"Mommy, I'm scared."

Nothing affects a parent like those three little words. They send the most seasoned mom and dad into a tither, searching for ways to calm their child's fears. Often, a reassuring hug or a soft-spoken word will do the trick. But sometimes, a hug is not enough and the words aren't convincing, especially when Mom and Dad are scared, too.

Every day, children throughout the world are subjected to uncomfortable medical testing and painful procedures. Though these acts are mostly life-improving and often life-saving, it is hard to help children understand why they have to go through it. Fortunately, most support and education does not rest solely on the parents.

What Is a Child Life Specialist?
After Judith Turner of Sandy, Utah, scheduled her 3-year-old daughter for surgery, she made an appointment with the hospital's Child Life department. The first meeting ended up being a group hospital tour. It was also the first time the Turners met Carolyn, a child life specialist.

According to Sharon M. McLeod, director of child life and recreational therapy at Children's Hospital Medical Center in Cincinnati, Ohio, "Child life specialists are health care professionals who use play and education interventions to reduce the stress of health care experiences and help children and families cope."

As a child life specialist, McLeod's day may consist of accompanying children to procedures, working as a liaison between the patients and their communities and schools and celebrating a child's birthday or observed holidays.

The activities vary according to patient age and medical condition. Turner's daughter learned about her procedures and eased her fears through many different activities, such as visiting the operating room, meeting other children with her disorder and playing with medically outfitted dolls.

What Fears Do Child Life Specialists Address?
"The most common fears for the 3- to 5-year-old child are separation from the parent or caregiver and pain or anxiety of the unknown," says Colleen Ducke, a child life specialist in Boston, Mass.

In order to alleviate these fears, child life specialists employ a variety of techniques. Ducke explains procedures to children and their families with the help of toys and picture books, depicting hospital admissions, blood draws, IVs, castings, lumbar punctures, suturing, operations, MRIs and CT scans. She adds that the actual medical equipment is on hand and welcomed to be explored.

During the actual procedure, a child life specialist may use different tactics to try and distract the child. Ducke explains that playing music during sutures, reading books during procedures and blowing bubbles during blood draws all help to refocus the child's attention and calm fears.

Another key to lessening a child's anxiety is to increase the feeling of comfort and welcome in the hospital environment. "[Carolyn] took a Polaroid picture of Sarah to put on a poster and filled out all the 'about me' things: foods that she liked and didn't like, favorite TV shows and movies, where she is from, where she goes to school and what grade, where she has traveled, etc." says Turner. "This poster was put up in her room when she arrived for admission."

Turner points out that this type of activity, done by the child life specialist, eases the job of other hospital staff. "[The poster] was helpful to nurses who tried to initiate conversation to take Sarah's mind off a treatment or otherwise interact with her," Turner says.

Where Do They Work?
Generally, a parent won't find a child life specialist working outside of the hospital, and they may not even find one at their local hospital.

"Child life specialists are not available in all hospitals, but they are available in many," Ducke says.

And surgery is not the only department or procedure that relies on assistance from the child life specialist. "There are child life specialists in the in-patient units, pediatric intensive care units, emergency departments, hematology and oncology departments, ambulatory clinics, day surgery area and various other places," says Ducke.

She suggests that before a child undergoes a surgery or procedure, the parents should call the hospital and inquire about a child life department. In the event that a specialist is not available, Ducke offers this advice:

• Bring blankets, dolls, toys and movies that the child is familiar with to the hospital. These items can serve to distract the child during some procedures.
• Call ahead to see if the hospital offers any pre-operative teaching for children. Many hospitals offer tours and educational introductions to surgeries and procedures.
• Talk to your child in a way she will understand. Don't overwhelm her with details, but do be honest.
• Tell the child if the procedure will hurt. It is better to tell the truth and maintain trust. Provide the child with some type of play medical equipment. Closely supervised play can offer parents an opportunity to observe a child's fears and misconceptions, which are often acted out during play.

Why Are Child Life Specialists Important?
Dealing with serious illnesses, complicated procedures and extended hospital stays are difficult on everyone involved. The child life specialist uses a bank of knowledge and a bag of tricks to help take the fear out of the hospital and return smiles to the children's faces.

"Sarah loved Carolyn, who was very fun and supportive," Turner says. "Carolyn was a godsend. [Her] involvement was key to getting through a very difficult experience."