular interventions
D.Positive touch
Positive touch
Which of the following is a common passive manifestation of psychological upset exhibited by hospitalized children?
A.Peer difficulties
B.Self-Destructive behavior
C.Aggressive Behavior
D.Decreased activity level
Decreased activity level
A research study randomly assigns children to one of the three different preparation approaches. Which kind of research design is this study using?
A.Experimental
B.Collaborative
C.Correlational
D.Descriptive
Experimental
The child life specialist has determined that a newly diagnosed nine-year old is acting withdrawn. The FIRST step in the care plan should be to
A.Interview the patient to identify specific concerns
B.Develop a supportive relationship and build trust
C.Bri
Develop a supportive relationship and build trust
Based on Erik Erikson's developmental theory, which of the following stages applies to infancy?
A.Trust vs. mistrust
B.Industry vs. inferiority
C.Initiative vs. Doubt
D.Autonomy vs. Shame and Doubt
Trust vs. Mistrust
A child life specialist teaches a child coping skills for a procedure. The success of the intervention is measured by how
A.Much the child cries during the procedure
B.Soon the child returns to the playroom after the procedure
C.The child uses the coping
The child uses the coping skills during the procedure
All of the following are principles from the Code of Ethical Responsibility for the Child Life Council members EXCEPT:
A.Recognizing when personal needs are interfering with professional duties
B.Demonstrating respect for all healthcare professionals
C.Sh
Demonstrating resect for all health care professionals
An accurate statement about coping strategies employed by hospitalized children is that they
A.Can be acquired, changed, or eliminated through personal experiences
B.Are innate and stimulated by traumatic events
C.Have limited value for preschool children
Can be acquired, changed or eliminated through personal experiences
A job description for volunteers should
A.Clarify expectations and responsibilities
B.List expectations for volunteer experiences and talents
C.Identify names of individuals to whom volunteers report
D.Clarify terms of termination
Clarity expectations and responsibilities
The BEST method for preventing separation anxiety during a procedure is
A.Having the parents present
B.Having a child life specialist present
C.Consistently having the same physician perform all procedures
D.Having the parents leave a transitional item wi
Having the parents present
According to Bowlby what are the 3 phases of separation anxiety?
A.Distress, ambivalence, and depression
B.Trust, mistrust, and guilt
C.Protest, despair, and depression
D.Protest, despair, and detachment
Protest, despair, detachment
Characteristics of a preschool child that would used while preparing him/her for medical procedures would include
A.A sense of autonomy
B.Animism
C.Limited Language skills
D.A sense of industry
Animism
All of the following contribute to an assessment of a child's potential vulnerability in a stressful situation EXCEPT
A.Chronological age
B.Response to similar situations in the past
C.Performance level in school
D.Parental Stressors
Performance level in school
Health care providers facilitating preparation for health care experiences should first and foremost consider the child's
A.Family structure
B.Developmental level
C.Medical condition
D.Personality
Developmental level
The age range of children MOST vulnerable to psychological upset related to hospitalization is
A.Birth to two and one-half years
B.Six months to four years
C.Two years to three years
D.Three years to six years
Six months to four years
A child being prepared for a hernia repair. Which age group would MOST likely need to be assured that their condition in not the result of thoughts or actions?
A.1-3 years
B.3-7 years
C.7-9 years
D.9-11 years
3-7 years
Children who use passive or avoidant coping strategies to deal with a venipuncture are MOST likely to benefit from
A.Comprehensive information about the procedure
B.Sedation during the procedure
C.Cognitive-behavioral therapies
D.Distraction strategies
Distraction strategies
To be comprehensive, the child life specialists developmental assessment should include physical, cognitive, affective, and which of the following other domains?
A.Medical
B.Play
C.Social
D.Environmental
Social
Which of the following activities would be MOST effective in helping a toddler address the issues of autonomy and separation/
A.Reading a book on separation
B.Discussing separation
C.Playing "hide and seek"
D.Playing "house
Playing "hide and seek
Problem-solving behaviors directed towards changing something in the environment are referred to as
A.Problem-focused coping
B.Emotion-focused coping
C.Stress appraisal
D.Unconscious stress
Problem-focused coping
Which of the following authors was instrumental via film and writing in establishing hospital policies regarding unlimited parental visitation?
A.James Robertson
B.Anna Freud
C.Margaret Mahler
D.John Bowlby
James Robertson
Which of the following does NOT demonstrate a child life specialist's commitment to collaboration?
A.Advocacy efforts
B.Projects to further the mission of the health care facility
C.Participation in committee work
D.Distribution of goals for patient care
Distribution of goals for patient care to other team members
Of the following, which is the MOST appropriate way for a schoolteacher to provide support at home for in the hospital for a child who is ill?
A.Maintain contact and support by various methods
B.Make certain that all schoolwork is collected and sent to th
Maintain contact and support by various methods
Observations of children engaged in health care play gives accurate information about all of the following EXCEPT:
A.Coping effectiveness
B.High levels of anxiety related to health care events
C.Understanding of the health care procedures
D.Developmental
Developmental status
The mother of an eight-year-old child with leukemia reports frustration regarding her daughter's ability to cope with the medical experience. One of the interventions a child life specialist suggests is a daily schedule, for the following reasons.
