How Far Have We Come?

Examination of Our Progress
To start, we highlight evidence demonstrating child life’s collective pursuit of research since Thayer’s article. A paramount concept to comprehend in this discussion is the term child life, which is generalized when it actually encompasses four distinctly significant components: (a) the emerging academic discipline, (b) the field of inquiry referring to research, (c) the profession, and (d) the professional organization. Currently, most examples are housed in the professional association, because neither child life’s academic discipline or the field of inquiry is mature enough to sustain the profession’s research.

Emphasis on Research at all Levels of Education
Thayer’s (2007) first goal was to emphasize research in all levels of education. In addition to the efforts described in Table 1, child life specialists are conducting more research with their interdisciplinary teams, students, and academic partners. The certification requirement of one research course provides child life students foundational research knowledge. As they become professionals, they carry this foundation, as well as academic relationships, into their interdisciplinary settings. As will be discussed when we look at Thayer’s third goal, academic endorsement requires full time Certified Child Life Specialist (CCLS) faculty members to hold advanced degrees. This expertise ensures that child life students have a research resource and potential mentor at both the undergraduate and graduate level. Though more growth is needed, these efforts clearly support Thayer’s goal. 

Graduate Education that Fosters Leadership and Academic Skills
Thayer’s (2007) second goal focused on graduate education for child life students. At the time his article was published, there were far fewer child life academic programs, and students were entering the profession from a number of interdisciplinary backgrounds. Today’s certification requirements allow students to earn either an undergraduate or graduate degree, and the increase in child life-specific programs ensures that students have access to Thayer’s hope for education that fosters leadership and academic skills like research. The results of his vision can be seen in a number of outcomes. There is some data to suggest that research consumption amongst child life students is increasing. In 2019, 180 students (16% of the 1100 attendees) attended the Annual Child Life Conference, the most since the certification exam was offered at conference (email correspondence on 12/2/19 from R. Spencer, ACLP Director of Professional Development). Also, students at both the undergraduate and graduate level are engaging in scholarly writing projects that draw from their leadership and research knowledge. For example, in 2017, ACLP’s Bulletin student column was created, and we have seen students sharing their writing with the community in this outlet. Of the ten Beyond the Classroom articles published since the column’s inception, there has been a balance between bachelor’s and master’s student authors, suggesting mentorship for scholarly writing at both levels of child life education.

Academic endorsement helps institutions remain focused on the goal of fostering leadership and academic skills. With curriculum that specifically draws from the child life competencies, child life students enter the profession well-prepared to be leaders within their scope of practice. Too, the Certified Child Life Specialist faculty member must demonstrate how they remain informed of professional requirements in child life academics, internships, and certification to support students’ professional development. Because of this, child life students have leadership models who are knowledgeable of the profession’s evolving standards. In addition to offering child life courses required for certification and content relevant to child life practice, child life faculty in endorsed undergraduate academic programs must also guarantee students are academically advised and professionally mentored. This way, each student engaged in learning about child life has direct support for gaining academic skills.
 

Preparation of Child Life Academic Teachers
Thayer’s third goal related to preparing child life academic teachers. The number of CCLSs teaching in child life academic programs has increased with the number of Certified Child Life Specialist faculty earning doctoral degrees. A review of the credentials of CCLS faculty teaching in the 65 university/college programs (80 degree programs: 51 undergraduate, 29 graduate) in the Child Life Academic Programs list on ACLP’s website showed that 11 faculty members earned PhDs, two faculty members possessed EdDs, and 37 held master’s degrees.

Recognizing the importance of Certified Child Life Specialist faculty leading child life academic programs, the ACLP’s Academic Endorsement standards require one full-time CCLS faculty member hold an advanced degree and have program oversight. The faculty member’s advanced degree and full-time dedication to the academic role offers professional credibility and bolsters quality child life education, which allows for long-term sustainability of all components of child life including the field of inquiry, the emerging academic discipline, the profession, and the professional organization. Too, the Child Life Certification Commission mandates faculty teaching the child life required topics of study hold the Certified Child Life Specialist credential and have fulfilled 4000 hours of paid work experience or minimum of two years teaching child life subject matter. This requirement ensures faculty have child life clinical practice experience to benefit students’ learning. Thayer’s goal of improving the preparation of child life academics is already well-developed, and we anticipate this goal will continue to develop as the profession sustains its popularity.

