title: A randomized controlled trial: child life services in pediatric imaging.
abstract: BACKGROUND
  Children undergoing procedures in pediatric health care facilities and their families have been shown to benefit from psychosocial services and interventions such as those provided by a Certified Child Life Specialist (CCLS). The comprehensive impact of a CCLS in a pediatric imaging department is well recognized anecdotally but has not been examined in a prospective or randomized controlled fashion.
  
  
  OBJECTIVE
  We prospectively assessed the impact of a CCLS on parent satisfaction, staff satisfaction, child satisfaction, and parent and staff perceptions of child pain and distress in a pediatric imaging department.
  
  
  METHODS
  Eligible children between 1 and 12 years of age (n = 137) presenting to the pediatric imaging department for an imaging procedure were randomly assigned to an intervention or control arm. Those assigned to the intervention received the comprehensive services of a CCLS. The control group received standard of care, which did not include any child life services. Quantitative measures of satisfaction and perception of child pain and distress were assessed by parents and staff using a written 5-point Likert scale questionnaire after the imaging procedure. Children 4 and older were asked to answer 3 questions on a 3-point scale.
  
  
  RESULTS
  Statistically significant differences between the intervention and control groups were found in 19 out of 24 measures. Parents in the intervention group indicated higher satisfaction and a lower perception of their child's pain and distress. Staff in the intervention group indicated greater child cooperation and a lower perception of the child's pain and distress. Children in the intervention group indicated a better overall experience and less fear than those in the control group.
  
  
  CONCLUSIONS
  Child life specialists have a quantifiably positive impact on the care of children in imaging departments. Measures of parent satisfaction, staff satisfaction, child satisfaction, child pain and child distress are shown to be positively impacted by the services of a CCLS. These results have significant implications for hospitals striving to increase satisfaction, decrease costs and improve quality of care. In a health care landscape that is changing quickly and increasingly focused on the cost of care, future research should assess whether the core tenants of the child life profession support and contribute quantifiably to high-quality, cost-effective practices in health care.
authors.affiliation: Pediatric Imaging Sciences, Golisano Children's Hospital at the University of Rochester Medical Center, Rochester, NY, USA, Mary_Tyson@dfci.harvard.edu.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Tyson
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Bohl
authors.forename: Johan G
authors.initials: JG
authors.lastname: Blickman
mesh_terms: D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002673:Child, Hospitalized / Q000523:psychology*; D002675:Child, Preschool; D003952:Diagnostic Imaging / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009518:New York; D010146:Pain / Q000517:prevention & control* / Q000523:psychology; D010290:Parents / Q000523:psychology*; D017060:Patient Satisfaction; D010372:Pediatrics / Q000458:organization & administration; D013315:Stress, Psychological / Q000517:prevention & control* / Q000523:psychology