A.Parti
Control, independence, and predictability
One characteristic of good volunteer supervisors in the ability to
A.Coach his/her volunteers
B.Give feedback only at scheduled meetings
C.Problem solve for volunteers
D.Allow volunteers to interact with children by trial and error
Coach his/her volunteers
A child with neutropenia has which of the following?
A.Decreased blood flow to the lings
B.An enlarged liver and spleen
C.Calcification of the joints
D.A decrease in the number of circulating white blood cells
A decrease in the number of circulating white blood cells
When engaging in medical play with a child, the child life specialist should do all of the following EXCEPT
A.Provide realistic materials
B.Allow the child the choice of avoiding play
C.Correct any apparent misconceptions as they are revealed
D.Monitor mi
Monitor misconceptions revealed through play
The coping effort in which one's behavior is directed towards dealing with the distressing thoughts and feelings that accompany stressful situations is
A.Problem focused coping
B.Emotion focused coping
C.Resolution focused coping
D.Equilibrium focused cop
Emotion focused coping
The child life program must have written policies and procedures to meet the requirements of accrediting agencies and to
A.Ensure a level of quality and consistency of care and practice within the program
B.Ensure equal status with other disciplines in th
Ensure a level of quality and consistency of care and practice within the program
Which of the following is an appropriate guideline to follow when preparing a child for potential stress inducing events?
A.Young children need to have their preparation accompanied with appropriate audio-visuals while adolescents prefer verbal explanatio
Preparation of each individual child should be the responsibility of one person should be supported by other staff members
Of a 6-year old who announces " I'm here for my methotrexate, " it can accurately be stated that the child:
A.Knows the technical name for the medication
B.Is not fearful of the treatment and has accepted the illness
C.Knows what to do to get through the
Knows the technical name for the medication
Which of the following is an accurate statement about the sequence of the physiological development of motor skills?
A.Motor Development begins when the child reaches age 6 months
B.The development sequence is disordered in children with cerebral palsy
C.
Motor development proceeds from the head downward to the lower body, and from the center of the body outward to the extremities
A 3-year old child brought into an emergency department assumes that the unfamiliar items in a tray on a counter are to be used in her treatment. Piaget would explain this behavior as an example of:
A.Disequilibrium
B.Accommodation
C.Conservation
D.Egocen
Egocentrism
A child repeatedly asks questions during a blow draw. According to Lazarus, this behavior is best identified as
A.Primary appraisal
B.Problem-focused coping
C.Emotion-focused coping
D.Secondary Appraisal
Problem-focused coping
According to theories related to body image, at which age would female patients be expected to become most distressed about learning that chemotherapy is likely to cause hair loss?
A. 7 years
B. 10 years
C. 14 years
D. 20 years
14 years
The child life specialist should observe a child's intensity of response, distractibility, adaptability to changes in routine, persistence, and attention span, in order to determine the child's:
A. Predominant pattern of behaving
B. Developmental level
C.
Predominant pattern of behaving
The child life specialist should interpret with caution certain nonverbal behaviors such as eye contact noted among parents in the hospital, since these behaviors
A.May change under the stress of hospitalization
B.Seldom provide reliable information about
May vary greatly among differing cultural groups
When talking with parents in a health care setting, the child life specialist should
A. Be accepting of silence
B. Refrain from asking questions
C. Talk about ones own experiences
D. Give advice and offer suggestions
Be accepting of silence
After working on an individual school project for weeks, a patient learns that hospitalization will prevent its completion. According to the work of Erikson, at which stage is a child most likely to be distressed by the situation?
A. Autonomy vs. shame an
Industry vs. inferiority
Knowledge of the child's temperament provided by the parents generally
A.May reflect the child's behavior when healthy, but is likely to have little or no relation to behavior in the hospital
B.Offers helpful information about preschool children but littl
Can provide child life specialists with valuable clues as to know to interact with the child
Which of the following instruments is most appropriate for assessing personal-social, fine motor, and gross motor skills of children under 6-years of age?
A. Child behavior checklist
B. Denver Developmental Screening tool
C. Brazelton Behavioral Assessmen
Denver Developmental Screening tool
Developmental assessment of a 6-month old infant indicates that the child is in the lower part of the normal range of performance for that age. The infant's parent is concerned that the child will have difficulties in the later years. A child life special
Infant assessments are not good predicators of later outcomes
The most critical factor associated with a child's vulnerability to the stresses of hospitalization is the
A. Age of the patient
B. Level of family support
C. Medical condition
D. Length of hospitalization
...
Children who have experienced trauma or loss require continuous assessment of which behavior?
A. Changes in interactions with siblings
B. Parent-child interactions
C. Responses to peer pressure
D. Self-blame
...
Preschool children typically conceptualize illness as something
A.Located inside the body
B.Caused by proximity or magic
C.Linked to death
D.Caused by physical contact with a person or object
...
An accurate statement about emotional stress is that it is:
A.Experienced by fewer hospitalized children today than in the past
B.Seen frequently in the hospital but rarely observed after discharge
C.Common during the period of hospitalization and followi
...
Which of the following statements most supports the use of temperament theory and its dimensions in child life assessments
A.The child life specialist should consider a cognitive-affective approach with an angry child
B. A temperamental child requires foc
...
Which statement is true about nondirective medical play?
A.Medical play and preparation are synonymous
B.The adult should follow the child's lead
C.The play is accompanied by positive affect and is not intense or aggressive
D.The child should be the only
...
