The Evolution of “The Play Lady”

Colette Case, one of the pioneers of Child Life care, explains how child life specialists are constantly expanding their roles to accommodate the needs of the most medically fragile children.

Colette Case, CCLS

Colette Case, CCLS

You may remember from earlier blogs that my passion for working with kids in hospitals began as a playroom candy striper. But what I didn’t share is that my supervisor was one of the people who has been responsible for shaping the child life profession itself—Colette Case, CCLS, the former long-time Director of Child and Family Life Services at Lucile Packard Children’s Hospital Stanford.

Colette participated in the Association for the Care of Children’s Health Child Life Study Section, which was formed to begin structuring the principles that would define and guide the profession. From its start, the field has been deeply rooted in the theoretical frameworks of child development, psychology, and recreation therapy. From the very first certificate programs at Mills College in California and Wheelock College in Massachusetts, the field has grown today to bachelor’s and master’s level degree programs offered in nearly 50 colleges nationwide.

The official validation of Child Life as an important part of hospital-based care for children came with the release by the American Academy of Pediatrics Policy Statement on Child Life Services. Today, Certified Child Life Specialists (CCLS) are an integral part of the multidisciplinary team and are present in every pediatric hospital in the country, as well as hundreds of community hospitals and in such diverse settings as private practice, hospice, outpatient clinics, medical camps, and even dentist offices. The role of child life specialists is also expanding, to include caring for well siblings and children of adult patients.

Colette Case at the Stanford Blood Center

Colette at the Stanford Blood Center

When Colette began her career at Oakland Children’s Hospital, there was one child life specialist for 77 patients. When she retired from Packard, there were 24 child life specialists on staff. The sheer growth in the number of positions available at hospitals to care for children and families attests to the career’s importance.

Although there are more child life specialists on staff than in the beginning of the profession, they are also called on to do things today that were not part of their responsibilities before. “Today, the expectation is that we (CCLSs) are there and are an integral part of everything going on. The role of the child life specialist has grown over time, where now we are called on to provide expertise from the perspective of the child and family on everything from sitting on the quality care committee, to designing a new pediatric hospital, to developing curriculum to train the entire clinical team—including physicians,” Colette explains.

“Although patient load is better, the acuity is much higher,” she says. Colette explains how child life specialists are constantly expanding their roles to accommodate the needs of the most medically fragile children.

Colette Case at George Mark Children's House

Colette Case at George Mark Children’s House

The field has also shifted to an evidence-based practice model—research is showing how interventions are impacting both patients and families, and even the hospital itself. One example of this is the impact child life has had on the hospital’s cost cutting efforts. “Children better prepared for procedures or supported during their hospital stays have been shown to require less staff time and require less sedation, for example,” notes Colette.

Hats off to Colette Case and all her early colleagues who have been instrumental in developing the profession!