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Thousands of people are attending the funerals of the 12 children and teenagers killed yesterday by a Hezbollah rocket that exploded in Israel’s Golan Heights. Several victims’ family members have fainted out of grief and are receiving medical treatment. https://t.co/wu9b6ab4Yf

Childhood bereavement is a profound public health issue and the most distressing form of childhood trauma. A parental death alters the trajectory of child development and can contribute to long-term negative mental health issues, including depression, prolonged grief, and suicidality. Grief is labile in nature and theory has recognized coping efforts as dynamic processes that allow for variation in individual experience. Individual experience can be empirically grouped into profiles based on the various ways of seeking support and expressing emotion via person-centered statistical approaches (e.g., latent profile analysis). The current study leverages longitudinal data (N = 244 bereaved youths; ages 8-16) from the Family Bereavement Program (FBP) to (1) conduct a latent profile analysis to explore individual differences to create profiles of support-seeking coping strategies and emotional expression amidst parental death; and (2) investigate how those individual differences contribute to risk for long-term depression, intrusive grief, and suicidality at one-and six-year follow-ups. Findings can improve the current understanding of child bereavement processing and provide more precise treatment for preventive interventions.

The aim of this review is to examine existing research on the topic of professional carers’ discussion of grief and loss with parents caring for children with life-limiting neurodevelopmental disabilities (LLNDD’s). Of particular interest is the timing of these discussions, and whether these occur early in the child’s life or towards the end of life. Summary Parents experience a range of emotional reactions when their child is diagnosed with a life-limiting condition, including grief and loss responses (Machin, 2014; Guerin and Sheehan, 2017). Children with LLNDD’s may have long periods of relative stability interspersed with episodes of acute, potentially life-threatening illness and complications (Eiser,1993). Parents live with the constant awareness of their child’s shortened lifespan, though little is known about professional support for dealing with such challenging emotions. A preliminary search of relevant articles identified that studies of professional carers’ discussion of grief and loss primarily focus on the end-of-life phase in tertiary settings. While the benefits of initiating these discussions during the earlier stages of the child’s trajectory have been noted (Carr, 2021; Kochen et al., 2019), evidence for this is unclear. Findings from bereavement literature suggest that lack of preparedness for death is associated with increased bereavement risk (Aoun et al., 2012). Neurodevelopmental disabilities comprise a diverse group of diseases that all have dysfunction of the nervous system in common. They may vary over time and include a broad range of severity and complexity (Morris et al., 2013). The term “life-limiting neurodevelopmental disability” refers to a condition of neurodevelopmental origin for which there is currently no cure, and which is likely to lead to the child dying prematurely (Sutherland et al., 1994). For the purposes of the current review, the definition proposed by Together for Short Lives (2017) will be used. Life-limiting conditions are defined as “those for which there is no reasonable hope of cure and from which children or young people will die. Some of these conditions cause progressive deterioration rendering the child increasingly dependent on parents and carers”. Key Review Questions The scoping review aims to address four research questions: 1. What is known from research of professional carers’ discussion of aspects of grief and loss with parents caring for a child with a LLNDD? 2. How common are these discussions? 3. To what end do these discussions take place? 4. At what point(s) in the child’s lifespan do these discussions occur? 5. What gaps exist in the body of primary research literature relating to professional carers’ discussion of aspects of grief and loss with parents following diagnosis of their child with a LLNDD? Objective To explore the factors associated with professional carers’ discussion of aspects of grief and loss with parents caring for a child with LLNDD’s. Primary Investigator Elaine Brennan, B.A. (Hons) Social Policy, MSW, C.Q.S.W., MSc Loss and Bereavement Other Investigator(s) Prof. Suzanne Guerin, BA, PhD Participating Institution(s) School of Psychology, University College Dublin Contact Details for Public/Scientific Enquiries Postal Address: Elaine Brennan c/o Prof. Suzanne Guerin, School of Psychology, Newman Building, University College Dublin, Belfield, Dublin 4, Ireland. E-Mail Addresses: [email protected] [email protected] Telephone Number: 00353877759240 (Elaine Brennan) Countries involved Ireland Funding The primary researcher who is a PhD candidate registered with the School of Psychology, University College Dublin, was awarded the Mc Kenna Scholarship funded by LauraLynn Ireland’s Children’s Hospice. Search Strategy The PCC framework (Peters et al., 2020) developed by the Joanna Briggs Institute (JBI) for the conduct of scoping reviews was selected for this study in order to identify the main concepts in the review questions and objectives and to inform the search strategy. Using the PCC mnemonic the main concepts were identified as follows: • Population: Parents of children with life-limiting neurodevelopmental disabilities as defined above (Sutherland et al.,1994; Together for Short Lives, 2017) • Concept: The review is interested in the extent to which professional carers initiate discussion of aspects of grief and loss with parents, with a particular interest in the timing of these discussion. • Context: The review will focus on the period following diagnosis and throughout the child’s lifespan. Studies in all settings of paediatrics including hospitals, community-based services and hospices will be included. Databases The following electronic databases will be searched using the same string of search terms: PsycINFO, CINAHL and PubMed. The search described below will be run on all three identified databases on the same day and results uploaded first to Endnote and then to Covidence software for removal of duplicates and screening. Search terms Search terms were identified based on existing reviews and following initial searching of three relevant databases to examine the terminology, synonyms and keywords used to describe the relevant concepts. The search terms developed for the PsycINFO database are provided below, with adaptations based on the specifics of the other databases. PsycINFO Database Search String: “life limiting neurodevelopmental disabil*” OR “neurodevelopmental disorders” OR "life limiting condition" OR "life limiting illness" OR “complex care need" OR "progressive disabil*" OR "life-threatening condition” OR "chronic illness" OR “chronic disease” OR “disease progress*” OR “end of life” OR (DE “Disease Progression”) OR (DE “Critical Illness”) OR (DE “Chronically Ill Children”) AND child* OR kid* OR infant* OR toddler* OR pre-school* OR youth* OR “young person” OR adolescen* OR p#ediatric OR teen* OR student* OR pupil* OR ( DE "Preschool Students") OR (DE "Pediatrics”) AND parent* OR mother* OR maternal OR father* OR paternal OR famil* OR caregive* OR (DE "Parents") OR (DE "Mothers") OR (DE "Fathers") OR (DE "Family") OR (DE "Caregivers") AND Death OR Grief OR Loss* OR "palliati* care" OR dying OR coping OR bereave* OR griev* OR mourn* OR terminal* OR "child mortality" OR adaptat* OR “end of life care” OR (DE "Death and Dying") OR (DE "Grief") OR (DE "Coping Behavior") OR (DE "Palliative Care") OR (DE "Adaptive Behavior") OR (DE" Bereavement") OR (DE "Child Death") Information Sources All types of empirical studies published in peer-reviewed journals will be included. This will include quantitative research, qualitative research, and mixed methods studies. Study designs that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, qualitative description and action research will be included. The search will be exhaustive of all years of records and countries of publication. Searching will be confined to peer-reviewed articles published in the English language. Inclusion Criteria 1. Articles reporting studies relating to children with life-limiting neurodevelopmental disabilities in line with the definition proposed by Together for Short Lives (2017). 