When families can visit hospitalized children only occasionally and the children exhibit difficulty coping with the separation, the most helpful action is to
A.Encourage staff and volunteers to assume parental roles
B.Avoid upsetting the child by talking
...
Which of the following would be most useful in helping a child work through a just completed medical procedure?
A. A visit to the activity center
B. Separation play
C. Interacting with peers
D. Medical Play
...
Which of the following determines priority goals in planning therapeutic play interventions for a child?
A. Health care team's treatment plan
B. Child Life Specialist's observations
C. Child's needs and milieu
D. Parent's concerns
...
A child life specialist should play for a child when the child:
A.Is either to ill, physically unable, or withdrawn to engage in play
B.Has exhibited inappropriate play behavior
C.Expresses feeling so inadequacy about performance on a game or project
D.Ha
...
The effect of a child life specialist using a standardized plan to prepare a 5-year old for different types of medical procedures is that:
A.The child's individual needs may not be met
B.Preparation standards are consistently reinforced
C.The specialists
...
When working with an adolescent struggling with lack of trust issues, the child life specialist should:
A.Encourage patient journal writing
B.Document interactions with patient and peers
C.Maximize communication opportunities
D.Organize a medical team con
...
Filmed modeling is believed to be an effective way of preparing children for health care experiences primarily based on:
A. Pavlov's model for classical conditioning
B. Skinner's theory of behavior shaping
C. Erikson's psychosocial theory
D. Bandura's soc
...
A researcher is designing a study to investigate whether reduced anxiety in children is associated with preparation before a medical procedure. To ensure confidence in the results, the most appropriate research design would be to:
A.Randomly select a grou
...
One of the most important forms of support for the families of children with special needs is:
A. Physician to parent support
B. Child to parent support
C. Parent to parent support
D. Child to child support
...
A primary benefit of the development of a supportive relationship is that it enhances the child life specialists ability to:
A.Engage in therapeutic interaction with the patient
B.Elicit cooperative behavior from the patient
C.Plan activities for the chil
...
A correct statement about the use of health care teams to meet the needs of children is that the:
A.Family is a critical member of the team
B.Professions represented on the team are consistent from patient to patient
C.Composition of the team remains the
...
Which approach is most appropriate for evaluating the effectiveness of an intervention designed to reduce fear, stress, and anxiety in a selected group of patients
A. Anecdotal reports
B. Critical pathway note
C. Behavioral rating scale
D. Cost/benefit an
...
A child life specialist has determined that a child is experiencing separation anxiety, identified an appropriate play intervention, and engaged the child in that play. The specialist's next logical step would be to:
A.Engage the child in conversation abo
...
To investigate the effectiveness of a hospital preadmission program for children undergoing day surgery, a researcher plans to randomly select a small group of patients who completed the program and a small group who did not, and then observe the child's
...
A female child is mature and willingly compliant in managing the frequent treatments associated with her chronic illness. At 14 years of age however, she begins to skip medications and misses other treatments and appointments. She does not exhibit signs o
...
Which of the following chart notes is appropriate for a child life documentation in a medical record?
A.Provide mother with ongoing psychotherapy
B.Provide consistent emotional support to reduce child's depression
C.This child must have anesthesia inducti
...
A child has not been prepared for a procedure during which the parent will not be present. During the procedure, the child cries softly. This response:
A.Demonstrates that the preparation was successful since the child maintained control.
B.Gives little i
...
When developing a child life care plan, theoretical assumptions:
A.Guide the goals, choices of interventions, and conclusions of all child life specialists
B.Affect the process of care indirectly, and have little direct relevance to care plans
C.Are of li
...
An effective supervisor of child life volunteers will do which of the following?
A.Minimize directive feedback in order to facilitate use of the volunteer's natural abilities
B.Make performance expectations clear and provide continuing feedback
C.Provide
...
A child life specialist notes in a patients chart that the patient "is very depressed today." A primary problem concerning this entry is that it:
A.It ignores the fact that depression is a common state among hospitalized children
B.Fails to say why the pa
...
Which of the following statements best describes the purpose of the Child Life Council Standards of clinical practice?
A.To establish the authencity and validity of child life interventions as they related to larger service delivery systems
B.To assure st
...
A non- child life staff member consistently fails to collaborate with the child life specialist's best efforts to work with a certain patient and family. The most effective starting point for resolving this issue is to:
A.Speak with the staff member about
...
In planning a special event for pediatric patients, the most important consideration is whether the event
A.Is sufficiently entertaining for children from all social strata
B.Is appropriate and safe for the developmental age of the children
C.Has any publ
...
Which of the following is a major component of the Official Documents of the Child Life Council?
A.Child Life Competencies
B.Vision to action statement
C.Articles of incorporation
D.By-laws
...
The person primarily credited with the development of the child life role is:
A Gene Stanford
B Thesi Bergmann
C Emma Plank
D Anna Freud
...
A student at the beginning of the a child life internship is in a critical phase of affirming professional self-worth. The best way for a child life specialist to assist the intern is to provide
A Time in the first staff meeting for the intern to present
...