Continued Emphasis on Evidence-Based Practice
Child life, formerly an applied science, once relied on professionals’ training and anecdotal patient outcomes to inform the craft. After evidence-based practice was introduced to pediatric health care (Sackett et al., 1996), it became clear child life specialists, as health care professionals, must also be able to translate new knowledge into clinically useful forms that can be implemented across systems and measured in terms of meaningful impact on practice and health outcomes. Evidence-based practice requires collaboration between contributors to the field of inquiry and those practicing in the profession. Child life practitioners must have skills integrating research into practice, while researchers must understand the practitioner’s workload so they can propose realistically replicable research.

ACLP has made strides in supporting evidence-based practice since Thayer’s publication. In 2011, Jones and Bonjour published the evidence-based practice model for child life. Later, in 2016, smaller research and scholarship committees were combined into the Scientific Advancement of Professional Practice Committee, a large work group focusing on varied research initiatives. In 2017, the Child Life Professional Data Center (CLPDC) was launched to provide access to clinical data from programs across the globe. These initiatives are responses to the growth in research engagement amongst our community. Evidence of this engagement is also seen in ACLP’s growing Resource Library which provides access to a catalogue of empirical journal articles, books, websites, and organizations related to child life that have been curated by the association. Finally, an increase in research engagement amongst our community led to the decision to separate Child Life Focus from ACLP Bulletin and rename it as The Journal of Child Life: Psychosocial Theory and Practice.

While progress has been made, this goal needs more attention in order to adhere to the idea that a field contributes to a new knowledge base. Evidence-based practice is a bridge between our applied identity and the scientific world of health care. Sharing our evidence beyond the walls of child life will help to solidify our role as an important contributor to pediatric research with novel and innovative ideas.

Build in Time for Research and Professional Development
Finally, Thayer recommended a goal of building in time for research and professional development in clinical settings. In the 2019 ACLP member survey, a lack of time was cited as the greatest barrier for not submitting writing, whether scholarly or research, to the ACLP Bulletin or Child Life Focus. Anecdotally, more clinical child life departments are protecting time for specialists to consume and conduct research; however, we need to see specific data on how this is being funded and what those roles specifically entail. Since Thayer’s publication, we are seeing an increase in child life-related publications by child life specialists in pediatric journals, implying there is more time to devote to research efforts (Boles et al., 2020). Again, this needs to be documented and program leaders need to share how these projects are supported by their health care institutions.

ACLP donor partnerships that emphasize evidence-based practice also help support efforts to prioritize research. From 2012-2014 ACLP was cumulatively awarded $1 million from Disney Citizenship to support multiple play initiatives, including a national survey on play and two studies examining the economic value of child life interventions in hospital settings. These grants enabled child life authors to take protected time from their clinical duties and focus on conducting and disseminating (Grissom et al., 2015) their research. But because child life is a small profession, we cannot depend on grant funding for each research endeavor. As such, child life academic and clinical research partnerships are essential for boosting our emerging academic discipline and improving feasibility since academics can relieve research burden. This synergy improves the speed and ease of conducting clinical research and provides students access to clinical samples for learning.

Hopes for the Future of Child Life
Evidence suggests we are making progress toward meeting Thayer’s goals for 2032. Efforts by the professional organization such as academic endorsement and the launch of The Journal of Child Life: Psychosocial Theory and Practice highlight the profession’s undergraduate or graduate degree, and the increase in child life-specific programs ensures that students have access to Thayer’s hope for education that fosters leadership and academic skills like research. The results of his vision can be seen in a number of outcomes. There is some data to suggest that research consumption amongst child life students is increasing. In 2019, 180 students (16% of the 1100 attendees) attended the Annual Child Life Conference, the most since the certification exam was offered at conference (email correspondence on 12/2/19 from R. Spencer, ACLP Director of Professional Development). Also, students at both the undergraduate and graduate level are engaging in scholarly writing projects that draw from their leadership and research knowledge. For example, in 2017, ACLP’s Bulletin student column was created, and we have seen students sharing their writing with the community in this outlet. Of the ten Beyond the Classroom articles published since the column’s inception, there has been a balance between bachelor’s and master’s student authors, suggesting mentorship for scholarly writing at both levels of child life education.

Academic endorsement helps institutions remain focused on the goal of fostering leadership and academic skills. With curriculum that specifically draws from the child life competencies, child life students enter the profession well-prepared to be leaders within their scope of practice. Too, the Certified Child Life Specialist faculty member must demonstrate how they remain informed of professional requirements in child life academics, internships, and certification to support students’ professional development. Because of this, child life students have leadership models who are knowledgeable of the profession’s evolving standards. In addition to offering child life courses required for certification and content relevant to child life practice, child life faculty in endorsed undergraduate academic programs must also guarantee students are academically advised and professionally mentored. This way, each student engaged in learning about child life has direct support for gaining academic skills.