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NOVEMBER 2006

From the NYU Child Study Center: Ask the Expert
How Can I Help a Grieving Child?
By Glenn S. Hirsch, MD

Death and bereavement are topics that are often difficult to talk about and comprehend, for adults and children alike.  Nevertheless, it is estimated that one in every seven children will experience the death of a loved one by the age of 10, and that one in every 20 children will experience the death of a parent before they turn 18.  By understanding how children cope with loss, trusted adults will be better able to help them through one of life’s more difficult experiences.

There are a variety of factors that influence how children respond following the death of a loved one, including age and level of cognitive development.  Preschoolers do not understand the finality of death, and they are likely to react most to the way in which the loss impacts their daily life.  They may continue to ask where the deceased is, expecting the person to return.  For this reason, it is particularly important to maintain routines and structure for young children, and to let them know who will be taking care of their daily needs.  School-age children are more likely to understand that death is final, but they will continue to have questions about what happens to people when they die.  Providing honest and concrete answers and helping children know what to expect over time are most helpful to children at this age.  Pre-teens and adolescents are likely to have an understanding of death that is similar to that of adults, and they tend to think about how the loss of significant people may impact their futures.  It is important that teens have trusted people, including friends, family, or teachers, with whom they can talk about their thoughts and feelings.

Perhaps the most important thing to keep in mind is that there is no right or wrong way to grieve.  In other words, there is no set “timetable” or series of “stages” that grieving children must follow.  There are certain responses that are common among bereaved children, however.  For example, bereaved children often feel isolated and different from their peers, and they may feel that they are treated differently at school or in social settings.  Children may also experience feelings of confusion, sadness, anger, and worry.  These feelings typically lessen over time, particularly when children have the support of trusted adults and peers with whom they can talk.  Other children seem to have a more difficult time, experiencing psychological distress that persists for several months.  The most common disturbances among bereaved children are depressed mood, irritability, and significant worry about the health and safety of family members.  There may also be a decline in school performance related to problems with attention and concentration.

Teachers and other school officials may help bereaved children and those around them by creating an environment in which children are able to express their feelings and ask questions.  It is beneficial for teachers to listen calmly and attentively, answer questions in a direct manner, and reassure children that their feelings are normal.  In addition, teachers should watch for emotional and behavioral reactions that signal the need to make a referral to a mental health professional, such as continued decreased ability to concentrate, persistent emotional distress, or expressed thoughts of suicide or aggression. It may also be helpful for educators to talk to the bereaved child’s caregivers about how classmates and teachers might best support the child and his or her family.

For information about services available for bereaved children and families, contact Dr. Michelle Pearlman, Director of Clinical Services of the Families Forward Program, Institute for Trauma and Stress at the NYU Child Study Center, at 212-263-2776.#

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