A Place for Attachment Theory in Child Life Programming: The Potential to Assess the Quality of Parent–child Relationships

Abstract

Child Life Specialists (CLS) working in pediatric health care settings provide programs designed to reduce the stress and anxiety associated with hospitalization and illness for children and families. Assessment in child life practice typically includes attention to a range of variables found to influence the response of children and families to the stressors of hospitalization. With roots in observations of early separation experiences, attachment theory may serve as an appropriate framework from which CLS may clarify the central role of the parent-child relationship to the well being of the child. Recognition of distinctions among secure, avoidant and resistant attachment relationships can inform child life assessment and interventions designed to address the specific needs of the child and family.KEY WORDS: child life; assessment; attachment theory; hospitalization.Over the last 40 years, the need to maximize positive outcomes and minimize stressors associated with illness and hospitalization for children and families has become an expectation in pediatric health care. As a result, a transition in the philosophy of care and the inclusion of Child Life programs is evident in many pediatric hospital facilities across North America. Trained in research and theory from the fields of human growth and development and family systems, Child Life Specialists (CLS) use play as the primary mode for the provision of unique services designed to meet the needs of children and their families experiencing hospitalization. Research results indicate the potential for the hospitalization of young children to be a stressful experience due to the child's age, separation from his/her parent, the discontinuity of caregiving provided in the hospital and the frightening and unfamiliar nature of hospital procedures (Hä gglöf, 1999; Correpondence should be directed to

Making Explicit the Implicit: Child Life Specialists Talk About Their Assessment Process

“…Assessment is a systematic procedure for obtaining information from observation, interviews, and collaboration used to determine the level of need for services. Existing child life literature is explicit in identifying the significant components of the assessment process (Koller 2008a;Turner 2005) but overlooks the qualitative components of the process. Therefore, the communication of the how to of assessment remains in the realm of implicit knowledge yet to be formally documented.…”

The PedsQL™ Present Functioning Visual Analogue Scales: preliminary reliability and validity

“…Hospitalized children may find the experience stressful [ 36 ], with elevated stress responses associated with severity of illness or injury and number of invasive procedures [ 37 , 38 ]. In response to these potential stressors, hospitals have developed child life programming, including pre-hospitalization preparation and subsequent support immediately at the time of hospitalization and during the hospitalization period, all intended to ameliorate the purported negative psychological reactions which may occur during hospitalization and the associated medical procedures [ 37 , 39 ].…”