Child Life Services

The Child Life internship program at Ochsner Medical Center is designed for individuals with the desire and knowledge to become a Child Life Specialist. Our Child life internship provides clinical development through a systematic learning experience centered on Child Life competencies.

• 14 week long internship
• 40 hours per week for a total of 560 hours
• Students will have rotations on the Pediatric unit, PICU, surgery centers, with mini-rotations in the Pediatric Clinic and other areas Child Life visits
• Supervision is provided by Certified Child Life Specialists, who strive to assist students as they apply theory to practice
• Internships are offered in the Fall and Spring

Our internship sessions are consistent with the recommendations from the Child Life Council. 

Minimum requirements for Child Life internship at Ochsner Medical Center

• Completed Application
• Resume detailing career objectives and experiences working with children             
• Academic transcripts reflecting completion of coursework recommended by the Child life Council
• Course work review by the Child Life Council
• Two letters of recommendation, one from an academic professor and one from a supervisor who has observed your work with children          
• Documentation of 150 hours of work with children of which, 75 hours must be completed in a child life practicum in a health care setting or in facility where children with medical and/or developmental challenges are served and must be under the direct supervision of a certified child life specialist.
• Minimum 3.0 GPA in related coursework

If you are interested in our Child Life internship, click here to fill out the Common Internship Application that is provided by the Child Life Council.

Please fill out this Child Life Internship Work Volunteer Experience Sheet and send it with your completed application.

Once you have completed this application, please send all paperwork to:
Child Life Department
Ochsner Hospital for Children
1514 Jefferson Highway
New Orleans, Louisiana 70121

If you have any further questions, please call our Child Life Department at 504-842-2032.

Child Life Practicum

The Children Life Department offers a Child Life practicum during the Fall, Spring and Summer semesters. The Child Life practicum is organized to give students the opportunity to gain insight and exposure to the Child Life profession and help students understand the unique needs of hospitalized children and families. Our practicum offers experience in all of our pediatric settings, as well as others areas in the hospital that we serve. Practicum students will have the opportunity to observe Child Life Specialists facilitate pre procedural preparation, procedural support and distraction and medical/therapeutic play. Various assignments and projects will be due throughout the practicum experience. Our practicum is a 12-14 week program with days varying, depending on individual needs. The student will be required to complete 120 hours.

• Spring Practicum Deadline (Starts in January):     October 31
• Summer Practicum Deadline (Starts in June):      March 31
• Fall Practicum Deadline (Starts in September):   June 30

If you are interested in applying for our practicum, click here to fill out an application and mail it to:
Child Life Department
Ochsner Hospital for Children
1514 Jefferson Highway
New Orleans, Louisiana 70121

If you have any further questions, please call our Child Life Department at 504-842-2032.

Tips for Coping with Hospitalization

Infants (birth - 12 months)
Infants feel most secure when they are with their primary caregiver.

• Provide for your child any comfort or security items from home, such as pacifiers, blankets, pillows, or stuffed animals.
• Talk to your child in soft, soothing tones. 
• Leave an item of yours (blanket, pillow) with the child when you are not available; particularly for newborn infants
• Help participate in basic care such as feeding, bathing, and dressing
• Evaluate stimulation needs for premature infants; sometimes premature babies need less stimulation
• Sing and play soothing music for your child. 
• Walk, rock, and hold your child often. 
• Keep the hospital room atmosphere a soothing one, with dim lights and low noise. 
• Encourage members of the medical team to speak soothingly to your child before touching her. 
• Speak with your Child Life Specialist about using comfort positioning during procedures.

Toddlers (1-3 years) and Preschoolers (3-5 years)
Separation anxiety and stranger anxiety are common for both toddlers and preschoolers to experience, especially in a new, strange environment like the hospital. It is also common for children of this age to need to assert their independence; many preschoolers fear and are preoccupied with bodily harm, especially an amputation of some kind. They often associate procedures with a form of punishment for a previous wrongdoing.