2. Articles reporting discussions of grief and loss by professional carers’ with parents of children with LLNDD at the time of diagnosis and throughout the child’s lifespan. 3. The study gathers the views of professional carers or gathers the views of parents reporting their engagement with professionals on this issue. 4. Studies that include parents of children with other life-limiting conditions if the findings relating specifically to children with life-limiting neurodevelopmental disability can be extracted and synthesised separately or if the majority of the sample meet the first criterion. 5. Articles reporting primary, empirical research. 6. Research articles published in peer-reviewed journals in the English language. 7. Children are defined as persons from birth to 18 years. Exclusion Criteria 1. Articles reporting secondary research (e.g. systematic reviews, meta analyses), conference abstracts, theoretical/conceptual papers, book chapters (unless peer-reviewed and presenting primary empirical research), opinion pieces, protocols. 2. Articles reporting discussions by professional carers’ with parents of children with life-limiting diagnoses that do not explicitly report on discussions with parents of children with life-limiting neurodevelopmental disabilities. 3. Studies reporting on professional carers’ discussions with parents of children over the age of eighteen years. Data Screening Screening of all results will be undertaken in two phases. First, a Title and Abstract screening by two reviewers to identify articles that may meet the eligibility criteria. Relevant articles will be screened at Full Text review using the same eligibility criteria. A pilot screening will be undertaken by two members of the research team on the first 50 title and abstract records generated by a search of the all three databases in order to test and refine the inclusion and exclusion criteria. Understanding of inclusion and exclusion criteria will be discussed and clarified among the three members of the research team to ensure consistent application, recognising that some criteria can only be established at full text level. All records with a Yes/Yes and Yes/Maybe determination will be brought forward for full text screening. No/No and No/Maybe determinations will lead to exclusion from full text screening. Any Yes/No conflicts will be resolved based on the review determination of the third member of the research team. A pilot screening of a sample of full texts will be undertaken by two members of the research team on the first 10 full text records generated by the Title & Abstract screening in order to test and refine the inclusion and exclusion criteria and to identify reasons for exclusion to be added to Covidence. All articles identified to progress to Full Text screening will be reviewed by two reviewers, using the original inclusion and exclusion criteria and with disagreements resolved as per the Title and Abstract Screening. Contact will be made with study authors as required, in order to clarify aspects of studies being considered for inclusion. Data Extraction Data extraction will be completed on each article identified for inclusion in the data extraction stage following full text screening to map the characteristics of included studies. The template developed will be piloted by two reviewers on a sample of 10% of papers to ensure consistent extraction of data and maximising relevance to research question. The template will be modified and revised as necessary during the process of extracting data from each included evidence source. Modifications will be detailed in the scoping review. Remaining data extraction will be completed by the primary reviewer, with double extraction on a sample of articles to allow for calculation of rates of agreement. Primary Outcomes A descriptive summary of data extracted relating to professional carers’ discussions of aspects of loss and grief with parents caring for a child with life-limiting neurodevelopmental disability, including details about the population, concepts, study methods and key findings. Secondary Outcome An identification of the gaps in primary research relating to the discussion by professional carers’ of aspects of grief and loss with parents caring for children with life-limiting neurodevelopmental disability. Assessment of Methodological Quality The Mixed Methods Appraisal tool (Hong et al, 2019) will be used to appraise the quality of studies at the data extraction stage to inform synthesis and interpretation of results. A risk of bias assessment is not required in scoping reviews as the purpose is not to interpret results for clinical practice. Data Synthesis The information gathered in the extraction and analysis stage will be included in a descriptive summary of the main results and will describe how the results relate to the review objective and question. Thematic synthesis (Braun and Clarke, 2022) will guide the process of summarising data. Extracted data will be mapped into particular categories based on the PCC framework and an explanation provided for each category. Results and limitations of the review will be discussed in the context of current literature, gaps in the literature and implications for future research. Reporting of Results The results will be reported in full in the final scoping review and presented using the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) (Tricco et al., 2018). Dissemination Plan Conference presentations (to professionals and parents). Summary of findings disseminated via social media and sent to relevant bodies (LauraLynn, Disability Service providers) with a request that they consider dissemination. Updated record including summary of findings will be submitted to Research Registry on completion of the study. Journal article publication. Stage of review at time of submission Searches of identified databases have been completed. References Aoun, S.M., Breen, L.J., O'Connor, M., Rumbold, B. and Nordstrom, C. (2012). A public health approach to bereavement support services in palliative care. Australian and New Zealand journal of public health, 36 (1), pp. 14-16. Braun, V. & Clarke, V. (2022). Thematic analysis: a practical guide. Los Angeles:Sage. Eiser, C. (1993). Growing Up With A Chronic Disease: The Impact on Children and Their Families. London: Jessica Kingsley Publishers. Hong, Q.N., Pluye, P., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.P., Griffiths, F., Nicolau, B. and O’Cathain, A. (2019). Improving the content validity of the mixed methods appraisal tool: a modified e-Delphi study. Journal of clinical epidemiology, 111, pp.49-59. Kochen, E.M., Jenken, F., Boelen, P.A., Deben, L.M.A., Fahner, J.C., van den Hoogen, A., Teunissen, S.C.C.M., Geleijns, K., Kars, M.C., Grief, T.A. and Boelen, L. (2020).When a child dies: a systematic review of well-defined parent-focused bereavement interventions and their alignment with grief- and loss theories. BMC palliative care, 19(1), pp. 28-28. Machin, L. (2014). Working with loss and grief: a theoretical and practical approach, Second Edition. Los Angeles: Sage. Morris, C., Janssens, A., Tomlinson, R., Williams, J. & Logan, S. (2013). Towards a definition of neurodisability: a Delphi survey. Developmental medicine and child neurology, 55( 12), pp.1103-1108. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. Available from https://synthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-20-12 Sutherland, R. Hear, J. Baum, D. Elston, S. (1994). Definitions in paediatric palliative care. Health Trends 25,pp.148-150. Together for Short Lives (2017). Children's palliative care definitions. Retrieved from http://www.togetherforshortlives.org.uk/professionals/childrens_palliative_care_essentials/definitions. Tricco AC, Lillie E, Zarin W, et al . (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine https://doi.org/10.7326/M18-0850

