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DEATH   One morning, many years ago, I was having breakfast with my family. Suddenly, my son started to cry. He had been watching Charlotte's Web and Charlotte just died. He had lost his pet turtle Raffe two weeks before and we had a burial ceremony in the back yard. How do you console your child when exposed to the death of a loved one?

A child's understanding of death changes with his age. Other influences include family beliefs, religious training, personal life experiences and cognitive ability. Before the age of two years, your child experiences things through his senses and expresses his feelings through actions. This is the sensorimotor stage of cognitive development. By nine months of age he can experience separation anxiety. This is the foundation for future understanding of this concept. The term death has no conceptual meaning during the first two years of life.

Between the ages of two and six years, your child does not understand the term death as we do. At about three years of age children start to use the term death. They think of death as a state other than alive. Being dead now does not prevent them from being alive later. Your child does not understand that death is an irreversible biologic state. The sense of permanency of separation through death is not well formulated yet. Children of this age also use "magical thinking." They believe that events in the external world are the direct result of their own thoughts and wishes. This is important to understand because a child at this age may blame himself for the death of a loved one. They also may believe that death is catching and that someone else might die.

The period of middle childhood is six to twelve years. Concrete and logical thinking influences the concept of death. They perceive death as a universal and irreversible event. They may have a morbid interest in skeletons and dead bodies. They may dissect dead animals out of curiosity. Their interest centers around the physiologic changes that occur with death. By the age of nine or ten years the child has a more adult understanding of death. They also understand that death could happen at any point in life and therefor could happen to them.

The adolescent is able to conceptualize death as a universal and irreversible process. He is capable of abstract thought. At this age it is difficult for him to think about his own death. In order to cope with the anxiety of death raised by thoughts of his own mortality, the adolescent uses denial. This is why the adolescent flirts with truly death-denying dangers. They may experiment with drugs, drive recklessly or riding on dangerous rides at an amusement park.

How can you, as a parent, help your child cope with the death of a loved one? What you should do depends on the age of your child and the circumstances surrounding the death. Up to the age of two, death is perceived as separation and abandonment. Help them cope by providing them with consistent care in a familiar environment.

From age two to six years, it is appropriate to discuss what the child can concretely understand. Do not use terms like, "He went to sleep." Your child may be afraid to go to sleep for fear of dying. Do not say that the deceased person "went away." This leaves the child with the hope that someday the person may return. Reassure your child that he is not responsible for the death. Make sure he understands that death is not catching - no one else will die. You should assure your child that someone will take care of him. Reactions to death at this age can rang from persistent, repeated questions about the dead person to behaving as if nothing happened. Behavioral problems such as bed-wetting and sleep disturbances are common for three to four months after a death.

The six to twelve year old uses concrete thinking. They have a more adult understanding of death. You can explain death in biologic terms, such as the heart has stopped pumping or the lungs have stopped breathing. The adolescent thinks in abstract terms and focus more on their own mortality. They attempt to act grown up and often deny their fears. They may protect themselves from their feelings by denial and distance. Make yourself available to discuss their feelings.

There are many excellent books that can help you to introduce the topic of death to your child. For the preschool child, "The Dead Bird," by Margaret Wise Brown, and "Ten Good Things About Barney," by Judith Viorst are excellent. For the young school-aged child, a good book is "Annie and the Old One," by Miska Miles. For the older school-aged child, I suggest "A Taste of Blackberries," by Doris Smith and "Charlotte's Web," by Elwyn White. "Roller Skates," by Ruth Sawyer, "The Magic Mouth," by Virginia Lee and "Thanksgiving Treasure," by Gail Rock are also very good. There is a review of each of these books at the office.

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