A parent has given informed consent for a 7-year old child to participate in a research project conducted by the child life specialist. However, before the researchers proceed, it is most important that they:
A.Be certain that the child is assigned to the
No answer on key
During a discussion with a personal friend, a child life specialist mentions the name and diagnosis of a patient and makes comments about the patient's family. This discussion is:
A.Inappropriate unless the friend is able to keep the information confident
No answer on key
When teaching adults:
A.An open structure, active learner approach is often the most meaningful
B.A passive learned approach is most effective, because most adults have experienced it in previous schooling
C.The formal lecture format is recommended, becau
No answer on key
A major factor in volunteer retention is
A.Encouraging volunteers to work independently with little assistance from staff
B.Matching volunteers needs with volunteers roles
C.Encouraging volunteers to work with very challenging children
D.Providing minimal
No answer on key
A child life student states angrily that the final internship evaluation performed by the child life specialist supervisor contains subjective opinions. The supervisor's most helpful action to address the students concerns would be to
A.Support the evalua
No answer on key
What are the child variables in child life planning in a stress potential assessment?
A. Responses to previous separation from home and family
B. Siblings and reaction to hospital
C. Anticipation of treatment and procedures
D. Values of health care profes
Responses to previous separation from home and family
When interviewing a family, which of the following is most important to assess?
A. Child's interests and talents
B. Child's position in the family
C. Developmental level of the child
D. Child's grade in school
Developmental level of the child
When prioritizing patients, regarding potential for psychological upset, which factor should be taken into consideration?
A. Age
B. Gender
C. Cultural Identity
D. Socio-economic status
Age
A 14-year old siblings response to his sister who is dying is " I don't know why everyone's so concerned about. She will pull through, she always does." What type of coping effort best describes the comment?
A. Psychological
B. Emotion focused
C. Physiolo
Psychological
What is a passive response to the stressors of hospitalization?
A. Whining
B. Excessive sleeping
C. Displaying compulsive behavior
D. Gaze avoidance
Excessive sleeping
Which of the following best describes why typical development may be interrupted for children with chronic health conditions?
A. Frequent medical visits
B. Difference from peers
C. Falling behind in school
D. Lack of social skills
Frequent medical visits
Which of the following is the primary reason for the child life specialist to conduct an initial assessment of the patient's and family's needs?
A. Plan interventions based on the patient's and family's interests
B. Formulate realistic patient and family
Formulate realistic patient and family treatment goals
The child life specialist may achieve which of the following through observing a child's play?
A. An assessment of the child's regression to earlier levels of development
B. An ability to interject parts of the child's play that are missing due to distres
An ability to interject parts of the child's play that are missing due to distress
What is the sequence of reactions of young children to separation from primary caregivers?
A. Sadness, anger, and depression
B. Protest, despair, and detachment
C. Regression, rage, and sadness
D. Anger, longing, and hopelessness
Protest, despair, and detachment
Children in which age group typically believe that a person who has died will come back to life?
A. 3-5
B. 6-9
C. 10-12
D. 13-18
3-5
What is an example of egocentrism in a 16-year old who is in a health care setting?
A. Believing others are preoccupied with their appearance
B. Rejecting attention from staff
C. Displaying a lack of empathy for other patients
D. Inquiring about personal
Believing others are preoccupied with their appearance
What should a child life specialist look for when assessing a child and family?
A. A wide range of variables and systems that influence the successful management of stressors
B. Adaptive behaviors and how the child reacted to past medical experiences and
A wide range of variables and systems that influence the successful management of stressors
A family's level of coping is most directly related to which of the following?
A. Social class
B. Support system
C. Level of education
D. Religious denomination
Support system
Which of the following child life practices is a key element of family-centered care?
A. Establishing a pediatric playroom
B. Developing a sibling support group
C. Working in partnership with families
D. Providing for rooming-in
Working in partnership with families
Which of the following examples demonstrates effective cross-cultural communication?
A. Being open and respectful to differences
B. Learning new gestures and facial expressions
C. Speaking in a loud voice with clear articulation
D. Paraphrasing everything
Being open and respectful to differences
When a parent does not want to tell his/her 9-year old child the diagnosis and prognosis of a life-threatening illness, which of the following is likely to occur?
A. Shielding from the truth may decrease anxiety
B. At this age the child is not able to und
The child will be unsure of who to trust
Hospital policies which encourage on-going peer relationships demonstrate responsiveness to which developmental group?
A. 11months-2 years
B. 3-5 years
C. 6-11 years
D. 12-18 years
12-18 years
When parents are provided information and emotional support, which of the following is most likely to happen
A. Children will regress
B. Fears will disappear
C. Anxiety will decrease
D. Dependency will escalate
Anxiety will decrease
Which of the following characterizes a 4-years old's thinking about death?
A. Perceives death as temporary and reversible
B. Understands the physiological cause of death
C. Empathizes with feelings of other family members
D. Comprehends that death is fina
Perceives death as temporary and reversible
Who is the best person to inform a child about the death of a family member?
A. An adult who they trust
B. Child Life Specialist
C. Psychologist
D. Grandparent
An adult who they trust
Which of the following is an example of behaviors that strengthen the predictability and reliability of supportive relationships between child life specialists, children, and families?
A. Hello and Goodbye rituals
B. Regular playroom hours
C. Permission f
Hello and Goodbye rituals
When facilitating a transition from hospital to home after an extensive stay in the hospital, which of the following is important for a child life specialist to initiate?
A. Encourage immediate return to normal activities
B. Discuss child's limitations wi
Inform parents about children's typical post-discharge behaviors
A child expresses reluctance to return home following an extended stay in the hospital. Which of the following is the most appropriate action for the child life specialist?