The aim of this review is to examine existing research on the topic of professional carers’ discussion of grief and loss with parents caring for children with life-limiting neurodevelopmental disabilities (LLNDD’s). Of particular interest is the timing of these discussions, and whether these occur early in the child’s life or towards the end of life. Summary Parents experience a range of emotional reactions when their child is diagnosed with a life-limiting condition, including grief and loss responses (Machin, 2014; Guerin and Sheehan, 2017). Children with LLNDD’s may have long periods of relative stability interspersed with episodes of acute, potentially life-threatening illness and complications (Eiser,1993). Parents live with the constant awareness of their child’s shortened lifespan, though little is known about professional support for dealing with such challenging emotions. A preliminary search of relevant articles identified that studies of professional carers’ discussion of grief and loss primarily focus on the end-of-life phase in tertiary settings. While the benefits of initiating these discussions during the earlier stages of the child’s trajectory have been noted (Carr, 2021; Kochen et al., 2019), evidence for this is unclear. Findings from bereavement literature suggest that lack of preparedness for death is associated with increased bereavement risk (Aoun et al., 2012). Neurodevelopmental disabilities comprise a diverse group of diseases that all have dysfunction of the nervous system in common. They may vary over time and include a broad range of severity and complexity (Morris et al., 2013). The term “life-limiting neurodevelopmental disability” refers to a condition of neurodevelopmental origin for which there is currently no cure, and which is likely to lead to the child dying prematurely (Sutherland et al., 1994). For the purposes of the current review, the definition proposed by Together for Short Lives (2017) will be used. Life-limiting conditions are defined as “those for which there is no reasonable hope of cure and from which children or young people will die. Some of these conditions cause progressive deterioration rendering the child increasingly dependent on parents and carers”. Key Review Questions The scoping review aims to address four research questions: 1. What is known from research of professional carers’ discussion of aspects of grief and loss with parents caring for a child with a LLNDD? 2. How common are these discussions? 3. To what end do these discussions take place? 4. At what point(s) in the child’s lifespan do these discussions occur? 5. What gaps exist in the body of primary research literature relating to professional carers’ discussion of aspects of grief and loss with parents following diagnosis of their child with a LLNDD? Objective To explore the factors associated with professional carers’ discussion of aspects of grief and loss with parents caring for a child with LLNDD’s. Primary Investigator Elaine Brennan, B.A. (Hons) Social Policy, MSW, C.Q.S.W., MSc Loss and Bereavement Other Investigator(s) Prof. Suzanne Guerin, BA, PhD Participating Institution(s) School of Psychology, University College Dublin Contact Details for Public/Scientific Enquiries Postal Address: Elaine Brennan c/o Prof. Suzanne Guerin, School of Psychology, Newman Building, University College Dublin, Belfield, Dublin 4, Ireland. E-Mail Addresses: [email protected] [email protected] Telephone Number: 00353877759240 (Elaine Brennan) Countries involved Ireland Funding The primary researcher who is a PhD candidate registered with the School of Psychology, University College Dublin, was awarded the Mc Kenna Scholarship funded by LauraLynn Ireland’s Children’s Hospice. Search Strategy The PCC framework (Peters et al., 2020) developed by the Joanna Briggs Institute (JBI) for the conduct of scoping reviews was selected for this study in order to identify the main concepts in the review questions and objectives and to inform the search strategy. Using the PCC mnemonic the main concepts were identified as follows: • Population: Parents of children with life-limiting neurodevelopmental disabilities as defined above (Sutherland et al.,1994; Together for Short Lives, 2017) • Concept: The review is interested in the extent to which professional carers initiate discussion of aspects of grief and loss with parents, with a particular interest in the timing of these discussion. • Context: The review will focus on the period following diagnosis and throughout the child’s lifespan. Studies in all settings of paediatrics including hospitals, community-based services and hospices will be included. Databases The following electronic databases will be searched using the same string of search terms: PsycINFO, CINAHL and PubMed. The search described below will be run on all three identified databases on the same day and results uploaded first to Endnote and then to Covidence software for removal of duplicates and screening. Search terms Search terms were identified based on existing reviews and following initial searching of three relevant databases to examine the terminology, synonyms and keywords used to describe the relevant concepts. The search terms developed for the PsycINFO database are provided below, with adaptations based on the specifics of the other databases. PsycINFO Database Search String: “life limiting neurodevelopmental disabil*” OR “neurodevelopmental disorders” OR "life limiting condition" OR "life limiting illness" OR “complex care need" OR "progressive disabil*" OR "life-threatening condition” OR "chronic illness" OR “chronic disease” OR “disease progress*” OR “end of life” OR (DE “Disease Progression”) OR (DE “Critical Illness”) OR (DE “Chronically Ill Children”) AND child* OR kid* OR infant* OR toddler* OR pre-school* OR youth* OR “young person” OR adolescen* OR p#ediatric OR teen* OR student* OR pupil* OR ( DE "Preschool Students") OR (DE "Pediatrics”) AND parent* OR mother* OR maternal OR father* OR paternal OR famil* OR caregive* OR (DE "Parents") OR (DE "Mothers") OR (DE "Fathers") OR (DE "Family") OR (DE "Caregivers") AND Death OR Grief OR Loss* OR "palliati* care" OR dying OR coping OR bereave* OR griev* OR mourn* OR terminal* OR "child mortality" OR adaptat* OR “end of life care” OR (DE "Death and Dying") OR (DE "Grief") OR (DE "Coping Behavior") OR (DE "Palliative Care") OR (DE "Adaptive Behavior") OR (DE" Bereavement") OR (DE "Child Death") Information Sources All types of empirical studies published in peer-reviewed journals will be included. This will include quantitative research, qualitative research, and mixed methods studies. Study designs that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, qualitative description and action research will be included. The search will be exhaustive of all years of records and countries of publication. Searching will be confined to peer-reviewed articles published in the English language. Inclusion Criteria 1. Articles reporting studies relating to children with life-limiting neurodevelopmental disabilities in line with the definition proposed by Together for Short Lives (2017). 2. Articles reporting discussions of grief and loss by professional carers’ with parents of children with LLNDD at the time of diagnosis and throughout the child’s lifespan. 3. The study gathers the views of professional carers or gathers the views of parents reporting their engagement with professionals on this issue. 4. Studies that include parents of children with other life-limiting conditions if the findings relating specifically to children with life-limiting neurodevelopmental disability can be extracted and synthesised separately or if the majority of the sample meet the first criterion. 5. Articles reporting primary, empirical research. 6. Research articles published in peer-reviewed journals in the English language. 7. Children are defined as persons from birth to 18 years. Exclusion Criteria 1. Articles reporting secondary research (e.g. systematic reviews, meta analyses), conference abstracts, theoretical/conceptual papers, book chapters (unless peer-reviewed and presenting primary empirical research), opinion pieces, protocols. 2. Articles reporting discussions by professional carers’ with parents of children with life-limiting diagnoses that do not explicitly report on discussions with parents of children with life-limiting neurodevelopmental disabilities. 3. Studies reporting on professional carers’ discussions with parents of children over the age of eighteen years. Data Screening Screening of all results will be undertaken in two phases. First, a Title and Abstract screening by two reviewers to identify articles that may meet the eligibility criteria. Relevant articles will be screened at Full Text review using the same eligibility criteria. A pilot screening will be undertaken by two members of the research team on the first 50 title and abstract records generated by a search of the all three databases in order to test and refine the inclusion and exclusion criteria. Understanding of inclusion and exclusion criteria will be discussed and clarified among the three members of the research team to ensure consistent application, recognising that some criteria can only be established at full text level. All records with a Yes/Yes and Yes/Maybe determination will be brought forward for full text screening. No/No and No/Maybe determinations will lead to exclusion from full text screening. Any Yes/No conflicts will be resolved based on the review determination of the third member of the research team. A pilot screening of a sample of full texts will be undertaken by two members of the research team on the first 10 full text records generated by the Title & Abstract screening in order to test and refine the inclusion and exclusion criteria and to identify reasons for exclusion to be added to Covidence. All articles identified to progress to Full Text screening will be reviewed by two reviewers, using the original inclusion and exclusion criteria and with disagreements resolved as per the Title and Abstract Screening. Contact will be made with study authors as required, in order to clarify aspects of studies being considered for inclusion. Data Extraction Data extraction will be completed on each article identified for inclusion in the data extraction stage following full text screening to map the characteristics of included studies. The template developed will be piloted by two reviewers on a sample of 10% of papers to ensure consistent extraction of data and maximising relevance to research question. The template will be modified and revised as necessary during the process of extracting data from each included evidence source. Modifications will be detailed in the scoping review. Remaining data extraction will be completed by the primary reviewer, with double extraction on a sample of articles to allow for calculation of rates of agreement. Primary Outcomes A descriptive summary of data extracted relating to professional carers’ discussions of aspects of loss and grief with parents caring for a child with life-limiting neurodevelopmental disability, including details about the population, concepts, study methods and key findings. Secondary Outcome An identification of the gaps in primary research relating to the discussion by professional carers’ of aspects of grief and loss with parents caring for children with life-limiting neurodevelopmental disability. Assessment of Methodological Quality The Mixed Methods Appraisal tool (Hong et al, 2019) will be used to appraise the quality of studies at the data extraction stage to inform synthesis and interpretation of results. A risk of bias assessment is not required in scoping reviews as the purpose is not to interpret results for clinical practice. Data Synthesis The information gathered in the extraction and analysis stage will be included in a descriptive summary of the main results and will describe how the results relate to the review objective and question. Thematic synthesis (Braun and Clarke, 2022) will guide the process of summarising data. Extracted data will be mapped into particular categories based on the PCC framework and an explanation provided for each category. Results and limitations of the review will be discussed in the context of current literature, gaps in the literature and implications for future research. Reporting of Results The results will be reported in full in the final scoping review and presented using the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) (Tricco et al., 2018). Dissemination Plan Conference presentations (to professionals and parents). Summary of findings disseminated via social media and sent to relevant bodies (LauraLynn, Disability Service providers) with a request that they consider dissemination. Updated record including summary of findings will be submitted to Research Registry on completion of the study. Journal article publication. Stage of review at time of submission Searches of identified databases have been completed. References Aoun, S.M., Breen, L.J., O'Connor, M., Rumbold, B. and Nordstrom, C. (2012). A public health approach to bereavement support services in palliative care. Australian and New Zealand journal of public health, 36 (1), pp. 14-16. Braun, V. & Clarke, V. (2022). Thematic analysis: a practical guide. Los Angeles:Sage. Eiser, C. (1993). Growing Up With A Chronic Disease: The Impact on Children and Their Families. London: Jessica Kingsley Publishers. Hong, Q.N., Pluye, P., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.P., Griffiths, F., Nicolau, B. and O’Cathain, A. (2019). Improving the content validity of the mixed methods appraisal tool: a modified e-Delphi study. Journal of clinical epidemiology, 111, pp.49-59. Kochen, E.M., Jenken, F., Boelen, P.A., Deben, L.M.A., Fahner, J.C., van den Hoogen, A., Teunissen, S.C.C.M., Geleijns, K., Kars, M.C., Grief, T.A. and Boelen, L. (2020).When a child dies: a systematic review of well-defined parent-focused bereavement interventions and their alignment with grief- and loss theories. BMC palliative care, 19(1), pp. 28-28. Machin, L. (2014). Working with loss and grief: a theoretical and practical approach, Second Edition. Los Angeles: Sage. Morris, C., Janssens, A., Tomlinson, R., Williams, J. & Logan, S. (2013). Towards a definition of neurodisability: a Delphi survey. Developmental medicine and child neurology, 55( 12), pp.1103-1108. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. Available from https://synthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-20-12 Sutherland, R. Hear, J. Baum, D. Elston, S. (1994). Definitions in paediatric palliative care. Health Trends 25,pp.148-150. Together for Short Lives (2017). Children's palliative care definitions. Retrieved from http://www.togetherforshortlives.org.uk/professionals/childrens_palliative_care_essentials/definitions. Tricco AC, Lillie E, Zarin W, et al . (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine https://doi.org/10.7326/M18-0850

