Death

The subjects of “children” and “death” seem somehow contradictory and yet it is clear, based on children’s drawings and writings, as well as a child’s adulthood memories, that the two subjects are often related. Consider the history of certain chants and games:

1. “Peekaboo” is said to be derived from an old English word meaning “dead” and “alive.”

2. The children’s rhyme, “Ring around a rosie, a pocket full of posies; Ashes, ashes, we all fall down,” began in the 1300s with children’s awareness of the symptoms of the Black Plague that killed over 25 million people.

3. An old English children’s prayer, “Now I lay me down to sleep, I pray the Lord my soul to keep; if I should die before I wake, I pray the Lord my soul to take.”

4. The history of the children’s games of “hide and seek” and even “tag” are thought to be related historically to children’s concerns with life and death.

Nevertheless, since the 1980s in the United States, we  are  experiencing  the  world’s  first  death-free  generation, meaning that a child is likely to grow to adulthood and never experience a death in their immediate family. (Death is experienced once in approximately 20 years for primary family members.) Yet 60% of children younger than 18 years of age will live in a single-parent home, for many an emotional equivalent of death. (Twenty percent of teens now live in single-parent homes.)

Developmental Aspects Of Death

Just as children’s understanding of their environment and their place in this environment change with time, so does their understanding of the concept of death. A child’s understanding of death is often described in four developmental stages:

1. Birth to 3 years of age

2. Three to 6 years of age

3. Five or 6 to 9 or 10 years of age

4. Ten plus years of age

From birth to 3 years, a child has no cognitive awareness or mental image of death, yet a physical response to death does exist. Rene Spitz’ classic work in the 1940s set the stage for the understanding of a very young child’s awareness of death of a significant caretaker. Spitz observed children placed in institutional settings as a result of the death of a parent or parents and from this work coined the term anaclitic depression. The symptoms of anaclitic depression are weight loss, increased demandingness and weepiness, and the arrest of developmental progress, with some children by the 3rd month refusing contact with people and assuming a prone position in the crib with an averted face. This term described the physical characteristics listed above. Thirty-seven percent of these children studied by Spitz died from malnutrition and infection at the end of 2 years.

The sources of studies of children and death between the ages of 3 and 10 years usually rely on the observation of children’s drawings and stories as told to various child development researchers. Two classic studies are those of Maria Nagy (1948) and Sylvia Anthony (1971). From 3 to 6 years of age, children see death as temporary and reversible. A child’s understanding is that death is like taking a trip or sleeping. During this period, children think concretely, and destroying and reviving persons is commonplace in children’s play. A young boy of 4, several weeks after the burial of the family dog, suggested that the family go and retrieve “Peter” from the cemetery. His belief was that Peter was living in the cemetery and only required being “dug up,” a reversal of the burying process that he had witnessed, to bring the pet back to life.

Another common thread in the belief set of 3to 6-year-olds is the sense that death is not only temporary and reversible but also “living under changed circumstances.”

One of Maria Nagy’s interviews of a 6-year-old Hungarian boy is as follows:

“He stretched out his arms and lay down. He can’t speak. Can’t move or see. He lies for four days.”

(Nagy) “Why for four days?”

“Because the angels don’t know yet where he is. The angels dig him out and take him with them.”

(Nagy) “What happens to him?”

“If it’s a woman, she does the cleaning. If it’s a man, then he’ll be an angel. He brings Christmas trees.”

(Nagy) “Well, what are you going to do when you get there?”

“I’m going to bake cakes the whole year. Each angel has his own stove.”

This is wonderfully illustrative of the belief of the young child that death brings life under changed circumstances, and this particular 6-year-old believes he will be baking and delivering Christmas trees after his own death.

