Service Delivery

Assessing Child Life Specialists' Management of Challenging Behaviors in Autistic Pediatric Patients.

Schenk et al. (2025) · Journal of autism and developmental disorders 2025
★ The Verdict

Child life staff feel braver with autism training, yet most still face aggression with bare-bones tools.

✓ Read this if BCBAs consulting on pediatric medical floors or training hospital staff.
✗ Skip if Clinicians who only work in outpatient clinics with no inpatient contact.

01Research in Context

01

What this study did

Schenk et al. (2025) asked 131 child life specialists how ready they feel to handle hitting, biting, and self-hitting in hospitalized autistic children.

The team used an online survey. They compared staff who had autism training with staff who did not.

02

What they found

Specialists with autism training said, "I feel more able and calm" when tough behavior starts.

Still, only a small slice felt both able and calm at the same time.

Most staff said they want more help with safety and behavior tools.

03

How this fits with other research

Wang et al. (2025) already warned that hours of therapy mean little if staff lack good training. The new survey shows the same gap inside children’s hospitals.

Hong et al. (2024) tracked older autistic youth in the psychiatric ER and found aggression as the top reason for arrival. Kaitlyn’s data now show that even the kid-friendly hospital floor feels under-prepared for the same issue.

Verriden et al. (2025) proved that simple tools like competing-stimulus assessments cut automatically reinforced behavior. Child life teams could borrow these tools, but the survey shows they rarely get that training.

04

Why it matters

You may call a child life specialist when a patient tears out an IV. If that person has had autism-specific training, they stay calmer and protect the child and staff. Push your hospital to add brief behavior-safety modules for these teammates. A one-hour inservice on prevention, redirection, and safe holds can cut injuries and length of stay.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Email the child life manager and offer a 30-minute lunch-and-learn on visual schedules and first-then boards for pre-procedure prep.

02At a glance

Intervention
not applicable
Design
survey
Sample size
131
Population
autism spectrum disorder
Finding
positive

03Original abstract

Given that autistic children are hospitalized at higher rates than neurotypical peers, it is important to understand the autism-specific preparedness of healthcare providers. Certified Child Life Specialists (CCLSs) play a crucial role in pediatric hospitalizations by providing socioemotional support and coping strategies. The present study assessed perceived competency and comfort levels among 131 CCLSs regarding the management of challenging behaviors exhibited by autistic pediatric patients, including aggression and self-injury. All participants reported experiences providing care to autistic children who exhibited challenging behaviors, but very few reported both high perceived competency and high comfort in managing these behaviors. Autism-specific training positively correlated with perceived competency and comfort. These results have implications for providing autistic children high quality hospital care.

Journal of autism and developmental disorders, 2025 · doi:10.1177/1179556519842816