The aim of this review is to examine existing research on the topic of professional carers’ discussion of grief and loss with parents caring for children with life-limiting neurodevelopmental disabilities (LLNDD’s). Of particular interest is the timing of these discussions, and whether these occur early in the child’s life or towards the end of life. Summary Parents experience a range of emotional reactions when their child is diagnosed with a life-limiting condition, including grief and loss responses (Machin, 2014; Guerin and Sheehan, 2017). Children with LLNDD’s may have long periods of relative stability interspersed with episodes of acute, potentially life-threatening illness and complications (Eiser,1993). Parents live with the constant awareness of their child’s shortened lifespan, though little is known about professional support for dealing with such challenging emotions. A preliminary search of relevant articles identified that studies of professional carers’ discussion of grief and loss primarily focus on the end-of-life phase in tertiary settings. While the benefits of initiating these discussions during the earlier stages of the child’s trajectory have been noted (Carr, 2021; Kochen et al., 2019), evidence for this is unclear. Findings from bereavement literature suggest that lack of preparedness for death is associated with increased bereavement risk (Aoun et al., 2012). Neurodevelopmental disabilities comprise a diverse group of diseases that all have dysfunction of the nervous system in common. They may vary over time and include a broad range of severity and complexity (Morris et al., 2013). The term “life-limiting neurodevelopmental disability” refers to a condition of neurodevelopmental origin for which there is currently no cure, and which is likely to lead to the child dying prematurely (Sutherland et al., 1994). For the purposes of the current review, the definition proposed by Together for Short Lives (2017) will be used. Life-limiting conditions are defined as “those for which there is no reasonable hope of cure and from which children or young people will die. Some of these conditions cause progressive deterioration rendering the child increasingly dependent on parents and carers”. Key Review Questions The scoping review aims to address four research questions: 1. What is known from research of professional carers’ discussion of aspects of grief and loss with parents caring for a child with a LLNDD? 2. How common are these discussions? 3. To what end do these discussions take place? 4. At what point(s) in the child’s lifespan do these discussions occur? 5. What gaps exist in the body of primary research literature relating to professional carers’ discussion of aspects of grief and loss with parents following diagnosis of their child with a LLNDD? Objective To explore the factors associated with professional carers’ discussion of aspects of grief and loss with parents caring for a child with LLNDD’s. Primary Investigator Elaine Brennan, B.A. (Hons) Social Policy, MSW, C.Q.S.W., MSc Loss and Bereavement Other Investigator(s) Prof. Suzanne Guerin, BA, PhD Participating Institution(s) School of Psychology, University College Dublin Contact Details for Public/Scientific Enquiries Postal Address: Elaine Brennan c/o Prof. Suzanne Guerin, School of Psychology, Newman Building, University College Dublin, Belfield, Dublin 4, Ireland. E-Mail Addresses: [email protected] [email protected] Telephone Number: 00353877759240 (Elaine Brennan) Countries involved Ireland Funding The primary researcher who is a PhD candidate registered with the School of Psychology, University College Dublin, was awarded the Mc Kenna Scholarship funded by LauraLynn Ireland’s Children’s Hospice. Search Strategy The PCC framework (Peters et al., 2020) developed by the Joanna Briggs Institute (JBI) for the conduct of scoping reviews was selected for this study in order to identify the main concepts in the review questions and objectives and to inform the search strategy. Using the PCC mnemonic the main concepts were identified as follows: • Population: Parents of children with life-limiting neurodevelopmental disabilities as defined above (Sutherland et al.,1994; Together for Short Lives, 2017) • Concept: The review is interested in the extent to which professional carers initiate discussion of aspects of grief and loss with parents, with a particular interest in the timing of these discussion. • Context: The review will focus on the period following diagnosis and throughout the child’s lifespan. Studies in all settings of paediatrics including hospitals, community-based services and hospices will be included. Databases The following electronic databases will be searched using the same string of search terms: PsycINFO, CINAHL and PubMed. The search described below will be run on all three identified databases on the same day and results uploaded first to Endnote and then to Covidence software for removal of duplicates and screening. Search terms Search terms were identified based on existing reviews and following initial searching of three relevant databases to examine the terminology, synonyms and keywords used to describe the relevant concepts. The search terms developed for the PsycINFO database are provided below, with adaptations based on the specifics of the other databases. PsycINFO Database Search String: “life limiting neurodevelopmental disabil*” OR “neurodevelopmental disorders” OR "life limiting condition" OR "life limiting illness" OR “complex care need" OR "progressive disabil*" OR "life-threatening condition” OR "chronic illness" OR “chronic disease” OR “disease progress*” OR “end of life” OR (DE “Disease Progression”) OR (DE “Critical Illness”) OR (DE “Chronically Ill Children”) AND child* OR kid* OR infant* OR toddler* OR pre-school* OR youth* OR “young person” OR adolescen* OR p#ediatric OR teen* OR student* OR pupil* OR ( DE "Preschool Students") OR (DE "Pediatrics”) AND parent* OR mother* OR maternal OR father* OR paternal OR famil* OR caregive* OR (DE "Parents") OR (DE "Mothers") OR (DE "Fathers") OR (DE "Family") OR (DE "Caregivers") AND Death OR Grief OR Loss* OR "palliati* care" OR dying OR coping OR bereave* OR griev* OR mourn* OR terminal* OR "child mortality" OR adaptat* OR “end of life care” OR (DE "Death and Dying") OR (DE "Grief") OR (DE "Coping Behavior") OR (DE "Palliative Care") OR (DE "Adaptive Behavior") OR (DE" Bereavement") OR (DE "Child Death") Information Sources All types of empirical studies published in peer-reviewed journals will be included. This will include quantitative research, qualitative research, and mixed methods studies. Study designs that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, qualitative description and action research will be included. The search will be exhaustive of all years of records and countries of publication. Searching will be confined to peer-reviewed articles published in the English language. Inclusion Criteria 1. Articles reporting studies relating to children with life-limiting neurodevelopmental disabilities in line with the definition proposed by Together for Short Lives (2017). 2. Articles reporting discussions of grief and loss by professional carers’ with parents of children with LLNDD at the time of diagnosis and throughout the child’s lifespan. 3. The study gathers the views of professional carers or gathers the views of parents reporting their engagement with professionals on this issue. 