• Provide your child with comfort items from home, including favorite toys, blankets, books, music and stuffed animals. 
• Read books with your child that are related to hospitalization or her specific illness or surgery. 
• Participate in play with your child with pretend medical equipment, or let her draw for you her interpretation of the health care or hospital experience. Make sure you address and clear up any misconceptions they may have.
• Offer your child realistic choices whenever possible (for example, "Do you want to walk to the treatment room, or do you want me to carry you?"), and avoid stating necessary actions as a choice to your child when she does not actually have a choice (for example, "You need to take your medicine now, okay?"). 
• Although your child is exerting her independence, it is critical for you to set limits for your child and clearly define them, to increase her sense of security. 
• Reassure your child that she is not being punished, and never threaten a medical procedure or abandonment if your child is not cooperating effectively (for example, "If you don't take this medicine right now, you are going to get a shot!"). 
• Encourage your child's budding independence by allowing her to take control of situations and participate in her medical care (for example, let her take the pills herself). 
• Speak with your Child Life Specialist about comfort positioning, procedural preparation, and distraction during procedures.

School Age (5-11 years)
School aged children continue to assert their independence and desire to be in control of situations. Children of this age have also developed the ability to worry, as well as to fear bodily harm or loss of bodily function. Some children may still exhibit separation or stranger anxiety; some children who have progressed past these fears may temporarily regress.

• Participate in medical play with your child with pretend medical equipment; use role reversal with your child, letting her make the decisions and play the role of the doctor or the nurse, caring for a doll or stuffed animal. 
• Offer your child realistic choices concerning her care, and let her be involved in her own care
• Read books with your child that relate to her illness or feelings. 
• Keep your child informed of events - both at the hospital and at home. 
• Provide comfort items from home, such as favorite games and books, and pictures of family and friends. 
• Allow your child to direct familiar procedures, when appropriate ("what comes next?" during a procedure such as a dressing change). 
• Speak with your Child Life Specialist about distraction, procedural preparation, and comfort positioning during procedures.

Adolescents (12-19 years)
They are able to think about the future and better understand medical language and procedures. Adolescents often have the misconception that they are invincible, or the "nothing can happen to them." Therefore, hospitalization and medical experiences can be overwhelming. Adolescents value their privacy and independence, as well as their interactions with peers.

• Respect your child's need to continue with her normal relationships with her peer group while in the hospital by allowing private time on the telephone and visits from friends, when appropriate. 
• Respect your child's need for privacy and allow her time alone. 
• Encourage medical staff to speak with your child and not just to you, her parents. 
• Allow your child to bring comfort items from home, such as favorite books, music, and movies. 
• Encourage your child to participate actively in her care
• Help your child to identify coping strategies that work best for her, such as watching a procedure or looking away. 
• Encourage your child to express her feelings - verbally, or through art, writing, or music. 
• Speak with your Child Life Specialist about distraction, preparation, and coping techniques to use during procedures.

Program Outline

One of the most normal parts of all children's lives is school. Being hospitalized does not change that. The Pediatric team believes that addressing issues that are related to school re-entry is an integral part of the treatment plan for all patients and families. Many patients often feel apprehensive about being among their peers again after a long break from school. The purpose of the School Re-entry Program is to facilitate the transition from the hospital to school environment by providing emotional support to the child and family and to educate the school personnel and classmates. The School Re-entry Program is designed for each patient, family, and school's individual needs.

Who can have a School Re-entry presentation?
Any patient who attends school (or will be attending school) is a candidate for the School Re-entry Presentation. Any Pediatric team member, home school personnel, parent, or patient can request a presentation at the patient's school.

How does the School Re-Entry Presentation get scheduled?
A Child Life Specialist will coordinate with the identified patient's home school teacher, guidance counselor, or school administrator to schedule an appropriate time for the presentation either on diagnosis or once the patient has been given a Medical Release to return to school.

Who is involved in planning and implementing the School Re-Entry Presentation?
The Child Life Specialist is the main person responsible for the presentation. With input from the Pediatric team physicians and nurses as well as from the patient and family.

What is done to organize the School Re-Entry Program before doing the presentation?
The Child Life Specialist will complete an assessment form with each parent and patient as well as obtain an Ochsner Children's Medical Center Authorization for Release of Information prior to the presentation. This will provide specific information about what will be discussed in the presentation. The Child Life Specialist will also speak with the designated school representative to coordinate a time for the presentation for classmates as well as a separate meeting with teachers and staff who will be interacting with the patient once returning to school.