A. Document concerns and share the information with the team
B. Refer the child an
Validate the child's feelings while addressing specific concerns
Why is early and continual assessment of the child's and family's changing medical and psychological situation necessary?
A. Identify the best ways to help reduce stress and promote coping
B. Create a positive professional image
C. Determine if the parent
Identify the best ways to help reduce stress and promote coping
A typically developing 16-year-old boy is admitted to the hospital the day before a scheduled surgery for a shunt revision. Outside of the patient's room, his mother states that her son does not know that he has a shunt and she does not want him to know.
Explore the mother's feelings and reasons, and discuss the concept of consent/assent
What is an important guideline to follow when providing support to children and families?
A. Highlight the area's of weaknesses in the parent/child relationship
B. Add to, but does not detract from the parent/child relationship
C. Center interventions aro
Add to, but does not detract from the parent/child relationship
Which of the following is a guideline for supportive listening?
A. Give constructive feedback
B. Provide gentle guidance
C. Minimize periods of silence
D. Use open ended questions
Use open ended questions
Which of the following best describes interactions that help children and families learn health care information?
A. Individualized, accurate, and age appropriate
B. Integrated with playful techniques and humor
C. Focused on being positive and minimizing
Individualized, accurate, and age appropriate
What is the purpose for providing opportunities for children to engage in health care play?
A. To normalize the environment
B. To provide opportunities for role identity
C. To distract patients from expressing feelings
D. To avoid the use of real medical
To normalize the environment
In preparing a 4-year old for surgery, which of the following should be included?
A. Sensory information
B. Abstract Ideas
C. Privacy Issues
D. Detailed pictures
Sensory information
What should the child life specialist do when preparing children for healthcare experiences?
A. Provide honest, accurate information using age-appropriate language
B. Use medical terminology so that children can become accustomed to this language
C. Omit
Provide honest, accurate information using age-appropriate language
What is an outcome of providing psychological preparation?
A. Decrease in crying and protesting
B. Healthcare provider is seen as less threatening
C. Decrease in anxiety and stress
D. Patient does not move during procedure
Decrease in anxiety and stress
Which of the following is an important strategy found to be helpful when preparing 3-4 year old children for surgery?
A. Offer appropriate choices to secure a sense of control
B. Prepare them one week before surgery
C. Provide preparation over the phone w
Offer appropriate choices to secure a sense of control
What is the purpose of encouraging patients who are 13-18 years old to dress in their own clothes and maintain personal grooming and hygiene during hospitalization?
A. Maintain hospital cost containment measures
B. Encourage independence and self responsi
Facilitate adjustment by normalizing the hospital environment
What should be considered when evaluating a child life plan of care?
A. Goal of achievement
B. Available resources
C. Patient satisfaction scores
D. Results of formal questionnaire
Goal of achievement
In addition to child oriented atmosphere creative materials, hospital objects, and meaningful play for children in healthcare also requires which of the following?
A. Private space to get away from others when desired
B. Other hospitalized children for pl
A permission-giving responsive adult
Which of the following is theoretical basis in support of the play behavior in hospitalized children?
A. Children are under stress and thus require adult guidance during play.
B. Directed play activities are most therapeutic
C. Specialized equipment is ne
Children may express ideas and feeling in play that they are unable to express verbally
What is the most important reason for the child life specialist to involve a child's family in the planning of the child's birthday celebration?
A. The family is responsible for what happens with the child
B. Involvement of the family supports the natural
Involvement of the family supports the natural role of the family
When a child expresses negative, hostile, or aggressive feelings during play, what should be the child life specialist's response?
A. Use distracters to redirect the child
B. Validate the child's feelings
C. Ignore the child's remarks
D. Help the child em
Validate the child's feelings
Which of the following should a child life specialist do to assess and effectively interact with infants, children, adolescents, and families?
A. Complete an academic program and internship in child life
B. Organize daily routines and calendars for play r
Match interactions and activities to developmental level, emotional state, and individual needs
Which of the following describes the obligation of the child life specialist to demonstrate veracity?
A. Being truthful
B. Being Timely
C. Being trusting
D. Being tenacious
Being truthful
According to the Child Life Council Code of Ethical Responsibilities, what is the minimum length if time required to lapse before a professional relationship may turn to a personal relationship with a patient or family member?
A. 1 year
B. 2 years
C. 1.5
2 years
What is the benefit of interdisciplinary collaboration?
A. Enhance patient care
B. Delineation of professional roles
C. Evaluation regarding child life services
D. Recognition of diversity
Enhance patient care
When a conflict arises between a child life specialist's plans and a co-worker's plan for the patient, it is most useful for the child life specialist to employ which of the following strategies?
A. Educate the co-worker about child life practice
B. Sched
Invite the co-worker to create a collaborative care plan
A 13-year old recently discharged from the hospital and has lost his/her hair due to treatment. Which of the following would be most helpful for this adolescent going back to school?
A. A home tutoring program
B. A school reentry program for the teens cla
A school reentry program for the teens classmates and teachers
Which of the following represents the effective process for problem solving?
A. Problem identification, implementation, problem analysis, and idea generation
B. Self evaluation, professional boundaries, respecting diversity, and problem analysis
C. Proble
Problem identification, problem analysis, idea generation, and implementation
Other than salary, what is the largest expense when hiring a new child life specialist?
