Anne Moffett is a nationally certified school psychologist and also works with the Journey Program as a leader of groups for children and adults who are dealing with grief and loss in the Eugene/Springfield area.

        Most of us find that each time we must cope with the death of someone close to us, we flounder.  What should we say to the family? How do we deal with our overwhelming emotions?  Our uncertainty and confusion are even greater when, we, as parents, grandparents, or other caring adults, struggle to find the right words and actions to comfort children who are experiencing the loss of a family member or friend.  We agonize over the "right" things to do and say to comfort them, fearing that the "wrong" thing may scar them for life.
        It is not unusual that, in the midst of strong emotional reactions of our own, we may want to protect our children from pain and distress by withholding the truth about a death for a while.  Or, by keeping things as normal and pleasant as possible, we act as if nothing has changed, hoping that the child will not notice the loss.  Although it is common and understandable, this approach fails to recognize the need of every child to openly confront and work through his or her grief with support and help from parents and other caring adults.

General Guidelines of Support
        There are guidelines that can help us know how to support children through the experience of a death and the resulting grief.  John Bowlby, a respected author and researcher on separation and attachment, wrote that children can resolve losses successfully if they have experienced a reasonably secure relationship with their parent(s) before the loss, and if the following conditions are met:

• They receive prompt and accurate information about what has happened.
• They are allowed to ask all sorts of questions and to have them answered as honestly as possible.
• They are allowed to participate in the family grieving process, including funeral rites.
• They have the comforting presence of a parent or adult they trust and can rely on in an ongoing relationship.

• Cognitive and conceptual delays can interfere with the ability of children with disabilities to understand the concept of death.
• The expressive and receptive language delays some children experience make it difficult to communicate ideas in a verbal context.  They also make it more challenging to check out what the child understands, misunderstands, or is feeling.
• Children with disabilities or developmental delays will often show a younger level of development.  They are able to accomplish the tasks of mourning if communication and activities are geared to accurate developmental levels rather than to chronological age levels.

Timing and Environment are Important
        Accept the fact that telling a child about death is not easy.  You may be feeling overwhelmed by your own emotions and tempted to wait until you are totally in control.  Even so, it is important to tell children as soon as possible after a death has occurred, since they will quickly suspect that something is wrong when they notice the body language and emotional reactions of those around them.  Giving accurate information prevents children from creating an imagined explanation for the nonverbal clues they pick up from the behavior of others.  Sharing the news as soon as you can helps children feel they are included in the family process from the beginning.
 It is usually best if the news can be shared by the parent or adult to whom the child feels closest, since the history of support and involvement that person will help the child feel protected in the face of the crisis.  When possible, use comfortable and familiar surroundings, which will convey a sense of safety.  Share your own feelings openly so that the child will know it is ok to be sad.  Physical contact, such as a hug, holding a child's hands or holding a young child on your lap will communicate warmth and caring that will be remembered after the painful message is given.

Preschoolers and Age Appropriateness
         Children at different ages understand information about death differently.  Preschool children often see death as a temporary state and have trouble grasping its finality.  They tend to believe that the person who died will return, and this belief can persist despite the best efforts of adults to explain.
         Preschoolers are very literal and concrete thinkers, so it is important to choose language that does not confuse them.  Explain death in terms of things that they can see and that relate to their everyday life, for example:  "when people die, they do not eat or breathe anymore.  They cannot see their family or hear things that are said to them.  They die because their body stops working".
         Referring to death as "being asleep" or "going on a trip" can reinforce a child's belief that the person will return, and it also may create fears that anyone who goes to sleep or takes a trip may die.  When death was the result of illness, it is important to discuss with the child that most illnesses can be treated and cured; people do not often die from colds or ear infections, only when an illness is very serious.
         Children often use magical thinking to help make sense of a death.  A child who has been naughty or who had previously been angry with the person who died may believe that he or she is responsible for the death.  Adults can pick up on these ideas by listening carefully to children's questions and by encouraging them to talk about their feelings about the death.  If a child is using magical thinking to explain the death, you might respond, "I can understand how you might think that, but that is not how death happens.   It was not your fault", and then proceed with a careful explanation aimed at the child's level of understanding.  Try not to overwhelm the child with information that he or she can absorb, but above all, answer questions factually, honestly and lovingly.
         Young children may need to ask questions repeatedly, even though the answers have been given previously.  They are not able to grasp all of what they are being told at once and need to repeat questions over a period of time to gain better understanding.  Each time the child discusses questions related to the death, the experience becomes a little more bearable.  Questions can also be attempts at reassurance that parents and adults are still available, interested, and concerned.  When questions are welcomed and answered openly, children will build a sense of security and trust based on the honesty in the relationship.
         Elementary school aged students with developmental delays frequently see death from the developmental stage of typically developing preschoolers.  Children with disabilities seem to need time and discussion to work through the notion that a classmate is not still living at home, won't be able to come back for the party next week, doesn't eat cookies anymore, and won't have another birthday next year.  Repeated explanations addressed to each idea that comes up seem to be necessary, since these children are often unable to generalize the permanence of death beyond each specific question.