4. Studies that include parents of children with other life-limiting conditions if the findings relating specifically to children with life-limiting neurodevelopmental disability can be extracted and synthesised separately or if the majority of the sample meet the first criterion. 5. Articles reporting primary, empirical research. 6. Research articles published in peer-reviewed journals in the English language. 7. Children are defined as persons from birth to 18 years. Exclusion Criteria 1. Articles reporting secondary research (e.g. systematic reviews, meta analyses), conference abstracts, theoretical/conceptual papers, book chapters (unless peer-reviewed and presenting primary empirical research), opinion pieces, protocols. 2. Articles reporting discussions by professional carers’ with parents of children with life-limiting diagnoses that do not explicitly report on discussions with parents of children with life-limiting neurodevelopmental disabilities. 3. Studies reporting on professional carers’ discussions with parents of children over the age of eighteen years. Data Screening Screening of all results will be undertaken in two phases. First, a Title and Abstract screening by two reviewers to identify articles that may meet the eligibility criteria. Relevant articles will be screened at Full Text review using the same eligibility criteria. A pilot screening will be undertaken by two members of the research team on the first 50 title and abstract records generated by a search of the all three databases in order to test and refine the inclusion and exclusion criteria. Understanding of inclusion and exclusion criteria will be discussed and clarified among the three members of the research team to ensure consistent application, recognising that some criteria can only be established at full text level. All records with a Yes/Yes and Yes/Maybe determination will be brought forward for full text screening. No/No and No/Maybe determinations will lead to exclusion from full text screening. Any Yes/No conflicts will be resolved based on the review determination of the third member of the research team. A pilot screening of a sample of full texts will be undertaken by two members of the research team on the first 10 full text records generated by the Title & Abstract screening in order to test and refine the inclusion and exclusion criteria and to identify reasons for exclusion to be added to Covidence. All articles identified to progress to Full Text screening will be reviewed by two reviewers, using the original inclusion and exclusion criteria and with disagreements resolved as per the Title and Abstract Screening. Contact will be made with study authors as required, in order to clarify aspects of studies being considered for inclusion. Data Extraction Data extraction will be completed on each article identified for inclusion in the data extraction stage following full text screening to map the characteristics of included studies. The template developed will be piloted by two reviewers on a sample of 10% of papers to ensure consistent extraction of data and maximising relevance to research question. The template will be modified and revised as necessary during the process of extracting data from each included evidence source. Modifications will be detailed in the scoping review. Remaining data extraction will be completed by the primary reviewer, with double extraction on a sample of articles to allow for calculation of rates of agreement. Primary Outcomes A descriptive summary of data extracted relating to professional carers’ discussions of aspects of loss and grief with parents caring for a child with life-limiting neurodevelopmental disability, including details about the population, concepts, study methods and key findings. Secondary Outcome An identification of the gaps in primary research relating to the discussion by professional carers’ of aspects of grief and loss with parents caring for children with life-limiting neurodevelopmental disability. Assessment of Methodological Quality The Mixed Methods Appraisal tool (Hong et al, 2019) will be used to appraise the quality of studies at the data extraction stage to inform synthesis and interpretation of results. A risk of bias assessment is not required in scoping reviews as the purpose is not to interpret results for clinical practice. Data Synthesis The information gathered in the extraction and analysis stage will be included in a descriptive summary of the main results and will describe how the results relate to the review objective and question. Thematic synthesis (Braun and Clarke, 2022) will guide the process of summarising data. Extracted data will be mapped into particular categories based on the PCC framework and an explanation provided for each category. Results and limitations of the review will be discussed in the context of current literature, gaps in the literature and implications for future research. Reporting of Results The results will be reported in full in the final scoping review and presented using the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) (Tricco et al., 2018). Dissemination Plan Conference presentations (to professionals and parents). Summary of findings disseminated via social media and sent to relevant bodies (LauraLynn, Disability Service providers) with a request that they consider dissemination. Updated record including summary of findings will be submitted to Research Registry on completion of the study. Journal article publication. Stage of review at time of submission Searches of identified databases have been completed. References Aoun, S.M., Breen, L.J., O'Connor, M., Rumbold, B. and Nordstrom, C. (2012). A public health approach to bereavement support services in palliative care. Australian and New Zealand journal of public health, 36 (1), pp. 14-16. Braun, V. & Clarke, V. (2022). Thematic analysis: a practical guide. Los Angeles:Sage. Eiser, C. (1993). Growing Up With A Chronic Disease: The Impact on Children and Their Families. London: Jessica Kingsley Publishers. Hong, Q.N., Pluye, P., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.P., Griffiths, F., Nicolau, B. and O’Cathain, A. (2019). Improving the content validity of the mixed methods appraisal tool: a modified e-Delphi study. Journal of clinical epidemiology, 111, pp.49-59. Kochen, E.M., Jenken, F., Boelen, P.A., Deben, L.M.A., Fahner, J.C., van den Hoogen, A., Teunissen, S.C.C.M., Geleijns, K., Kars, M.C., Grief, T.A. and Boelen, L. (2020).When a child dies: a systematic review of well-defined parent-focused bereavement interventions and their alignment with grief- and loss theories. BMC palliative care, 19(1), pp. 28-28. Machin, L. (2014). Working with loss and grief: a theoretical and practical approach, Second Edition. Los Angeles: Sage. Morris, C., Janssens, A., Tomlinson, R., Williams, J. & Logan, S. (2013). Towards a definition of neurodisability: a Delphi survey. Developmental medicine and child neurology, 55( 12), pp.1103-1108. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. Available from https://synthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-20-12 Sutherland, R. Hear, J. Baum, D. Elston, S. (1994). Definitions in paediatric palliative care. Health Trends 25,pp.148-150. Together for Short Lives (2017). Children's palliative care definitions. Retrieved from http://www.togetherforshortlives.org.uk/professionals/childrens_palliative_care_essentials/definitions. Tricco AC, Lillie E, Zarin W, et al . (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine https://doi.org/10.7326/M18-0850

