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DALLAS - Imagine an ill second-grader who's heading to the hospital for the first time because of an attack of bronchitis, a broken leg or cancer.
That child's life experiences and coping skills may not equip him to deal with the worries and fears that come with that trip and ensuing treatment.
That's where people such as Ellen Hollon and her staff step into the picture.
Hollon is the director of the Child Life Program at Children's Medical Center of Dallas, Texas, which treats more than 270,000 children each year.
Child life specialists put health care experiences into the context of a child's world - whether it's a second-grader or a high school sophomore who's being treated. They address misconceptions about the hospital stay and make sure stressful procedures, such as having blood drawn, are explained in easy-to-understand terms.
Thirty years ago, research about how hospital stays affected children was just emerging, Hollon said. A cutback in child life programs in the late 1980s and early 1990s followed a growth period in the 1970s and '80s.
The field is growing again in part because of nursing shortages and hospital expansions.
Hollon, who has taught college courses and served as president of the Child Life Council, was hit by a car when she was 10 years old and spent three months in a hospital.
"There were lots of things that happened to me that I didn't understand," she said. "When I found out there was a job that helped children through that process, I thought that would be a cool job."
She's been doing it for 26 years.
Many large children's hospitals and smaller hospitals with pediatric wards employ child life specialists. Most of those professionals have an educational background in child development or family studies, and all go through a rigorous certification process that includes a 480-hour clinical internship and a written exam.
There are 28 staff positions at Children's, where 256 beds were filled on a recent Thursday. Professionals there work with children in various ways.
For example, Hollon said that a 3-year-old does not have the same concept of time that a teen has. For that child, a child life specialist might explain that a procedure will not last as long as an episode of Barney but might take as long as the drive to the grocery store.
The child life professional might help other children get ready for a surgical process by showing them actual medical equipment, including anesthesia masks and finger sensors. Some might partake in art sessions that relate to medical conditions: making pictures by blowing paint to help an asthmatic understand respiratory function.
Vicki Kelley has been in the profession for about 20 years and recently started working at Cook Children's Medical Center in Fort Worth, Texas.
"We take a child's way of thinking and use it to help them cope and understand," she said.
Kelley holds a master's degree in human development and family studies. She has worked with children ranging from those who are staying overnight for a short illness to children living with HIV.
She said that when working with HIV-positive children at another hospital, she started a family camp that was one of the first places some families got to meet others dealing with the challenges of the disease.
"There is so much for a parent to understand about an illness," Kelley said. "We also have to help parents understand. Someone going into child life has to have very strong communication skills - both listening and talking."
She and Hollon recommend that someone considering the field volunteer in a clinical setting. Hollon said that when hiring, she looks for someone who's had an internship. She also said that being a child life specialist requires stamina and a support network both inside and outside the hospital.
The Child Life Council is a professional group that sets the standards for education, clinical training and certification. The group's mission, research information, educational resources and certification information can be found at www.childlife.org.
"You may be working with a child who is HIV-positive, but if you've gotten them to understand the importance of taking their medicine every day, you've impacted the rest of their life," Kelley said.
(c) 2004, The Dallas Morning News. Distributed by Knight Ridder/Tribune News Service.