A. Consumable supplies
B. Tuition reimbursement
C. Travel/ conference fees
D. Employee Benefits
Employee Benefits
How should the use of statistics, numerical analysis, and databases be beneficial to a child life program?
A. Assist in the evaluation and program development
B. Provide standards for rewriting job descriptions
C. Provide framework for evaluating competen
Assist in creating staff development programs
Members of the child life team are aware of hospital wide staff reductions in the next fiscal year. The staff seeks to maximize efficiency in their department. How should the staff begin?
A. Collect data to show how many children and families are receivin
Collect data to show how many children and families are receiving child life services and the outcomes
What is the primary research technique in a co-relational study?
A. Perform experimental manipulations of independent variables to assess their effects on dependent variables
B. Perform simultaneously comparisons of a cohort in terms of age of subjects an
Describe the relationships between variables without experimental manipulations
Why is child life assessment important?
It is an effort to reduce the negative impact of hospitalization on pediatric patients.
Child Life Assessment:
Variables Associated with a child's ability to cope with hospitalization
How studies identify factors associated with coping
� Quantative and correlational in design
� Linked to self-report scales completed by children and parents.
� Four categories of variables:
.) Child variables
o 2.) Family variables
o 3.) Illness variables
o 4.) Medical Experiences.
Autonomy
the duty to respect and foster self-determination and freedom of action of the individual
Justice
the duty to be fair, impartial and equitable and to avoid any discriminatory practices
Veracity
the obligation to be truthful, essential to foster trust
fidelity
the duty to keep promises
competence
the duty to attain and maintain adequate skills and abilities to perform
emancipated minor
self-supporting and/or not living at home, married, pregnant, in the military or declared emancipated by a court
Mature minor
younger than the statutory age of consent, still dependent upon parents at the age of discretion and capable of making sound judgements
principle 1
Hold paramount the welfare of children, youth and families whom they serve
principle 2
maintain objectivity, integrity and competence in fulfilling the mission, vision and values and operating principles of their profession
principle 3
obligation to serve children and the their families regardless of their race, gender, religion, sexual orientation, economic statues, values, national origin or disability
principle 4
respect the privacy and maintain confidentiality of their children and families. ensure the standard of verbal and written communication of their employer
principle 5
promote effectiveness by continuous efforts to improve professional services and practices
principle 6
continually seek knowledge and skills that will enhance their understanding of all relevant issues
principle 7
individuals engaged in study/research shall be guided by conventions of scholarly inquiry and shall recognize their responsibility for ethical practice in research
principle 8
obligation to engage only in areas in which they are qualified
principle 9
act with respect for the duties, competencies and needs of their professional colleagues and shall maintain integrity
principle 10
shall use integrity to assess and amend any personal relationships or situations that may interfere with professional effectiveness
principle 11
recognize that financial gain should never take precedence over the delivery of service
principle 12
when supervising or training others, there is responsibility to teach professional values and provide optimal learning experiences
principle 13
refrain from illegal conduct in their professional practice
longitudinal research
one group of subjects who are the same age and measured over years
longitudinal-sequential reserach
2+ groups of subjects w/ differing ages measured repeatedly with age
cross-sectional reserach
2+ groups of subjects with differing ages measured once at the same point in time
retrospective research
designed after subjects have experiences the event
Pavlov
Classical conditioning
thompson
believe most neglect group in the hospital is adolescents
responenses to stress
passive, regressive, overt/active
passive response to stress
excessive sleeping, decreased communication, decreased activity and eating
regressive response to stress
alterations in sleeping, eating too much or too little, anxiousness, overly concerned with body and/or compulsive behaviors
overt/active response to stress
crying, screaming, whining, clinging to parents
skinner's operant conditioning theory-behavior shaping
behavior can be shaped/modeled by reinforcing responses that are closer to the desired behavior
Operant conditioning
the process by which a response is gradually learned via reinforcement or punishment
goal of operant conditioning
to increase appropriate behavior and decrease inappropriate behavior
john watson
established the psychological school of behaviorism
Bolig's types of child life programs
diversionary, therapeutic, child development, comprehensive
diversionary child life program
divert attention away from thinking about experience
therapeutic child life program
assist in expression of emotional and fantasies related to their experiences
child development child life program
program activities that emphasize normal development
comprehensive child life program
maintain the objectives of providing socialization experience, normalizing environment, facilitating expression of feelings and family involvement
james robertson and john bowly's sequence of reaction of young children to separation
protest, despair, detachment
protest
strong expectation that parent will return, example upset pt
despair
increasing hopelessness, will suffer long term, example quiet and withdrawn
detachment
respond to parent with indifferencw
james robertson
advocated unlimited parental visitation. children should be prepared for hospitalization no earlier than one week prior to the child's admission.
