Decreasing the Risk of Complicated Bereavement and Future Psychiatric Disorders in Children

Journal of Child and Adolescent Psychiatric Nursing,  Apr-Jun 2005  by Kirwin, Kathleen M,  Hamrin, Vanya

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The strategies of connection identified by Silverman et al. (1992) are as follows: 74% of the children believed the deceased was located in heaven. Eighty-one percent of the children felt that their deceased parents were watching them and of those who felt watched (57%) were scared because they were afraid that their dead parent might not approve of what they were doing. Another way the children experienced the deceased was through dreams, as 45% of the children reported dreams about their parents. Some of the children took the initiative to keep a connection by visiting the cemetery. Fifty-seven percent of the children spoke to the deceased parent and 43% felt they received answers. Ninety percent of the children had daytime memories. Out of the 125 children, 77% had transitional objects, which is something personal that belonged to the dead parents. As the first year of mourning proceeded, some of these transitional objects became less powerful and more like precious keepsakes.

Children's Concept of Death

Infancy

Joy Johnson (1999), a bereavement specialist, acknowledges that infants respond to the grief of survivors around them. The infant responds to the changes in the schedule, the tension he or she feels in his or her loved ones, and to the disruption in the home. Geis et al. (1998), states that children between 6 months and 1 year can maintain object constancy (which is an internal representation) of their caregiver even when this person is absent. Which leads to the conclusion those young children can experience an emotional reaction following the death of a caregiver.

Toddlers and Preschoolers

According to Johnson (1999), toddlers between the ages of 2-5 have little sense of permanence; they may ask when the deceased is going to come back. The toddler may regress to a younger stage of development when the family was in a safer time, before the death of the family member.

The family may find that the toddler becomes clinging, whiny, starts bedwetting, and may have more physical illnesses. The toddler at this age will alternate between grieving behavior and playing behavior. A toddler's lack of a sense of permanence and magical thinking may play a part in how he or she perceives the loss of a loved one (Johnson, 1999).

According to Geis et al. (1998), during the preschool years, children can display regressed behaviors during mourning. These children have short attention spans and cannot deal with intense emotions for prolonged periods of time. The adults in their lives may conclude that these children are not dealing with sadness or grief. Preschool age children use play activities to cope with strong feelings, which may lead adult family members to believe that they are not grieving.

School-Age Children

In Black (1998), Geis et al. (1998), Silverman & Worden (1992) and Steen (1998), there has been a longstanding discussion about whether school-age children have the capacity to grieve. Black (1998) states that at age 5, many children can understand the difference between a temporary separation and death. They may know that death is irreversible. In children from 5-11 years old, there is an increased understanding that there are bodily changes that occur with death.