Yehudit and Shmulik Waiss were both victims of the horrific October 7 attack on Kibbutz Be’eri. Nearly a year later, their five children—Hagar, Asaf, Omer, Daniel, and Ohad—had to endure the heartbreaking reburial of their parents at their beloved Kibbutz Be'eri. This devastating reburial reopened unimaginable wounds, and the painful process of moving graves only added to their grief. OneFamily has been by their side every step of the way, providing unwavering support to these double orphans as they navigate a life filled with the pain of losing both their mother and father. Join us to ensure that their children and every family affected by terrorism and war have the love, support, and assistance they need for a lifetime of healing.

Children and Grief (Seminar) Children grieve, yet they grieve differently to adults. Their grief is rarely supported and not usually recognised because it is often demonstrated as disruptive behaviour, depression, anger, fear, guilt, poor attention span and confusion. Consequently we often misunderstand or misinterpret their behaviour or misbehaviour. In this seminar we learn the differences between the way children and adults grieve, and develop some practical tools for supporting children though times of grief and loss. Programme: How separation or loss affects different ages of children; The five stages of the grief process as specifically applied to children; Helping a grieving child; Grieving the loss of a child; Questions and answer session. Quote: Getting through - not getting over... "Grief is not a fence that we climb over hoping the other side is greener; it is a winding tunnel that we enter, with all its associated darkness, gloom and uncertainty and our grief work is to journey forward until we see a glimmer of light at the other end; and then bravely move onward into the sunshine of a very different landscape" © Also available as an audio podcast from www.lrhartley.com