What is the format for each presentation?
Each presentation will be individualized to the patient. The family will dictate what information will be shared with the school. Typically the following information will be discussed with the patient's classmates:

• Disclosure of why child was hospitalized
• Treatment obtained for hospitalization including any side effects 
• Body image/self-esteem issues

If there is a separate meeting with teachers, the following information will usually be discussed:

• A brief overview of common misconceptions children the patient's age have.
• Special considerations that need to be made for returning student (if applicable)

 Is there a method for evaluation of the presentation?
One week following the presentation, the Child Life Specialist will send the school and parent an evaluation form with a self-addressed, stamped envelope to be returned to the Pediatric team. The Child Life Specialist will use this information to make improvements to future presentations.

What kind of follow-up support is provided to schools and families?
At the conclusion of the presentation, school personnel will be given a phone number for how to contact the Pediatric team if they have any further questions or problems. Two weeks following the presentation the Child Life Specialist will call the school and patient to see how things are going. Any issues or concerns will be directed to the appropriate Pediatric team members. The Child Life Specialist will also visit the patient on their next scheduled outpatient clinic appointment for further follow-up.

If you are interested in learning more about the School Re-entry Program, please call the Child Life Department at 504-842-2032.

Grief and Bereavement Support

The Child Life Specialists at Ochsner have special training in working with critically ill children and their siblings. They can help explain illnesses and concepts such as death in developmentally appropriate language. They can also engage your child in activities that will help communicate feelings your child cannot or will not communicate verbally, as well as help siblings gain a feeling of closure upon the death of the sick child.

The Child Life Department can also be consulted by a family or staff from the Adult ICU to help prepare and support a child during an adult family members' hospitalization or death.

If you feel that your child would benefit from these services, please call the Child Life Department at 504-842-2032.

Signs of a Grieving Child: Toddlers, Preschool and School Age

• Decrease or increase in appetite - Children often use food to feel a sense of power and safety in a situation where they do not have much control. They may demand to eat the same kind of comfort foods for every meal, or refuse to eat at all. Caregivers can often compromise with children and allow these foods along with healthy options. This is typically a short-term coping mechanism.
• Increase in activity level - You may notice that children have increased activity or hyperactivity immediately after a traumatic event. This is often an outlet in an attempt to gain control over a powerless situation. Some of the child's emotions are displayed physically rather than verbally.
• Severe decrease in social activities -Children may choose to decrease time spent with groups, so they can have an opportunity to process the event individually. Allow the child to do this on their own, but be available for discussion and support when they are ready.
• Hyper vigilance - Attention seeking behaviors are common following traumatic events. Educating all the individuals in the child's life (teachers, child care facilities, health care providers) is important so appropriate consequences can be communicated. If a child continues these behaviors, additional efforts should be made to restore their sense of safety and power. 
• Dreams and Nightmares - Children often have nightmares or dreams about the traumatic event or the loved one that was affected. It is important to allow the child to describe the dream, and not to assume that it was scary. Help your child process these dreams and devise a plan to make them feel safe. This may include playing calming music before bedtime, reading books, letting them sleep where they feel safe.
• Sleeplessness - Children may be fearful and afraid of what will happen next, and this may increase sleeplessness or nightmares after the event. Allowing them to choose where they feel safe to sleep, and choosing their comfort items (blankets, pillows, stuffed animals, etc.) is an important step in restoring feelings of safety.
• Breakdown in communication (specifically with adolescents) - Older children and parents often try to "protect" their loved ones from grief by not expressing their emotions about the traumatic event. Relaying your feelings of loss and grief to your child is appropriate, but teens will often process these thoughts with peers or other adults. This is a normal response to grief and loss, and it encourages discussion within families about the event.

Caregivers remember:
Keeping a consistent daily schedule will reduce anxiety and stress in children that have experienced a traumatic event. When children do not know what to expect, agitation, regression, and anger can be common side effects. Communication in words and actions is vital. Follow the child's lead to understand how to meet their needs.

Infancy - 3 years: What Can Caregivers Do to Help?