Preadolescents and Age Appropriateness
         At ages 6 to 9, is often seen as a person or thing that "comes to get you" such as an angel, ghost, or skeleton.  Death is real to children at this age, but only happens to others.  They reassure themselves that they are "stronger, or smarter, or can run faster" than the person who died, and therefore are safe. They are interested in the human body and often have many questions, which sometimes may seem "gross" to adults.  These questions deserve answers that are specific but not too advanced or technical.
 Preadolescents understand that death is universal and will someday happen to them, but not until they are very old.  They think about how their life will change because of the death of a particular person, for example: who will be their best friend now?  They may become overly concerned about their own health and the health of loved ones; cover up feelings with inappropriate humor; or act out feelings through falling grades, misbehavior, or irritability.
 In attempting to understand a death, children with disabilities, like their peers without handicaps, may use magical thinking to attribute causality to their own thoughts or actions, or to events that preceded the death.  Delayed language skills that many of these youngsters display may make it quite difficult to uncover magical thinking about what caused a death.  At times the adult may need to bring up the questions or ideas that these students could be expected to have but do not have the skills to ask, such as "Was it my fault?" or "Who else will die?"  In addition to careful listening and skillful questioning, it can be useful to closely observe free play situations to see what death scenarios are played out that can shed light on any confusion a child with disabilities may be experiencing.

Teens and Age Appropriateness
         Teen-agers are busy with the job of separating from their families and establishing their own identities.  To do this successfully, they need to feel that life is safe and secure, and that their families will be there if they are needed.  The death of a family member or close friend can strip away this security and interfere with the developmental task of breaking away from the family and establishing independence.   Teen-agers' grief is often expressed with peers rather than with family members. They may prefer to develop their own rituals rather than participate in the family rituals.  Dealing with the death of someone close challenges their feelings of immortality.  As a result, they may engage in risk-taking behavior as a way of testing out their own limits of mortality.
 Karen Gravelle and Charles Haskens, authors of "Teenagers Face to Face with Bereavement," write that adolescents frequently experience numbness and shock for at least part of the first year after a death. They may be flooded with intense and conflicting emotions eight months to a year later, much to the surprise of everyone around them.
 
 

Signs and Symptoms of Grieving
         During the course of grieving, a wide range of symptoms is normal for children.  Physical symptoms could include loss of appetite, stomachaches or nausea, headaches, chest pain, shortness of breath, difficulty sleeping, and may others.  (It is not unusual for a child to experience symptoms similar to those that were experienced by the person who died from an illness.)  Children with disabilities often have the need to communicate the news of a death to every person they come into contact with in the school setting.  It is helpful, therefore, to give advance notice to other adults and to coach them in appropriate ways of responding to the student's reports.  Some children may show a pattern of dealing intensely with loss and grief one moment, and abandoning themselves to other activities the next.  They may deal with their grief in brief spurts since they cannot sustain it on a cognitive level for longer periods of time.  Some may show a dramatic increase in opposition or mischievous behavior.  Others may show signs of significant depression and anger.  While maintaining familiar routines, classroom structure, expectations and consequences is important at this time, it is a general guideline that children who are grieving should not be isolated.  If behavior is becoming seriously disruptive or causes concern, consultation by a counselor or school psychologist may be useful in helping the parent to identify the needs of the grieving child and to form a plan of action to meet those needs with school and community resources.
         Behavioral symptoms could include misbehavior, hyperactivity, social withdrawal, obsession with certain thoughts or memories, apathy or loss of interest in activities, nightmares or over-compensation by becoming the "perfect child," among others.  Emotional reaction could include fear, depression, guilt, anger, helplessness and dependence, loneliness, anxiety, and shock.  Cognitive symptoms often include disorientation, confusion forgetfulness, poor concentration and loss of productivity.  Children need reassurance that these symptoms are a normal part of the process of grief , and that with time they will be less intense.

Useful Activities for Working Through Grief
         Within a secure and caring relationship, parents can help grieving children explore activities which help to express their feelings and make sense of the loss that has occurred.  Art activities such as paints, finger-paints, clay, and collages provide a great way to express feelings that may be difficult to talk about.  Music is another excellent means of expression for some children.  Movement activities such as dance, sports and vigorous play are valuable ways of expressing the bodily feelings that are so common in grieving children.  Writing a journal to record thoughts, feelings, and experiences is helpful to many children and reading stories about others' death and loss experiences can also provide a means of working through questions and fears.  Some families find that participating in support groups for children and families who are mourning a death provides a valuable chance to be with others who are dealing with similar feelings and changes. Feelings of isolation and "differentness" can be eased.

Time and Recognizing the Need for Professional Help
         Grieving does not follow a straight path. Just when it seems that things are getting better, something may happen to trigger the most intense feelings all over again.  There is no answer to the question, "How long does it take to recover from a death"? It usually takes several years to begin to feel that life is back on a normal course again.
 How can a parent tell when professional help is needed?  Most importantly, if a child is engaging in behavior that is dangerous to himself or herself or others, it is time to seek help.  If intense feelings of sadness, depression, or anger persist after a year, are interfering with the child's life, and do not seem to be easing, the child may be stuck in the grieving process and need help to begin to heal.  If a child, through his or her words or behavior, seems to be asking for more than you can give, or if you are feeling overwhelmed by needs of your child, these are also signals to consider getting professional assistance for your journey through grief to healing.