CHILD LIFE EXAMINATION TEST 2025/2026 QUESTIONS
WITH ANSWERS TAGGED A+
✔✔Newborn Individualized Developmental Care and Assessment Program (NIDCAPS)
- ✔✔Provision of developmentally supportive care in NICU
- Consistency of Care giving
- Structure 24hr day
- Pacing of care giving
- Support during transitions
- Appropriate positioning
- Individualized feeding support
- Skin to skin holding
- Collaborative Care
- Quiet, soothing environment
- Developmental support
✔✔Older infant (6m-1y) - ✔✔Developmental needs: Develop trust: consistent
nurturing/loving caregivers (maximize parental participation)
Threats: Separation Anxiety, restriction of movements, changes in rituals/routines
✔✔Separation Anxiety - ✔✔Bowlby (1960); Primary source of stress (6m-3y)
Protest: active/aggressive response to absence of parent
- crying, screaming, kicking
- refuses attn from anyone else (seems inconsolable)
Despair: increasing hopelessness
- stops crying and appears depressed
- cries intermittently; ore often appears withdrawn/quiet
Detachment: after long period of parental absence; characterized by reinvestment in
surroundings and normal activity
- forms superficial attachments
- increased self-centeredness
- more interested in material obj
- parent met with apathy and inability to reattach
✔✔Toddlers (1-3 years) - ✔✔Focus on increasing autonomy and goal-directed
behaviors (mastery)
- Parental presence still greatest need
- Learn through exploring, play, socializing activities
- limited language
- egocentric
,Challenges in hospital:
- restriction in movement
- changes in routine
- perceive hospital as punishment
- confused when parent/caregiver doesn't rescue them from pain/fear
- loss of control
- regression
*lessen parental anxiety (participate in anticipatory coping)
✔✔Preschoolers (4-5 years) - ✔✔Suffer most from physical restrictions and loss of
control
Challenges in Hospital:
- punishment (unable to separate selves from external world)
- magical thinking
- threats of bodily injury/mutilation
-
*provide concrete reasoning with medical play, preparation learning, and expressive
play (use real equipment) to minimize fear, misconceptions, concerns to increase
coping
✔✔Safe place - ✔✔Patient's room and playroom should be free of invasive procedures
Treatment room
✔✔School-age Child (6-12 years) - ✔✔Developmental achievements:
- more social; able to be away from parents for longer times
- cognitive reasoning/concrete operational (understand relationship between events and
experiences)
Fears in Hospital:
- being away from family/school
- length of stay
- shots
- something is "wrong" with them/death
*important to know implications of diagnosis/treatment to process events and
consequences
Coping:
- art, journaling, games, role playing, socializing
- express feelings
- master experience by learning new skills and coping
,- structure/routine
✔✔Stressful events for School-age children in Hospital - ✔✔- Intrusive events
- Physical symptoms
- Therapeutic intervention
- Restricted activity
- Separation
- Environment
✔✔Adolescents (12-18 years) - ✔✔Erickson: Identity vs Role Confusion
Challenges in Hospital:
- Separates from normal group/activities/plans
- Insecurities about appearance/self-worth
- loss of independence/control
- privacy/confidentiality
Response: anger/frustration
Interventions:
- peer support
- access to appropriate activities
- information/preparation to lessen fears/anxiety while increasing coping
- give teens a voice
✔✔Vulnerable Children - ✔✔Need Individualized approaches to meet needs
- young children or previously hospitalized children with misconceptions/fears
- emotionally disturbed (distorted perceptions about illness/injury)
- parent-child reactions (transferred anxiety)
- Sensory impaired, neurologically compromises, developmentally delayed
✔✔Resilient Children - ✔✔Adapt to experience without negative sequelae; ability to
return rapidly to previous psychological or physiologic state
Respond quickly/appropriately to life events and changes; Cope better with stressors,
isolation, immobility; Rely on strengths and ability to develop supportive relationships
Protective factors:
- involvement in action
- give directions
Psychosocial Principles (Bolig & Weddle 1988):
- Relate actions to reactions/outcomes
- Provide social reinforcement upon performance of task (not before)
- Reward degrees of effort (how hard child works instead of how successful)
- Encouraging extraordinary effort and tasks even under stress
, - Model both expression of feelings and self-talk
- Train new skills and practicing old behaviors
✔✔Toddler (1-3) - ✔✔Erickson: Autonomy vs Shame/Doubt
- To hold on
- To let go
Piaget: Sensorimotor / Preoperational
- Can hold and recall images
- Increasing use of symbolism
- highly egocentric perception of world
Hospitalization Issues:
- Separation
- Fear if bodily injury and pain
- Frightening fantasies
- Immobility or restriction
- Forced regression
- Loss of routine/rituals
Possible Troublesome Responses:
- Regression (including loss of newly learned skills)
- Uncooperativeness
- Protest (verbal/physical)
- Despair
- Negativism
- Temper Tantrums
- Resistance
Interventions:
- Maximize parental involvement/information
- Facilitate medical play
- Promote therapeutic play (environmental exploration, freedom within limits,
routine/ritual, self-expression, movement activities, sensory stimulation games)
✔✔Infant (0-1) - ✔✔Erickson: Trust vs Mistrust
- To get
- To give in return
Piaget: Sensorimotor
- Exploration of physical self/environment
- Object constancy
- Cause/effect
Hospitalization Issues:
