Talking with children about death and dying

Abstract

This paper outlines the development of childrens' understanding about the concept of death, and describes common grief reactions. Using this framework, the principle elements of talking with children on such a sensitive topic are discussed. A variety of potential clinical interventions at individual, family and group levels are proposed.

On the Child's Own Initiative: Parents Communicate with Their Dying Child About Death

“…The understanding of the concept of death is believed to evolve with age, and the finality of death has been assumed to be fully understood sometime after the age of 10 (Pettle & Britten, 1995;Piaget, 1929), although studies focusing on children suffering from severe or lifethreatening illnesses often report that children may reach such understanding at an earlier age (Raimbault, 1981;Spinetta, 1974). Many studies have also described the terminally ill child's own awareness of the gravity of his or her situation and the possibility of forthcoming death, often manifested through remarks or conversations at unexpected times (Beale et al, 2005;Chapman & Goodall, 1980;Hinds et al, 2005;Spinetta, 1974;Spinetta, Rigler, & Karon, 1973).…”

“…The child's understanding of death develops with age (Pettle & Britten, 1995;Piaget, 1929); hence one of the challenges with talking with children about death is to adapt the conversation to the child's level of understanding. It has also been proposed that children with severe or life-threatening illnesses have a better understanding of these matters than their peers (Raimbault, 1981;Spinetta, 1974).…”

“Mourning With the Morning Bell”: An Examination of Secondary Educators’ Attitudes and Experiences in Managing the Discourse of Death in the Classroom

“…According to McNeil, Silliman, and Swihart (1991), the loss of a close friend, a peer, or an acquaintance in school can have a profound impact on the adolescent survivors “due to the fragility of the youthful ego and the intense relationships adolescents often have with their friends” (p. 133). Pettle and Britten (1995) posited that children and adolescents have a different understanding of death. Children below the age of five understand that death exists; however, they are unable to comprehend the finality of death, which often results in them asking questions about the day-to-day functioning of the dead person, or when the dead person will be returning.…”

“…Nevertheless, they may not be able to express their feelings or emotions when they experience contradictions in the information that they receive after the death of a peer. Thus, “teenagers may need help to connect their feelings in the present with the past events, and feel that their sense of grief is validated” (Pettle and Britten, 1995, p. 398).…”

Suffer the Little Children

“…Misconceptions about children needing protection from pain, assumptions about their ability to understand, or the thought that they are too young to be affected continue today (17). In one study of dying hospitalized children in Edmonton between January 1996 and June 1998, only one child among 77 was documented as being specifically told that they were dying (18).…”