Child Life Specialists: Taking Care of D-H’s Youngest Patients
Parents always know their kid the best, but, in stressful situations, it really helps to have someone there to help reduce stress and increase coping skills for both the child and parent.Jessica Laperle, child life specialist
Jessica Laperle, child life specialist, admits that her work day is often filled with play time—therapeutic play time. “We might be playing games or blowing on pinwheels, but we’re supporting the developmental, psychological and social needs of our youngest patients during their medical experience,” Laperle says. “There is a lot of scientific theory and evidence behind what we’re doing.”
There are nine child life specialists at the Children’s Hospital at Dartmouth-Hitchcock (CHaD). Seven work in Lebanon and two in Manchester, New Hampshire. “We work with patients from infancy to 18-years old, and help them and their families understand diagnoses, testing processes and how to adhere to treatment plans,” says Laperle. “We’re fully integrated members of the medical team.”
Child life specialists are assigned to a unit or service line, and typically receive referrals from physicians, nurses and care coordinators.
“We meet kids and families where they are and make sure that the medical team understands any developmental issues that might impact testing and treatment,” Laperle says. “For example, we make sure that teenagers aren’t scheduled for treatments at 6 am, a horrible time for adolescents, or that babies don’t have to give up their pacifiers during an X-ray. Small sucking motions are less disruptive than flailing arms.”
One of the most important aspects of the child life specialist's job is to reduce anxiety in patients and families. “Parents always know their kid the best, but, in stressful situations, it really helps to have someone there to reduce stress and increase coping for both the child and parent,” Laperle says. Infants might benefit from holding techniques that allow them to be comforted during procedures. Games that allow practice in holding still or breathing help reassure young children. Information often allays the fear of teenagers.
Karen Piacquadio saw the difference a child life specialist can make when her 16-year-old daughter, Kayla, underwent Vertebral Body Tethering (VBT) surgery, a minimally invasive procedure that corrects scoliosis, at Dartmouth-Hitchcock (D-H) Lebanon. “Kayla gets really quiet when she’s nervous, and she was so quiet when we got to D-H,” says Piacquadio. “Slowly but surely, thanks to the calm approach of Mollie Saults, her child life specialist, Kayla began to ask questions and relax.”
A child life specialist for just three-and-a-half years, Mollie Saults is already a social media sensation, at least in the world of Vertebral Body Tethering. “I learned about Mollie on Facebook,” says Piacquadio. “There’s a group for parents of kids with scoliosis and another mom wrote that Mollie had been an essential member of the team—a godsend. Vertebral Body Tethering is a surgery. Kids get really nervous. But when Mollie gets done, they’re feeling pretty good.”
The Piacquadios arrived at D-H the day before Kayla’s surgery and Mollie was there to meet them. “I gave them a tour of all the places Kayla would be and explained what would happen in each,” says Saults. “Then we talked about what Kayla could expect after the procedure and during recovery.”
“Mollie asked Kayla if she wanted to know details and she did,” says Piacquadio. “Being prepared was such a huge benefit for her. The doctors were great, but they just don’t have time to answer questions about things like the funny underpants you’ll have to wear, and how the anesthesia needle will feel.”
Reassured by Saults’ calm manner and the information she provided, Kayla slept well the night before surgery. When she woke up from anesthesia, Saults was the first person she asked for. “You can’t put a price on that,” says Piacquadio.
Laperle points out that, by helping to calm patients, child life specialists not only reduce the stress of hospital visits, they can simplify procedures and reduce risks. “We had a young patient who had to undergo a series of MRIs,” says Laperle. “Her parents worried about claustrophobia so the child was always sedated. We gave parents exercises the child could practice at home, and pointed out a website that allowed her to experience the noise before the procedure. She was able to have an MRI without sedation, and was so proud. Less medication meant less risk, and also lower costs.”
Child life specialists continue to support kids as they progress through pediatric treatment, often attending the first visits with adult providers to ensure a smooth transition. “I wanted a career that allowed me to do something valuable that really made a difference,” says Saults. “I feel so lucky to work with physicians and nurses to support our young patients and their families.”