Children and Adolescents

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					Children and Adolescents

    Development, levels of
comprehension, and types of death
         Developmental Psych:
• 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
  – 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
• 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
• 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.
• 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
• 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).
• 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
• Listen actively – look for subtext.
• Accept their feelings as real, important, and
• Use responses that reflect acceptance and
• Don’t solve their problems.

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