“A” is for Assessment
Assessment of children and families in healthcare settings requires multiple facets. The assessor must have adequate knowledge, excellent communication skills, and a keen eye for observation. Assessment can be defined as “a systematic procedure for obtaining information from observation, interviews, and collaboration used to determine the level of need for services” (Turner & Fralic, 2009). The body of research concerning assessment procedures is largely based on the components. The present study, “Making Explicit the Implicit: Child Life Specialists Talk About Their Assessment Process”, written by Tuner and Fralic (2009), is aimed towards revealing the qualitative characteristics of the assessment process. In other words, they work to show how child life specialists conduct assessments in healthcare settings. In an effort to forge declarative and procedural knowledge, their study begs the questions, “what does the child life assessment process look like?” (Turner & Fralic, 2009).
Participants in this study included twelve child life specialists currently practicing in health care facilities located in Canada. Their work experience ranged from 3 to 27 years with academic experience varying from college diplomas to master’s degrees. Participants were contacted first by email to set up a phone interview. Phone interviews lasted anywhere from 25 to 60 minutes. There were five interview questions developed to serve as a general guide for conversation. These questions were sequenced specifically to reveal the process of assessment. The following outlines the questions that were asked in each interview:
What is the general process of meeting the child and family for the first time? Do you have any general practices that you use either to gain rapport with the child and family or for informational purposes? What practices or policies guide documentation and follow-up assessments of the child and family? What factors do child life specialists focus on in order to assess the needs of a child and family? How do child life specialists prioritize services and interventions for the child and family? (p. 43)
After gathering their data and reviewing the transcripts from each interview, the next step was to analyze the transcripts for initial descriptive coding. Transcripts were read multiple times, although the amount not recorded in the study. This was done to find the present themes in the responses of the participants’ interviews. Repeated reviewing and re-writing is proven to help clarify the responses and perspectives of the participants (Tuner & Fralic, 2009).
Their findings show a plethora of patterns consistent across their participants. When asked about the general process of meeting the child and family the first time, there seemed to be two starting points. One approach involved the child life specialist obtaining information prior to meeting the child and family, and the other approach utilized conversation with the family first then obtained additional information after the initial meeting. The next step typically involved introducing Child Life and their role with children and families. Most introductions included conversation concerning play and preparation. The following step included a casual question and answer session while covertly observing the child and family dynamics to assess coping styles, temperament, and developmental stage.
When asked about the general practices used in gaining rapport, child life specialists seemed to show three general practices. First, they all relied on materials or activities that were grounded in a developmental approach to building relationships. Second, they employed a strategy or practice termed as “coming and going”. This means they briefly introduce and assess then return later to continue building the relationship and forming an assessment. Third, they agreed that outpatient and playroom settings can enable child life specialists to utilize specific features of the environment to create a sense of belonging. Furthermore, they agreed that building relationships and rapport is a complex practice. However, it is characterized most by showing genuine interest, providing a sense of connection and opportunities for choice and control.
When asked about practices regarding documentation and follow-up assessments, child life specialists agreed that there is a need to reassess daily with patients in more long-term care, collaborate with other healthcare professionals who work with the pediatric patient and family, and document information in informal notes, chart notes, and standardized assessment forms. Most noted that documentation processes were more informal than formal. When asked about the factors focused on in order to be able to assess needs, child life specialists agreed that developmental level, coping style, temperament, parental availability, and previous hospital experiences were considered relevant. When asked about how they prioritize services and interventions for the child and family, two processes emerged: integration of multiple perspectives and prioritization the patient’s needs.
Personally, I thoroughly enjoyed reading the contents of the present study. I would highly recommend it to other aspiring child life specialists as well as current Child Life educators. As a Child Life student, the content of this study helps me in numerous ways. I have been able to gain further insight into the aspect of assessment, approaches to preparation, and how assessment and preparation can be fulfilled in multiple ways. The way the article is written also allows for me to feel like I observed what the child life specialists were describing in some of the examples that were written. I think this article will enable me with better preparation skills and insight that supplements the knowledge I’ve gained from previous college courses.
The article’s relation to Child Life is that it helps better prepare students, new CCLSs, as well as accomplished and established CCLSs. Furthermore, this article can be extremely beneficial for other non-Child Life healthcare professionals in such a way that enables them to see how a child life specialist’s assessment process falls back on our knowledge in development. This study also impacts the work of Child Life in several ways. Current research on how we educate students is brought to light in this article. Turner & Fralic (2009) demonstrate that students have the knowledge, but often truly learn after they have obtained field experience and practiced these skills because there are some qualities concerning assessment that are only verbally taught while in the field. An idea that came to my mind would be somehow incorporating a clinical experience in a Child Life program. Nursing students must complete countless clinical hours. I believe that Child Life may also benefit from incorporating clinical hours into their programs. This may help ease some of the competition for obtaining practicums and allow for future professionals to become even more prepared as they find future job/internship opportunities and begin their work.
Works Cited/Additional Resources