Developmental Responses to Separation/Loss

• Increased irritability due to change in environment, caregiver, and routine
• Change in appetite/sleep patterns
• Sense trauma through senses (touch of others)

General Concepts of Development

• World is experienced through senses
• Attachment is developing, experiences some stranger anxiety
• Language, motor, cognitive, social/emotional development is critical
• Trust vs. Mistrust is developing

General Concepts of Death

• Has no concept of death
• Sense that something has changed if main caregiver is no longer present
• Able to sense a caregiver's emotional distress

Grief Issues

• May respond to death or loss with irritability, change in sleep, eating and play patterns
• May regress
• May search for caregiver
• May be very attached to remaining caregiver and fear separation

What Can You Do to Help?

• Provide nurturing, love, and physical closeness (snuggle, hold, coo, sing, etc.)
• Language holds a special appeal for this age; they love to hear familiar voices repeating favorite words and phrases
• Maintain a schedule/routine - Feeding times, play times, storytelling times, singing and holding should continue without interruption
• Have photos so that child can look at them at a later date
• Use appropriate vocabulary for age
• Answer questions
• Model/Encourage appropriate expression feelings and memory sharing
• Keep a journal for child of important event ceremonies, newspaper clippings, stories

3 - 6 Years: What Can Caregivers Do to Help?

Developmental Responses to Separation/Loss

• Increased separation anxiety (more "clingy" behavior)
• Regression
• Increased irritability due to change in environment, caregiver, and routine

General Concepts of Development

• Egocentric
• Focuses on one thing at a time
• Inanimate things can be alive
• Magical thinking - child believes that just thinking about something can make it happen
• Continues to learn about the world through senses
• Play is critical to development
• Time is reversible, may be able to recall some very memorable past events
• Continues to develop trust

Concept of Death

• May have concept of death, depending upon experience
• Death may be caused by thoughts or feelings (Magical thinking)
• May be interested in physical and biological aspects of death and the dead body
• May think death is like sleep
• Senses caregiver's emotional distress

Grief Issues

• May appear fine
• May respond to death and loss with irritability, change in sleep, eating, and play patterns
• May regress
• May be concerned with who will be the caregiver
• May show feelings, thoughts through play, because they may not have the vocabulary to explain self
• May be very attached to remaining caregiver and fear separation
• May ask questions repeatedly
• Very curious
• Physical reactions and acting out behaviors

What Can You Do to Help?

• Answer questions
• Maintain a schedule
• Take photos, so children can view at a different time
• Use appropriate vocabulary for age
• Provide play opportunities
• Model/encourage appropriate expression of feelings and memory sharing
• Keep a journal for child of important events, ceremonies, newspaper clippings, and stories

7 - 9 years: What Can Caregivers Do to Help?

Developmental Responses to Separation/Loss

• Believe they caused death
• Interested in physical aftermath of body
• Increased physical activity, especially males
• Violent play, even if the death was not violent

General Concepts of Development

• Egocentric
• Beginning to understand cause and effect
• Concrete-operational: understands more concrete concepts
• Magical thinking (lessening) - believes they can just think about something and make it happen
• Continues to learn about the world through senses
• Play is critical to development

General Concepts of Death

• Death is sometimes thought of as ghosts
• Beginning to understand finality of death
• May be interested in physical and biological aspects of death
• May feel caused death

Grief Issues

• May appear fine
• May respond with irritability, change in sleep, eating, and play patterns
• May regress
• May be concerned with who will be the caregiver
• May feel a stigma at school or around peers
• May be very attached to remaining caregiver and fear separation
• May be concerned about future of self and others
• Very curious
• Physical reactions and acting out behavior

What Can You Do to Help?

• Answer questions
• Maintain a schedule
• Take child to funeral, memorial, or service - let them be a part
• Use appropriate vocabulary for age 
• Be honest
• Provide play opportunities
• Model/encourage appropriate expression of feelings and memory sharing
• Keep a journal or scrapbook
• Keep in contact with school

10 - 13 years: What Can Caregivers Do to Help?

