Grief and loss in children with intellectual disabilitiesPamela L. Harding,Psychologist (B Psych; P Grad Dip Psych)Children grieve the loss of someone special in many different ways. For children with developmental delay, concepts such as death can be difficult to understand and the implications of that loss (permanence) can vary accordingly. It is important for parents and carers to take the time to explain loss in ways that are developmentally appropriate, taking into account the child's emotional maturity as well as the child's language and intellectual development.Reactions to grief vary in every child however typically these can be physical, psychological, behavioural, and spiritual in nature. In young children as well as in children who have developmental delay, these reactions are often difficult to identify as the ability to express complex emotions is still largely under developed.It is therefore important to pay close attention to children's behaviours following a loss, being aware that reactions can vary in intensity, frequency and duration depending on the type of support the child receives.Typical grief reactions observed can include: Behavioural Regression and temporary loss of skills previously mastered such as toileting, or getting dressed independently.Becoming more clingyLacking a reaction due to difficulties understanding the permanent nature of lossWithdrawing from activities or othersLoss of interest in foodDifficulty sleeping or not wanting to sleep aloneDisruptive behaviours such as tantrumsBecoming more sensitive to others' emotions and repeating those emotional behaviours seen inother people who are grieving around them.EmotionalAppearing sad or crying often.Separation anxietyNeeding constant reassurance that things are ok.Trying to make sense of what has happened by showing curiosity and interest in details / facts (lots of questions about death)Confusion about what has happened: asking repetitively after the person who has passed away, or wanting to see the person.Fear (of the dark, of being left on their own, of noises)SomaticPhysical pains stomach aches or other complaintsWhat can help?Strategies that can be helpful in supporting children during times of loss:1. Ensure that basic needs are met (food, drink, sleep, affection)2. Routine: keeping things as normal as possible is important in that it provides the child with asense of safety and predictability which allows him/her to regain some control over theirenvironment.3. Provide reassurance: regardless of whether or not the child's reaction is as you would expect,provide reassurance that their feelings are normal and that the sadness will eventually decrease.4. Help understanding: explain what has happened as honestly as possible, using simple factuallanguage. "Poppy has died and won't be coming back"5. Explain death: be concrete, use age appropriate visual resources such as books, social storiesand play to help understanding.6. Allow opportunities for the child to express their grief: this can include reading and tellingstories, playing, drawing, making a memory box.7. Be consistent in your answers: children may want to ask questions over and over again. It isimportant for you to provide answers that are consistent, simple and factual as this allows thechild to make sense of what has happened.8. Make use of rituals and symbols at home: prepare a farewell ceremony. Have photographs ofthe person and take turns talking to him/her to say farewell.Read More