- Separation
WITH ANSWERS TAGGED A+
✔✔Newborn Individualized Developmental Care and Assessment Program (NIDCAPS)
- ✔✔Provision of developmentally supportive care in NICU
- Consistency of Care giving
- Structure 24hr day
- Pacing of care giving
- Support during transitions
- Appropriate positioning
- Individualized feeding support
- Skin to skin holding
- Collaborative Care
- Quiet, soothing environment
- Developmental support
✔✔Older infant (6m-1y) - ✔✔Developmental needs: Develop trust: consistent
nurturing/loving caregivers (maximize parental participation)
Threats: Separation Anxiety, restriction of movements, changes in rituals/routines
✔✔Separation Anxiety - ✔✔Bowlby (1960); Primary source of stress (6m-3y)
Protest: active/aggressive response to absence of parent
- crying, screaming, kicking
- refuses attn from anyone else (seems inconsolable)
Despair: increasing hopelessness
- stops crying and appears depressed
- cries intermittently; ore often appears withdrawn/quiet
Detachment: after long period of parental absence; characterized by reinvestment in
surroundings and normal activity
- forms superficial attachments
- increased self-centeredness
- more interested in material obj
- parent met with apathy and inability to reattach
✔✔Toddlers (1-3 years) - ✔✔Focus on increasing autonomy and goal-directed
behaviors (mastery)
- Parental presence still greatest need
- Learn through exploring, play, socializing activities
- limited language
- egocentric
,Challenges in hospital:
- restriction in movement
- changes in routine
- perceive hospital as punishment
- confused when parent/caregiver doesn't rescue them from pain/fear
- loss of control
- regression
*lessen parental anxiety (participate in anticipatory coping)
✔✔Preschoolers (4-5 years) - ✔✔Suffer most from physical restrictions and loss of
control
Challenges in Hospital:
- punishment (unable to separate selves from external world)
- magical thinking
- threats of bodily injury/mutilation
-
*provide concrete reasoning with medical play, preparation learning, and expressive
play (use real equipment) to minimize fear, misconceptions, concerns to increase
coping
✔✔Safe place - ✔✔Patient's room and playroom should be free of invasive procedures
Treatment room
✔✔School-age Child (6-12 years) - ✔✔Developmental achievements:
- more social; able to be away from parents for longer times
- cognitive reasoning/concrete operational (understand relationship between events and
experiences)
Fears in Hospital:
- being away from family/school
- length of stay
- shots
- something is "wrong" with them/death
*important to know implications of diagnosis/treatment to process events and
consequences
Coping:
- art, journaling, games, role playing, socializing
- express feelings
- master experience by learning new skills and coping
,- structure/routine
✔✔Stressful events for School-age children in Hospital - ✔✔- Intrusive events
- Physical symptoms
- Therapeutic intervention
- Restricted activity
- Separation
- Environment
✔✔Adolescents (12-18 years) - ✔✔Erickson: Identity vs Role Confusion
Challenges in Hospital:
- Separates from normal group/activities/plans
- Insecurities about appearance/self-worth
- loss of independence/control
- privacy/confidentiality
Response: anger/frustration
Interventions:
- peer support
- access to appropriate activities
- information/preparation to lessen fears/anxiety while increasing coping
- give teens a voice
✔✔Vulnerable Children - ✔✔Need Individualized approaches to meet needs
- young children or previously hospitalized children with misconceptions/fears
- emotionally disturbed (distorted perceptions about illness/injury)
- parent-child reactions (transferred anxiety)
- Sensory impaired, neurologically compromises, developmentally delayed
✔✔Resilient Children - ✔✔Adapt to experience without negative sequelae; ability to
return rapidly to previous psychological or physiologic state
Respond quickly/appropriately to life events and changes; Cope better with stressors,
isolation, immobility; Rely on strengths and ability to develop supportive relationships
Protective factors:
- involvement in action
- give directions
Psychosocial Principles (Bolig & Weddle 1988):
- Relate actions to reactions/outcomes
- Provide social reinforcement upon performance of task (not before)
- Reward degrees of effort (how hard child works instead of how successful)
- Encouraging extraordinary effort and tasks even under stress
, - Model both expression of feelings and self-talk
- Train new skills and practicing old behaviors
✔✔Toddler (1-3) - ✔✔Erickson: Autonomy vs Shame/Doubt
- To hold on
- To let go
Piaget: Sensorimotor / Preoperational
- Can hold and recall images
- Increasing use of symbolism
- highly egocentric perception of world
Hospitalization Issues:
- Separation
- Fear if bodily injury and pain
- Frightening fantasies
- Immobility or restriction
- Forced regression
- Loss of routine/rituals
Possible Troublesome Responses:
- Regression (including loss of newly learned skills)
- Uncooperativeness
- Protest (verbal/physical)
- Despair
- Negativism
- Temper Tantrums
- Resistance
Interventions:
- Maximize parental involvement/information
- Facilitate medical play
- Promote therapeutic play (environmental exploration, freedom within limits,
routine/ritual, self-expression, movement activities, sensory stimulation games)
✔✔Infant (0-1) - ✔✔Erickson: Trust vs Mistrust
- To get
- To give in return
Piaget: Sensorimotor
- Exploration of physical self/environment
- Object constancy
- Cause/effect
Hospitalization Issues:
- Separation
