Staff Spotlight: Child Life Specialist in Diabetes Care

Date Posted: Friday, February 22, 2019


What is a Child Life Specialist?

The Certified Child Life Specialist at the UMass Memorial Diabetes Center of Excellence supports children and families as needed, beginning at their very first office appointment.  She works closely with the pediatric diabetes care team to provide unique and age appropriate supports and interventions.  They include: therapeutic activities in the waiting room and exam room, procedural support, medical play, recreational play, developmentally appropriate education and general family support.   

Ways she helps families during office visits

  • Assessing how the child is doing with fingersticks, injections, and rotating sites.  Developing incentive/reward charts with pre-school and younger elementary students as needed to reinforce positive diabetes care. 
  • Socialization and managing life with diabetes at school, with siblings, and other peer relationships.
  • Reducing stress, anxiety, and fear of medical staff, D.K.A.,  hypoglycemia, injections, and procedures/lab work.
  • Transitioning to CGM and insulin pump therapy

Types of interventions

There are different strategies and interventions for helping toddlers, preschool, elementary, and middle school students.  After speaking to the child and/or parent to assess their concerns– techniques vary from distraction, deep breathing and/or guided imagery exercises - to playing with toys, medical play, or coloring/crafts.  The goal is to normalize the process and eliminate stress, fear, or whatever is making the child nervous or uncomfortable.     

Helping a toddler

A young toddler with type 1 diabetes (T1D) was fearful and upset during his first visit to clinic after being diagnosed. He was recently diagnosed while on a vacation with his family and hospitalized in the Bahamas. According to his family, this experience was traumatizing for him and made him fearful of doctors. At their first UMass Memorial Diabetes Center of Excellence appointment he was traumatized and inconsolable.  Nicole tried to engage him in play but he was too upset and fearful.  Two weeks later, there was a slight improvement for his second visit, and Nicole blew bubbles from the corner of the exam room, and again provided toys, which he played with on his own.  She also provided Mom with resources on ways help a toddler cope with diabetes clinic appointments and procedures. By the third visit, with more bubbles and toys, he did not cry and was more comfortable and trusting of Nicole, the nurses and doctors.  Nicole interacted with him, and he was blowing and popping bubbles with her.  He started to equate his doctor appointments with normal experiences, and not with shots and discomfort.       

Helping a teenager

Recently, Nicole was asked to help an 18-year-old boy, who had lived with T1D for years.  He always had his mother administer his injections.  His care team had Nicole work with the young man to determine what the source of the fear/anxiety was, and to develop a plan to help him finally self-inject.  After talking it through with the teenager, she introduced the ShotBlocker, a pain management tool, and he used it to administer his own injection for the very first time.  He left his appointment confident and reassured that he could do it himself that evening and going forward.       

  Staff Spotlight:       Nicole Gray, MS, CCLS

- BS in Human Development and Counseling Psychology from Wheelock College in Boston 
- Masters degree in Child Life and Family Centered Care from Wheelock College  
- Nicole grew up in New Hampshire and now lives in Plainville, MA 
- She enjoys exploring in New Hampshire, especially on her family’s boat on Lake Winnipesaukee
- Hobbies include reading, crocheting, and following all New England sports teams
- Favorite TV shows: Grey’s Anatomy and Friends

* Best part of my job: "Meeting families and helping them cope with diabetes. It's both challenging and rewarding."