Judy Wechter and Kathleen Bohannon discuss grief issues of children and adolescents.

Educators contribute to children's anxiety and pain when they fail to provide children with information about loss and death and ways of coping with loss and death. Children who are denied factual information about experiences of loss and death develop fantasies and misconceptions regarding the experiences and suffer more anxiety and pain than they otherwise would. This paper provides educators with information about concepts that preschool children are capable of understanding during times of loss in order that educators might help young children develop coping skills to use during grieving. The paper describes: (1) different feelings of grief and loss preschool children may experience when they are unable to keep or have someone or something that is meaningful to them; (2) factors that affect preschoolers' understanding of the grief process, such as their limited concepts of death, time, and emotion; (3) behavioral changes of preschool children who are affected by a death in the family; (4) stages of grief experienced by preschoolers; and (5) signs and symptoms of reactions to loss. Helping a child work through the grieving process involves adults' open expression of thoughts and feelings, honesty, and provision of an atmosphere that is safe and friendly. A list of nine behaviors to avoid when helping a child work through the grieving process is provided. Contains 54 references. (SM)

Educators contribute to children's anxiety and pain when they fail to provide children with information about loss and death and ways of coping with loss and death. Children who are denied factual information about experiences of loss and death develop fantasies and misconceptions regarding the experiences and suffer more anxiety and pain than they otherwise would. This paper provides educators with information about concepts that preschool children are capable of understanding during times of loss in order that educators might help young children develop coping skills to use during grieving. The paper describes: (1) different feelings of grief and loss preschool children may experience when they are unable to keep or have someone or something that is meaningful to them; (2) factors that affect preschoolers' understanding of the grief process, such as their limited concepts of death, time, and emotion; (3) behavioral changes of preschool children who are affected by a death in the family; (4) stages of grief experienced by preschoolers; and (5) signs and symptoms of reactions to loss. Helping a child work through the grieving process involves adults' open expression of thoughts and feelings, honesty, and provision of an atmosphere that is safe and friendly. A list of nine behaviors to avoid when helping a child work through the grieving process is provided. Contains 54 references. (SM)

In psychotherapy, sudden gains depict large and stable reductions in symptoms between two consecutive treatment sessions (Tang & DeRubeis, 1999). A recent meta-analysis showed that on average about one third of patients experience sudden gains, and patients with sudden gains had better treatment outcomes at post-intervention and follow-up than patients without sudden gains (Shalom & Aderka, 2020). The effects of sudden gains in treatments for children and adolescents are comparable to those in treatments for adults but have so far been investigated in fewer studies (Shalom & Aderka, 2020). No study to date investigated sudden gains in the treatment of prolonged grief disorder (PGD), a new diagnosis in ICD-11 and DSM-5-TR. It is therefore the aim of the study to examine if 1) sudden gains occur during two different treatment programs for children and adolescents with PGD symptoms, 2) whether sudden gains are related to treatment outcome, and 3) if the occurrence of sudden gains is related to the content of the session prior to the gain.

In psychotherapy, sudden gains depict large and stable reductions in symptoms between two consecutive treatment sessions (Tang & DeRubeis, 1999). A recent meta-analysis showed that on average about one third of patients experience sudden gains, and patients with sudden gains had better treatment outcomes at post-intervention and follow-up than patients without sudden gains (Shalom & Aderka, 2020). The effects of sudden gains in treatments for children and adolescents are comparable to those in treatments for adults but have so far been investigated in fewer studies (Shalom & Aderka, 2020). No study to date investigated sudden gains in the treatment of prolonged grief disorder (PGD), a new diagnosis in ICD-11 and DSM-5-TR. It is therefore the aim of the study to examine if 1) sudden gains occur during two different treatment programs for children and adolescents with PGD symptoms, 2) whether sudden gains are related to treatment outcome, and 3) if the occurrence of sudden gains is related to the content of the session prior to the gain.

In psychotherapy, sudden gains depict large and stable reductions in symptoms between two consecutive treatment sessions (Tang & DeRubeis, 1999). A recent meta-analysis showed that on average about one third of patients experience sudden gains, and patients with sudden gains had better treatment outcomes at post-intervention and follow-up than patients without sudden gains (Shalom & Aderka, 2020). The effects of sudden gains in treatments for children and adolescents are comparable to those in treatments for adults but have so far been investigated in fewer studies (Shalom & Aderka, 2020). No study to date investigated sudden gains in the treatment of prolonged grief disorder (PGD), a new diagnosis in ICD-11 and DSM-5-TR. It is therefore the aim of the study to examine if 1) sudden gains occur during two different treatment programs for children and adolescents with PGD symptoms, 2) whether sudden gains are related to treatment outcome, and 3) if the occurrence of sudden gains is related to the content of the session prior to the gain.

In psychotherapy, sudden gains depict large and stable reductions in symptoms between two consecutive treatment sessions (Tang & DeRubeis, 1999). A recent meta-analysis showed that on average about one third of patients experience sudden gains, and patients with sudden gains had better treatment outcomes at post-intervention and follow-up than patients without sudden gains (Shalom & Aderka, 2020). The effects of sudden gains in treatments for children and adolescents are comparable to those in treatments for adults but have so far been investigated in fewer studies (Shalom & Aderka, 2020). No study to date investigated sudden gains in the treatment of prolonged grief disorder (PGD), a new diagnosis in ICD-11 and DSM-5-TR. It is therefore the aim of the study to examine if 1) sudden gains occur during two different treatment programs for children and adolescents with PGD symptoms, 2) whether sudden gains are related to treatment outcome, and 3) if the occurrence of sudden gains is related to the content of the session prior to the gain.