Mildren Parten's Categories of Play
Unoccupied, Onlooker, Solitary, Parallel, Associative, Cooperative
Unlooker Behavior Play
no focus or interest
Onlooker Play
consciously observing (child not actively involved in play)
Solitary Play
playing but no effect to interact with others, playing alone
Parallel Activity Play
play beside but not with others
Associative Play
play and interact with each other but there is no plan, unorganized
Cooperative or Organized Supplementary Play
group goal developed and lead by 1 or 2 player
Freud's Psychoanalytic Theory (Psychosexual Stages)
Oral, Anal, Phallic, Latency, Genital
Oral Stage
0-1, pleasure on mouth
Anal Stage
1-3, toilet training
Phallic Stage
3-6, fondles genitals, wants their parent of opposite sex
Latency Stage
6-11, drives are stable
Genital Stage
12+, sexual development and reproduction
Anna Freud and Rene Spitz
maternal deprivation
Emma Plan
Mother of child life, "working with Children in hospital", Founder of ACCH 1967-Association of the Care of Children in Hospitals which later changed to Associate of the Care of Children's Health
Banduras Social Learning Theory
An application of behaviorism that emphasizes that many human behaviors are learned through observation and imitation of other people (Nature)
Modeling (Meladment and Siegel)
the process in which people observe and then copy the behaviors of others. Filmed modeling is an effective way of preparing a child
Preparation, play and parent=
less psychosocial upset
Prugh 1954
first experimental designer research study to prove that adverse psychological upset resulting from hospitalization could be changed by unlimited parental visitation, preparation and play
Children under three are...
most susceptible to circumstance surrounding hospitalization
Trust vs. Mistrust
0-1, come to trust that basic needs will be met
Autonomy vs. Shame and Doubt
1-3, most acquire a sense of independence or else they will develop feelings of shame about their individuality, become independent or feel shameful about dependence
Initiative vs. Guilt
must feel free to act, create and take risks. Children who are inhibited by these pursuits become overwhelmed by guilt. If they aren't brave enough to take initiative, guilt arises.
Industry vs. Inferiority
6-12, Must feel competent with skills and valued by society. Failing too often will bring about feelings of inferiority. Skills not valued=inferiority
Identity vs. Role Confusion
12+, try to figure out who they are. Establish sexual, political, and career identities and are confused about what role to play
Intimacy vs. Isolation
Young Adulthood, willing to risk offering themselves to others or become isolation by fear and rejection
Generativitiy vs. Stagnation
Mature Adult, must gain a sense that they have contributed to the world in some lasting fashion.
Integrity vs. Despair
Older Adulthood, must feel great accomplishment and satisfaction in the events of their lives.
Piaget's Cognitive Development Theory
a grand theory of human development that focuses on the structure and development of thinking, which shapes people's attitudes, beliefs and behaviors
Piaget's stages
Sensorimotor, Preoperational, Concrete Operation, Formal Operations
Sensori-motor
1-2 Relay on action and sense to know things, purely reflective (w/o though) through movement and perception.
Toward end of stage object permanence occurs
Pre-operational
2-6 Use of symbols and Internal thought to solve problems. Thinking is tied to concrete objects and they are fooled by the appearance of things.
Egocentrism-everything is though of as how it relates to them
Can only focus on one thing at a time
Concrete Operations
6-12vUse early logic to solve problems. Require concrete objects to learn.
Reversiblity-reverse direction of their thoughts
Formal operations
12+ can think abstractly and hypothetically
Vygotskys Zone of Proximal Development
the task requires thinking just above student level of current mastery. The zone in which the student can learn with help from others.
The right amount of information to teach a specific age group in order for them to comprehend on their own development l
Vernon
Self Causation, pt's under 7, number of hospitalizations, length of stay determines psychological upset in the child. Child may begin to fear: punishment, mutilation, death or abandonment
Garmezy
Resilience, protective factors found in individual response to stress of risk, the ability to bounce back. Variables: Personal features, Family cohesion, External support to reinforce coping
Kohlberg's Moral Judgement Development
Preconventional, Conventional, Postconventiional
Nature
biological affects
Nurture
environmental affects
Age most vulnerable to psychosocial upset by hospitalization
6 months-4 years
Development assessment includes
physical, cognitive, affective, social
most effective way of helping a toddler cope with separation
is a game of hide and seek
APIE format
Assessment, Planning, Interventions, Evaluation
SOAP formate
Subjective, Objective, Assessment, Plan
Core values
respect, strengths, choices, information, support, flexibility, collaboration, empowerement
affects of hospitalization-Infants
immune to psychological effects of hospitalization
affects of hospitalization-Toddlers & Preschool
most susceptible to circumstance surrounding hospital care
affects of hospitalization-School Aged
deal better because they are better with separation and make friends with other hospitalized children
affects of hospitalization- Adolescents
challenged with developmental aspects, physical development and privacy issues
A children's attachment behavior is
activated by pain, fatigue, and anything firghtening
Alert/Active Responses to Situations
crying, screaming, whining, clinging to parents, self-destructive, fighting, resisting meds and treatment
Passive Responses
Excessive sleeping, decreasing communication, decreasing activity,
Regressive Behavior
alterations in sleeping patterns, eating too much or too little, being tense anxious restless, concerned with body image
elements related to the degree of psychological upset
unfamiliar setting,
authoritative parents
has clear rules and beliefs, kids are well adjusted. High warmth, moderate discipline with much discussion, high communication between parent and child
Indulgent parents
wants to keep you happy, permissive. Kids are aggressive and have low achievement. Non-serious delinquent. No boundaries, accommodate everything
Authoritation parents
uses physical punishment. Kids are anxious, conflicted and not aggressive. Low warmth, strict physical discipline more parent to child communication
Neglecting Parents
don't care about child. Child has low self-esteem, is moody. High rate of deliquency
cognitive appraisal
process of evaluating what is happening for his/her well being, appraisal=familiarization
coping
process of managing stress and emotions generated
strategies to coping
