Thursday, March 15, 2018

Grieving Kids Need Guidance
By Naomi Naierman
To both adults and children, grief is a highly emotional experience that includes fear, anger, relief, despair, peace, guilt, numbness, agitation, and sorrow. Children, in particular, can feel a sense of abandonment and a loss of security and control when they lose a loved one. In her book The Grieving Child, Helen Fitzgerald notes, "Children haven’t had many of the experiences life has to offer, nor are they cognitively able to understand death as we do. Thus they grieve without the same level of comprehension of what is happening to them, for they have not had the experience of the finality that accompanies someone’s death" (1992, p. 53).
Like adults, children don’t process their grief on a predictable timetable. Fitzgerald notes that young people may grieve intensely, but sporadically. For them, a major loss experienced in early childhood can reverberate throughout the years as they progress through life’s milestones—birthdays, first date, graduation, marriage, and parenthood.
In the me-centered world of the early years, young children may feel responsible for the illness or death of a loved one. They may think that because they misbehaved or had a "bad thought," they caused the crisis. Magical thinking has not yet been replaced with reality, and unpleasant events like death are seen as avoidable or reversible. Small children may believe that there is something they can do to bring a loved one back. 
Failure to address the needs of young, grieving children can have dire consequences later in life. Studies show that bereaved children under the age of five are more susceptible than older children to long-term negative outcomes, such as depression and pathological behavior. (See Bereavement: Reactions, Consequences and Care by Marian Osterweis, et al., 1984, National Academy Press, Washington DC.) Teachers and child care providers can play a vital role in helping children understand and manage the pain of grief. They can also help parents by communicating what they observe in a child and suggesting coordinated responses to help a child grieve effectively. 
The first step in becoming familiar with children’s grief is to understand the nature of grief at various developmental stages. A child under the age of two, for example, may not understand loss, but will nevertheless sense any emotional changes among surrounding adults, especially after a primary caregiver dies. The child may regress, and there may be a noticeable increase in fussiness and clinging. To reassure the child, every effort should be made to provide structure and affection, if not a substitute primary caregiver on a continuous basis.
Toddlers, ages three to five, perceive death as temporary and find the concepts of heaven, soul, and spirit difficult to understand. When the loved one does not return, a sadness sets in, as well as acting-out behaviors such as aggression, noncompliance, and nightmares. These behaviors may be exhibited in brief episodes interspersed with periods of play that mask the grief. Like their younger counterparts, these children need consistent affection and a daily structure that is as close as possible to their previous routine. 
Beginning at the age of six, children can understand that death is permanent, but they are subject to many misconceptions and guilty feelings. They may blame themselves for the tragedy or fear their own death. Words describing their feelings will not come easily. Common acting-out behaviors include aggression, withdrawal, possessiveness, compulsive caregiving, and phobias. 
As important role models, caregivers and teachers have the responsibility and privilege to help grieving youngsters. Providing safety and acceptance is the guiding principle of an orchestrated response in and outside the classroom. As outlined in Grief at School, A Guide for Teachers and Counselors by the American Hospice Foundation, teaching adults are helpful when they assume a proactive role and take strategic actions. Among the suggestions made in this guide are the following:
1.       Acknowledge a child's grief by conveying your own compassion and reassurance in age-appropriate ways. Explain to a child you are feeling sad and missing the person who has died. Reassure him or her that after you have had a good cry you will be feeling better, and then let the child know what he or she can do to make you feel better. This may be a hug, getting a glass of water, or finding a box of tissues.

2.       Be vigilant; anticipate new behaviors; and provide opportunities for safe, emotional outlet. Anticipate some anger in a child. The intensity will vary depending on the circumstances of the loss as well as the ability of the child to cope and the presence of support. Let him or her know it is okay to be angry, but it is not always okay to do what you do when you are angry. Teach children some things that he or she could do to express anger: activities such as tearing up old magazines, writing on a helium balloon and letting it go, writing in a journal, etc.

3.       Provide structure and set limits—a firm hand is a sign of normalcy at a time of confusion.

4.       Discuss a child's behaviors and needs with the family and coordinate consistent messages. This is particularly important for the issues of religion and family routines. Encourage parents to share what they are teaching their child about death, the vocabulary they are using, and the child’s involvement in the funeral ritual. As a caregiver, you can provide extra support and assistance to the children in your care.

5.       Plan age-appropriate activities designed to facilitate constructive expressions of grief. For children ages six and under, the following activities are effective:

·         Use coloring books with subjects related to death and grief (often available through local hospices).

·         Read age-appropriate books on death and grief (see the resource list below for suggestions).

·         Encourage the children to write poems, stories, and plays based on the characters and themes in books or based on their own experience.

·         Have the children make a scrapbook or poster about the special person who died.

·         Create a memorial with the children, including a ceremony and meaningful symbols of remembrance. 

Understanding children’s grief, recognizing the signs of grief, and learning how to reach out to children through gestures and activities are skills that every educator should possess. Helping young children deal with their losses can be as crucial to a happy, productive future as any reading lesson can be.
Naomi Naierman is president and CEO of the American Hospice Foundation, a national nonprofit organization advancing the hospice concept of care through public education and consumer research. In this role since 1995, Ms. Naierman has been responsible for raising public awareness about the hospice mission, which includes community education about grief as well as care for dying patients and their grieving families.
Grief at School, A Guide for Teachers and School Counselors, by the American Hospice Foundation. (Send $3 and a stamped, self-addressed #10 envelope to AHF, 1130 Connecticut Ave., NW, Suite 700WashingtonDC 20036.)

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