1 v. (unpaged) : 25 cm

1 v. (unpaged) : 25 cm

1 v. (unpaged) : 25 cm

Children and Grief . A live recorded seminar by Lionel Hartley. How separation or loss affects different ages of children; The five stages of the grief process as specifically applied to children; Helping a grieving child.  [Dur: 25min] Transcript available from archive.org/details/childgrief

Children and Grief . A live recorded seminar by Lionel Hartley. How separation or loss affects different ages of children; The five stages of the grief process as specifically applied to children; Helping a grieving child.  [Dur: 25min] Transcript available from archive.org/details/childgrief

Children and Grief . A live recorded seminar by Lionel Hartley. How separation or loss affects different ages of children; The five stages of the grief process as specifically applied to children; Helping a grieving child.  [Dur: 25min] Transcript available from archive.org/details/childgrief

Children and Grief . A live recorded seminar by Lionel Hartley. How separation or loss affects different ages of children; The five stages of the grief process as specifically applied to children; Helping a grieving child.  [Dur: 25min] Transcript available from archive.org/details/childgrief

Children and Grief . A live recorded seminar by Lionel Hartley. How separation or loss affects different ages of children; The five stages of the grief process as specifically applied to children; Helping a grieving child.  [Dur: 25min] Transcript available from archive.org/details/childgrief

This presentation explores the complexity of the "conspiracy of protection" in working with grieving children and offers a better understanding of ways to manage differences and conflicts while maintaining a patient - and family - centered focus. Presented by Kate Eastman.

After the death of a loved one, grief is normal. However, some people experience intense and persistent grief that causes problems and interferes with daily life. Reflecting this, Prolonged Grief Disorder has been added to the latest edition of the Diagnostic Statistical Manual (DSM-5-TR). Prolonged grief is characterized by persistent feelings of intense emotional pain, preoccupation with the deceased, and associated functional impairment (APA, 2022). Prolonged Grief Disorder affects around 10% of children and young people (CYP) following a bereavement (Melhem et al., 2013). There is currently no validated measure of DSM-5-TR Prolonged Grief Disorder for use with CYP. Therefore, the first aim of this project is to validate a newly adapted measure which is consistent with DSM-5-TR criteria - the Prolonged Grief Assessment-Revised (PG-13-R-Child). The second aim of the project is to investigate two potential factors in the development and maintenance of prolonged grief in CYP based on the literature in adults: 1) social disconnection; which relates to negatively interpreting other people’s reactions to expressions of grief, a sense that an individual’s social self has been altered by the bereavement, and feeling safety in solitude, and 2) parent/carer’s prolonged grief; how much parent/carer’s symptoms of prolonged grief influences their child’s prolonged grief. The study will involve asking CYP who have been bereaved and their parent/carer to fill in online questionnaires about prolonged grief and social disconnection at two timepoints (2 months apart). They will also complete a smaller set of measures 1-week after the first timepoint for measure validation.

Noting that the death of a loved one brings grief to children as well as adults, this Digest draws on research to examine how children respond to death and the role of parents and teachers in helping children cope with loss. The Digest delineates children's "tasks" during mourning that are essential to their adjustment to loss, such as accepting the reality of the loss, and adjusting to the environment in which the deceased is missing. Next, the Digest explores how children understand the concept of death, and how they are likely to react to the death of a loved one. Ways that parents can help children cope are then explored, such as explaining death in simple terms while avoiding euphemisms and trying to suppress expressions of grief. These are followed by ways teachers can help, such as being sensitive to how family or holiday activities in the classroom may affect a grieving child. Finally, signs that a grieving child may need extra help are delineated. The Digest concludes with a list of eight children's book titles on death and grief. (Contains 18 references.) (HTH)

Noting that the death of a loved one brings grief to children as well as adults, this Digest draws on research to examine how children respond to death and the role of parents and teachers in helping children cope with loss. The Digest delineates children's "tasks" during mourning that are essential to their adjustment to loss, such as accepting the reality of the loss, and adjusting to the environment in which the deceased is missing. Next, the Digest explores how children understand the concept of death, and how they are likely to react to the death of a loved one. Ways that parents can help children cope are then explored, such as explaining death in simple terms while avoiding euphemisms and trying to suppress expressions of grief. These are followed by ways teachers can help, such as being sensitive to how family or holiday activities in the classroom may affect a grieving child. Finally, signs that a grieving child may need extra help are delineated. The Digest concludes with a list of eight children's book titles on death and grief. (Contains 18 references.) (HTH)

Noting that the death of a loved one brings grief to children as well as adults, this Digest draws on research to examine how children respond to death and the role of parents and teachers in helping children cope with loss. The Digest delineates children's "tasks" during mourning that are essential to their adjustment to loss, such as accepting the reality of the loss, and adjusting to the environment in which the deceased is missing. Next, the Digest explores how children understand the concept of death, and how they are likely to react to the death of a loved one. Ways that parents can help children cope are then explored, such as explaining death in simple terms while avoiding euphemisms and trying to suppress expressions of grief. These are followed by ways teachers can help, such as being sensitive to how family or holiday activities in the classroom may affect a grieving child. Finally, signs that a grieving child may need extra help are delineated. The Digest concludes with a list of eight children's book titles on death and grief. (Contains 18 references.) (HTH)

Noting that the death of a loved one brings grief to children as well as adults, this Digest draws on research to examine how children respond to death and the role of parents and teachers in helping children cope with loss. The Digest delineates children's "tasks" during mourning that are essential to their adjustment to loss, such as accepting the reality of the loss, and adjusting to the environment in which the deceased is missing. Next, the Digest explores how children understand the concept of death, and how they are likely to react to the death of a loved one. Ways that parents can help children cope are then explored, such as explaining death in simple terms while avoiding euphemisms and trying to suppress expressions of grief. These are followed by ways teachers can help, such as being sensitive to how family or holiday activities in the classroom may affect a grieving child. Finally, signs that a grieving child may need extra help are delineated. The Digest concludes with a list of eight children's book titles on death and grief. (Contains 18 references.) (HTH)

48 pages : 23 x 29 cm

48 pages : 23 x 29 cm

48 pages : 23 x 29 cm

48 pages : 23 x 29 cm

48 pages : 23 x 29 cm

48 pages : 23 x 29 cm

48 pages : 23 x 29 cm