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Children and Adolescents Development, levels of comprehension, and types of death Developmental Psych: Background • Erickson – Trust vs. mistrust: 0-1 – Autonomy vs. shame and doubt: 1-3 – Initiative vs. guilt: 3-6 – Industry vs. inferiority: 6-puberty • Piaget – Sensorimotor: 0-1 ½ – Preoperational: 1 ½ - 7 – Concrete operations: 7-11 – Formal operations: 11 and up Theories of Childhood Comprehension of Death • Maria Nagy: 3 developmental stages – (1) There is no definitive death. Death is not seen as final, it is a trip or sleep. e.g., how long do you stay dead after you die? (less than 5 years of age. Magical thinking – did I cause it? – (2) Death= a man. It is personified. Death is final, but still avoidable and not inevitable. (5-9 years of age). – (3) Cessation of corporal life. Death is both final and inevitable. Further Theories • Speece and Brent: Five sub-concepts – Universality: all living things must eventually die. – Irreversibility. – Nonfunctionality: understanding that the physical body stops working. – Causality: understanding of events that lead to death (usually reached by age 7). – Noncorporeal continuation: trying to understand life apart from the physical body. Keys to Understanding Children and Death • View the child as a whole. This includes: – Developmental level. – Life experiences. – Individual personality. – Patterns of communication and support. Tips for Grieving Children • Whenever possible prepare children ahead of time. – Include visits to ill people, involve them in rituals. • Help children to express emotions through a variety of media (art, music, play). • Use words that your child can understand. • Recognize that every child grieves in their own way. Tips for Grieving Children • Avoid confusing euphemisms. • Listen for unasked questions. – Will it happen to me? – Who’s going to take care of me? – Did I cause it? • Allow children to see your grief. • For young kids help them to realize body doesn’t work any more and that deceased can’t see, hear, or feel. Tips for Grieving Children • Don’t be surprised that kids turn grief on and off. • Invite, but don’t force children into funeral rituals. • Help children with commemoration. • Expect some regression, it is a normal reaction to anxiety. Children Coping with Life Threatening Illness • Incorporating disease into one’s life history. • Learning to live with uncertainty. • Learning to live with compromise and repercussions of disease. • Overcoming social stigma. Adolescence • Bridge between child and adulthood. – Puberty is occuring earlier and earlier. • Developmental Tasks – Erikson: Identity vs. Role Confusion – Marcia: Identity foreclosure, role diffusion, moratorium, identity achievement. Death Rates • 1.5% of all death rates. Lowest rate of any age group. • But, causes of death are often shocking. • 76% of deaths are either homicide, accidents, or suicide (cause 4-10 don’t equal number of suicides. • 75% of accidents are motor vehicle accidents. • ½ of accidents are alcohol related (TX is worst in the nation for adults and teens). • Why? May not understand risks, or may view the risks as worthwhile (for peer approval). Homicide • 31% of adolescent deaths. • Males and African-Americans are more likely to be killed. • Most murders are committed by members of same race. • Rates are higher in lower socio-economic status areas. Guidelines for Communicating with Adolescents about Death • Take the lead in openness to discussing death. • Listen actively – look for subtext. • Accept their feelings as real, important, and normal. • Use responses that reflect acceptance and understanding. • Don’t solve their problems.
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