Developmental Responses to Separation/Loss Infancy - 3 years Increased irritability, due to change in environment, caregiver, and routine Change in appetitite/sleep patterns Sense trauma and change through senses (i.e. touch of others) 3 - 6 years Magical Thinking Stage Increased separation anxiety (More "clingy" behavior) Regression Increased irritability, due to change in environment, caregiver, and routine 7 - 9 years Concrete Thinking Stage Believe they caused death Interested in physical aftermath of body Increased physical activity, especially males Violent play, even if the death was not violent 10 - 13 years Needs Answers NOW Stage Constantly waiting for something else to happen (hypervigilance) - unsafe/daring behaviors Increased physical activity, especially males Needs to know answers regarding death immediately Suicidal ideations 14 and up Problem Solving & Abstract Thinking Stage Intense & increased emotions Constantly waiting for something else to happen (hypervigilance) - unsafe/daring behaviors Depression Suicidal ideations Questioning own morbidity May refuse to discuss death or grief issues, DO NOT pressure them to talk All Children May Experience: Intrusive nightmares where they are the victims in the nightmare, which results in sleeplessness Decreased sense of safety Decreased appetite Behavior and personality changes (i.e. social to anti-social) Anger Guilt Increased irritability Decrease in academic achievement Child Development and its Relationship to Grief and Loss What can Parents Do To Help? Reference: Myers, D. (1986) Psychology, New York, Worth Publishers Birth - 3 years General Concepts of Development World is experienced through his/her senses Attachment is developing � experiences some stranger anxiety Language, motor, cognitive, social/emotional development is critical Trust vs. Mistrust is developing Concepts of Death Has no concept of death Sense that something has changed if main caregiver is no longer present Able to sense a caregiver�s emotional distress Grief Issues May respond to death with irritability, change in sleep, eating and play patterns May regress May search for caregiver May be very attached to remaining caregiver and fear separation What Can You Do to Help? Provide nuturing, love and physical closeness (hold and snuggle child, coo and sing with them sitting on your lap) Language holds a special appeal for children this age; they love to hear familiar voices repeating familiar words and phrases Maintain a schedule/routine � Feeding times, play times, storytelling times, singing and holding should continue without interruption. Take photos of deceased so that the child will be able to look at them at a later date if needed Take child to a portion of funeral or service Use appropriate vocabulary for age (�Mommy is dead, she is not coming back.�) Answer questions Model/Encourage appropriate expression of feelings and memory sharing Keep a journal for child of important events, ceremonies, newspaper clippings and stories 3 - 6 years General Concepts of Development Egocentric Focuses on one thing at a time Inanimate things can be alive Magical Thinking � Child believes that just thinking about something can make it happen Continues to learn about the world through senses Play is critical to development Time is reversible, may be able to recall some very memorable past events Continues to develop trust Concept of Death May have concept of death, depending upon the experience Death may be caused by thoughts or feelings (Magical Thinking) May be interested in physical and biological aspects of death and the dead body May think death is like sleep Senses caregiver�s emotional distress Grief Issues May appear fine May respond to death with irritability, change in sleep, eating and play patterns May regress May be concerned with who will be caregiver May show feelings, thoughts through play because he may not have the vocabulary to explain self May be very attached to remaining caregiver and fear separation May ask questions repeatedly Very curious Physical reactions and acting out behaviors What can you do to help? Answer questions Maintain a schedule Take photos of deceased so that child will be able to look at them at a later date if needed Take child to a portion of the funeral/service Use appropriate vocabulary for age Provide play opportunities Model/encourage appropriate expression of feelings and memory sharing Keep a journal for child if important events, ceremonies, newspaper clippings and stories 7 - 12 years General Concepts of Development Egocentric Beginning to understand cause and effect Concrete-operational: understands concrete concepts Magical Thinking � Believes that just thinking about something can make it happen (This is lessening) Continues to learn about world through senses Play is critical to development Peer relationships are becoming very important Self esteem is developing Concept of Death Death is sometimes thought of as ghosts Beginning to understand the finality of death May be interested in physical and biological aspects of death May feel that he caused death Grief Issues May appear fine May respond to death with irritability, change in sleep, eating and play patterns May regress May be concerned with who will be the caregiver May feel a stigma at school or around peers May be very attached to remaining caregiver and fear separation May be concerned about future of self and others Very curious Physical reactions and acting out behaviors What can you do to help? Answer questions Maintain a schedule Take child to funeral or service if he chooses Include child in funeral/service Use appropriate vocabulary for age Be honest and factual Provide play opportunities Model/encourage appropriate expression of feelings and memory sharing Keep a journal for child of important events, ceremonies, newspaper clippings and stories Keep in contact with school Teen Years General Concepts of Development Formal operational: thinks abstractly, like an adult Egocentric Magical thinking � believes that just thinking about something can make it happen (this is minimal) Attempting to find a balance in terms of independence and dependence of caregiver Peer relationships are very important Self esteem is developing Searching for identity Concept of Death Death is final, an end to physical life Realization of own mortality and thinks about the meaning of life May be interested in physical and biological aspects of death May feel that he caused death Understands future and what loss will mean Grief Issues May appear fine May respond to death with irritability, change in sleep, eating, school and social behaviors May be concerned with who will be caregiver May feel stigma at school or around peers May be attached to remaining caregiver/family May be concerned about the future of self or others May attempt to take on role of deceased Struggles with needing support and not wanting it What can you do to help? Answer questions Maintain a schedule Talk adolescent to funeral or service if he chooses Include adolescent in funeral/service Be available when teen wants to talk Be honest and factual Reduce expectations Model/encourage appropriate expression of feelings and memory sharing Keep a journal for adolescent of important events, ceremonies, newspaper clippings and stories Keep in contact with school Start a family communication journal