The next stage—5 or 6 until 9 or 10 years of age— is characterized by a more sophisticated but still concrete view of death. Hungarian children in Maria Nagy’s study personified death, making death into a person or being that would capture or take little children. These children, from a different cultural background, discussed death as equivalent to the presence  of  skeletons,  ghosts,  or  the  boogieman. They often described death as coming with a scythe. Children in the United States, even though equally fascinated by death as their Hungarian peers, describe their beliefs in different ways. Children in the United States are particularly fascinated with the subject of death and seem to be riveted by discussions, pictures, and the rituals of death and dying. Halloween is often the favorite holiday for children in this age group. Boys in this age group most often draw pictures of blood  and gore and emphasize the violence of death in their drawings and stories. Girls, on the other hand, emphasize the “romance” of death and put tombstones, flowers, angels, and other heavenly beings in their drawings.

Ten years and older marks the beginning of a more adult understanding of death. This is the first time that children begin to comprehend that death is final. It is around this age that children begin to comprehend abstractions and grasp the concepts of the universality, irreversibility, and nonfunctionality of death:

1. Universality: the knowledge that every living thing eventually dies

2. Irreversibility: the knowledge that once dead, living things do not return to life

3. Nonfunctionality: the knowledge that death means the cessation of all bodily functions

Expressions Of Grief

Children  differ  from  adults  in  their  expressions of the grieving process. Some of the more common expressions are as follows:

1. Shock, denial, lack of feelings: Children tend to grieve in “bits and spurts” rather than in a continuous fashion as do most adults; therefore, it is less obvious, when children are playing and seemingly not sad, that they are experiencing a grieving process.

2. 2. Physical changes: Children are likely to express grief in physical rather than verbal ways. Children have little permission or opportunity to talk about death and are less capable of putting words to their feelings, and so they often express their sadness or loss by being tired, showing lack of energy, having difficulty with sleep or appetite, having headaches or stomach aches, and/or experiencing skin rashes or hair

3. 3. Regression: After the death of a caretaker, a child may become overly dependent on the remaining parent, often having an inability to separate from the still living

4. 4. “Big man” or “big woman” syndromes: Children experiencing a significant loss may take on the role of the missing adult, seemingly becoming more mature than their

5. Disorganization, panic, fear: A child’s life after a significant death feels chaotic and out of control.

Many children express fear that their other caretakers may die as well.

6. Explosive, “acting out”   behavior:   Some children become increasingly angry at themselves or others, behaving uncharacteristically in an angry, outof-control fashion.

7. Loss, emptiness: A child may become dependent on someone outside the family, avoiding the reminders in their home of the family loss.

8. Relief: Particularly after a long illness, a child will express relief that the difficult period has ended. This behavior is similarly felt among adults, but expressed more privately, in that this response is seen in society as an inappropriate one.

9. Gender differences: Girls and boys are socialized to express grief differently. Girls are likely to be reinforced for sharing grief openly; boys are expected to be strong and express their grief privately.

Summary

Death  is  a  part  of  a  child’s  life.  From  birth onward, an understanding of death is expressed by children commensurate with their developmental age and gender. Children have characteristic ways of responding to death that differ from a typical adult response.

References:

1. Anthony, S. (1972). The discovery of death in childhood and after. New York: Basic
2. Danielson, H., & Bushaw, K. (n.d.). Talking to children about death. Retrieved from http://www.enodak.edu/extpubs/yf/famsci/fs441w.htm
3. Doka,  J.  (1996).  Living  with  grief  after  sudden  loss. Washington, DC: Hospice Foundation of America.
4. Hospice (n.d.). Talking to children about death. Available from http://www.hospicenet.org
5. Nagy,  (1948).  The  child’s  theories  concerning  death. Journal of Genetic Psychology, 73, 3–27.
6. Parry, K., & Ryan, A. S. (1995). A cross-cultural look at death, dying, and religion. Chicago: Nelson-Hall.
7. Silverman, P. R. (2000). Never too young to know: Death in children’s lives. New York: Oxford University
8. Spitz, A. (1945). Hospitalism. In R. S. Eissler (Ed.), The psychoanalytic study  of  the  child  (Vol. I).  New York: International Universities Press.
9. Wilkin, C. S., & Powell, J. (n.d.). Learning to live through loss: Helping children understand death. Retrieved from http://www.nncc.org/Guidance/understand.death.html
10. Williamson, J. , & Schneidman, E. S. (1995). Death: Current perspectives. Mountain View, CA: Mayfield.