relaxation techniques, systematic desensitization, medical play, distraction, calming self talk
ways of avoiding stress
denial, regression, withdrawal, impulsive acting out
ways of accepting stress
altrusim/the helper, humor, sepression, anticipation, sublimation
Young Infants
max parental participation, Max info to parents, Provide stimulation
Older Infants
separation is great concern, support max parental participation and info, provide age appropriate stimulation
Toddlers
express through play, continue mother-child relationships, familiar routines, structure, mastery and control
Preschoolers
fears of castration and mutilation, imaginative thoughts and fantasy, preparation is necessary,
School Aged Child
fear of anesthesia and death, feels that death is something they caused, separation concerns
Adolescents
neglected group in hospital, social life, body image and self worth are tied to peer groups
assessment
medical infomation, development information, environment information, idiosyncratic information, issues with child & fam
factors to be considered
age of pt, high risk children, medical conditions, manifested problems
facilitation coping behaviors
choices, honesty, reassurance
coping with emotional conflict through play
normalize situation, mastery through play, self espression
staff response to play
monitoring regress, understanding fears and feelings, enhance communication, education and prepare
Jean Piaget
Assimilation and Accomodation
Assimilation
continually learning through actions and explorations and taking in information
Accomodation
the process of altering old patterns of thinking to allow further assimilation of information
Physical Development
activities that are appropriate for the child's level of development and medical conditions. Should adapt to the physical abilities of the child
Intellectual development
stimulating activies for all age groups, direct exploration of the unique aspects of the hospital environment. CL should coordinate to see the child's schooling continues
Social Development
adequate space and differing age areas should be provided for play and interaction. Encourage inter patient mingling. CL should structure and facilitate group activites
Emotional Development
provide materials for self-expression. Be open and non-judgement of child's play. Summarize child's feelings
Importance of play to hospitalized children
monitoring regression, understanding fears and feelings, enhancing communcation, educate and parpare
case advocacy
problems handled on an individual basis
class advocacy
a general change in rules of practices affecting children and parents as agoup
emotional support
success of mental health depends on the establishment and maintenance of supportive relationships
preparation for health care procedures
may include play activities, specific sensory information, rehearsal, filmed modeling, teaching of coping skills and various combinations of these
play activities
children can actively participate in the learning process, better understand the information being presented and become familiar with impending procedures. Dramatic play provides opportunities for children to rehearse and express feelings
sensory information
to reduce stress, children need accurate minimally threatening descriptions of the sensation they will experience before and after the event
modeling
can help improve non-hospitalized children's attitudes toward hospital and medical events
coping technqieus
relaxation techniques, distracting imagery, comforting self talk
stress point preparation
designed to psychologically prepare children for potentially threatening or painful procedures using appropriate communication techniques. Prior to procedures children were give age appropriate education about procedure and sensations possible and then ha
parental involvement
anxiety and discomfort may be reduced by providing parents with information and emotional support, preparing parents well can not only reduce their stress but also the psychological upset of their child
play
children may use play to cope with stress accompaning healthcare,children who are willing to do medical play are less anxious than others after d/c
two aspects of psychological stress
event, children's response to that event
major goals of CL programming
to minimize or remove sources of stress, to help children and families with their situations as effectively as possibl
problem focused coping
trying to solve the problem by changing something in the environment
emotion focused coping
dealing with the distressing throughts and feelings that accompany stressful situations
learned helplessness
children who have repeated experiences of ineffective coping may develop the maladaptive syndrome, may never learn to deal properly
communication techniqures
consistent supportive interactions, psychological preparation, antcipatory guidance, play interactions, expressive activities
Stress vulnerability
chronological and developmental age, response to current and previous healthcare, abilities to communication
familiarization
positively influencing cognitive appreasial by decreasing uncertainty
anticipatory guidance
provision of information that can influence cognitive appraiseal
cognitive appraisal
personal evaluate the significance of what is happening of his or her well-being, harm, loss challenges threat
Sensorimotor
Learn through senses and reflexes, manipulate materials
Peroperational
Form ideas based on their own perceptions, can only focus on one variable at a time, overgeneralize based on limited experience
Concrete Operations
Form ideas based on reasoning, limit thinking to objects and familiar events
Formal operations
think conceptually and hypthetically
Strength gained from trust vs. mistrust
hope
Strength gained from autonomy vs. shame and doubt
willpower
Strength gained from initiative vs gult
purpose
Strength gained from industry vs. inferiority
competence
Strength gained from identity vs role confusion
fidelity
Strength gained from intimacy vs. isolation
love
infant
Disruption in normal routines seen in Fussiness and irritability
Immediate physical response to pain-seeks comfort
Stranger anxiety begins at 6 months
Toddlers
Stranger anxiety, fear of strangers
immediate physical response to pain and unfamiliarity
Regression in skills (motor, language, toilet)
Preschool
Separation anxiety
Anxiety about intrusions and mutilation
Anxieties aroused by egocentric thought, fantasies, and magical thinking
Fear of punishment aroused by guilt
Regression can occur
School Age
Fear of pain, body injury and mutilation, loss of control,
Fear of anesthesia
Cognitive regression can be seen
Separation concerns related to daily routine, school and peers
Modesty Concerns
Adolescents
Anxiety related to long term implications of illness and disability
separation concerns related to peers
anxiety related to body injury and pain
Concern for body image changes in physical appearance
Concern for privacy and modesty
Cognitive regression can