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How to talk to children about tough topics

Sunrise Children's Hospital September 11, 2016

Having conversations with children about complex emotional subjects can be difficult, but illness, death and violence can affect children directly and indirectly, so it’s important to address hard topics, even when they are upsetting. Doing this helps children understand and rationalize events, and it encourages positive coping mechanisms.

The child-life specialists at Sunrise Children’s Hospital are experts at helping children through distressing times, and offer these tips when having important conversations with children.

Three important things to remember

  • Be honest: Be as truthful as possible. Parents may want to downplay subjects that are difficult, but children pick up on a lot more than you realize. Child-life specialists urge parents to remember that children are both smart and resilient, and need to be treated as such.
  • Validate the child’s feelings and responses: Crying is normal, fear is normal and feeling overwhelmed is normal. Parents should validate their children’s responses and let them know the emotions they’re experiencing are OK.
  • Age, development and temperament should be considered: Children are able to comprehend things differently at different ages, and parents should be aware of that when shaping tough conversations. Many school-aged children cannot understand abstract ideas, so keep these conversations as honest and concrete as possible. Remember, every child is different, so sensitive or empathetic children might process things differently. Parents should respect that.

Talking about death

Child-life specialists note that if a death affects a child’s life, it needs to be discussed when it happens or shortly thereafter. If the death goes unaddressed, the impact could manifest later through negative behaviors such as acting out, aggression or shutting down emotionally. The child’s ability to comprehend death can vary based on age and development.

Birth to age 3

Children view death as a loss, separation or abandonment. Infants and toddlers can sense sadness or anxiety around them. They’re affected by the response of parents, caregivers and other significant adults in their lives. Depending on that response and the overall circumstance, the child may exhibit changes in sleeping, eating and mood.

How to help: Infants and toddlers rely on nonverbal communication and consistent nurturing. Surrounding the child with love and care while maintaining their regular routine is helpful.

Ages 3 to 6

Until age 6, children may not be able to understand death’s permanence. They may believe in “magical thinking,” the idea that something they did or said may have caused the death. Abstract concepts like heaven or the afterlife may be difficult for them to comprehend. Some children might revert to earlier developmental stages or seem unaffected by a death. Some may escape through play and fantasy.

Child-life specialists warn that children of these ages may interpret words too literally. For example, if they’ve been told their uncle died of a stomach ache, they might worry they’ll die of a stomach ache, too. Parents should use concrete terms to describe death. For example, “dead people no longer breathe or grow.” Avoid using terms such as “sleeping,” “resting,” “passed away,” or “taking a trip.”

How to help: Parents should repeat simple and honest explanations when asked for information and can use books about death and loss to aid understanding. Giving children an opportunity to express their feelings through play, drawing, etc., is also helpful.

Ages 6 to 9

Children start to view death as final. They may have an increased curiosity about illness, death and the body, and also may worry about how a dead person eats, sleeps, etc. They may have feelings of guilt and self-blame for a death, may experience separation anxiety, and may have trouble expressing their feelings verbally.

How to help: Parents should provide their child alternate ways of expression (art, journaling, play, etc.) and give them opportunities to share positive memories. It’s also important to identify their fears or misconceptions about what happened and continue to reassure them that the death wasn’t their fault.

Talking about violence

It’s difficult to shield children from scary things going on in the world. When talking to your kids about these subjects, start by finding out what they already know and dispelling any misconceptions they may have. Give them information they need about what happened without scaring them with too many details.

For example, a proper response to a tragedy such as 9/11 is to reassure them with statements like, “Mommy and Daddy are here to make you feel safe,” “Lots of brave firefighters and police officers helped out that day,” and, “Lots of people are working hard to make sure it doesn’t happen again.”

It’s OK to tell them that what happened makes you sad and scared, too. Child-life specialists suggest limiting exposure to graphic images and video.

Answering difficult questions

Children may hear things from the news, from other kids at school or even from adult conversations. When children have questions about these things, don’t shy away from answering even when it feels uncomfortable.

If a child asks a difficult question, answer honestly and calmly, and let him or her know you’re willing to discuss. Encourage more questions and understand that if a child is asking, he or she likely has some idea of what’s going on.

Also remember that you don’t need to know all the answers. It’s perfectly acceptable to say, “I don’t know.”

Pick up on your child’s cues

Be sure to listen to children and pick up on cues that they’re becoming overwhelmed. If, in the middle of the conversation, the child says something like, “I want to go play,” or “I want a snack,” this is their way of telling you they’re overwhelmed and need a break. Listen and respect these messages.

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