Developmental Responses to Separation/Loss

• Need answers now stage
• Constantly waiting for something else to happen (hypervigilance), unsafe and daring behaviors
• Increased physical activity, especially males
• Needs to know answers regarding death
• Potential suicide ideations

General Concepts of Development

• Peer relationships are becoming very important
• Self-esteem is developing

Grief Issues

• May appear fine
• May respond with irritability, change in sleep, eating, and play patterns
• May regress
• May feel a stigma at school or around peers
• May be concerned about future of self and others
• Very curious
• Physical reactions and acting out behavior

What Can You Do to Help?

• Answer questions
• Take child to funeral, memorial, or service - let them be a part
• Use appropriate vocabulary for age 
• Be honest
• Model/encourage appropriate expression of feelings and memory sharing
• Keep a journal or scrapbook
• Keep in contact with school and peers

14 and up: What Can Caregivers Do to Help?

Developmental Responses to Separation/Loss

• Intense and increased emotions
• Constantly waiting for something else to happen (hypervigilance)
• Depression
• Potential suicidal ideations
• Questioning own morbidity
• May refuse to discuss death or Grief Issues (best not to pressure them to talk)

General Concepts of Development

• Formal operational: thinks abstractly, like an adult
• Egocentric, "What is going to happen to me?"
• Attempting to find a balance in terms of independence and dependence of caregivers
• Peer relationships are very important
• Self-esteem is developing
• Searching for identity

General Concepts of Death

• Death is final, an end to physical life
• Realization of own mortality and thinks about the meaning of life
• May be interested in physical and biological aspects of death
• May feel caused death
• Understands future and what loss will mean

Grief Issues

• May appear fine
• May respond with irritability, change in sleep, eating, and play patterns
• May be concerned with who will be caregiver
• May feel stigma at school or around peers
• May be attached to remaining caregiver/family
• May be concerned about the future of self or others
• May attempt to take on role of deceased
• Struggles with needing support and not wanting it

What Can You Do to Help?

• Answer questions
• Maintain a schedule
• Take adolescent to funeral or service if they choose
• Include in ceremonies, services, memorials, if they wish
• Be available when they want to talk
• Be honest and factual
• Reduce expectations
• Model/encourage appropriate expression of feelings and memory sharing
• Keep a journal or scrapbook
• Keep in contact with school and friends
• Start a family communication journal

Suggestions for Parents

Siblings of hospitalized children experience a variety of emotions. Their lives have also been changed and "disrupted" by this event. Be mindful that each child is different - an individual - and will therefore experience her own individual feelings and express them in her own individual ways. Caregivers know their child best, and you are the most qualified to identify your child's needs and concerns.

Behaviors you may note if your child is having a difficult time coping with the hospitalization or illness of a sibling:

• Having difficulty in school. 
• "Acting out" to get attention. 
• Regressing to previous behaviors (for example, a potty-trained child may regress to needing diapers again). 
• Having difficulty eating or sleeping. 

Honesty and communication are important. Explain clearly to your child what is happening with her brother or sister, in a language she can understand. When children do not have the information they crave, they often fantasize about what is happening to their sibling or the reasons behind the illness. Let your child visit the hospital to see that her sibling is OK, and be sure to prepare her properly for what she will see, as well as other possible sensory experiences. Keep the lines of communication open, and take the time to really listen to what your child is telling you. Encourage your child to communicate her feelings with you, and reassure her that all of her feelings are okay. For younger children who do not have the verbal capacity to express their feelings, pay special attention to their play habits and other ways young children have of expressing themselves; you may even want to engage your child in role play, in order to identify and correct any misconceptions she may have.

Typical feelings of children with a hospitalized brother or sister:

• Guilt for causing the sibling to be ill (fantasy). 
• Lack of involvement in the sibling's care. 
• Desertion by parents, family, and friends. 
• Anger at parents for their inability to protect the sibling. 
• Guilt for being the healthy child. 
• Fear of "catching" the illness. 
• Embarrassment at any visible signs of the sibling's illness or lack of capacity. 
• Anger at the disruption in their own lives. 
• Jealousy due to a lack of personal attention. 

Be sure to inform your children's' teachers of what is happening, so they will be understanding of and observant of any unusual behaviors.

If you feel that your child could benefit from a consult with a Child Life Specialist regarding the illness or hospitalization of a sibling, please contact the Child Life Department at 504-842-2032.