不同视角下的临终关怀学 (2).pdf

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1、Young childrens understanding of deathVIRGINIA SLAUGHTEREarly Cognitive Development Unit,School of Psychology,University of Queensland,Brisbane,Queensland,AustraliaAbstractThereisalonghistoryofresearchonchildrensunderstandingofdeath.ThisarticlebrieflyreviewspsychoanalyticandPiagetianliterature on ch

2、ildrens death concepts,then focuses on recent research in developmental psychology that examines childrensunderstanding of death in the context of their developing folk theory of biology.This new research demonstrates that childrenfirst conceptualise death as a biological event around age 5 or 6 yea

3、rs,at the same time that they begin to construct a biologicalmodel of how the human body functions to maintain life.This detailed new account of childrens developing biologicalknowledge has implications for practitioners who may be called on to communicate about death with young children.For adults,

4、the concept of death is complex andmulti-layered,incorporatingsocialandculturaltraditions and beliefs,personal and emotional issues,religious doctrines and conceptual understandings.While there is some debate about what constitutes amature death concept(Carey,1985;Klatt,1991;Speece&Brent,1985,1996)i

5、t is certainly true that,for adults,death is fundamentally understood as abiological event,and this biological understandinginforms and impacts the other facets of this complexconcept.Adults recognise that death comes to allliving things,that death is the final stage in the lifecycle,that it is inev

6、itable and irreversible,and that itis ultimately caused by a breakdown in the function-ing of the body.The purpose of this article is tobriefly overview the last 50 years of research onchildrens understanding of death,then describe indetail a body of recent research in developmentalpsychology that s

7、heds new light on how childrenmake the transition to an adult-like,biologicalunderstanding of death.This new research hasimportantimplicationsforcliniciansandotherprofessionals who may be required to address thetopic of death with youngsters.Psychoanalytic researchThe first published research on chi

8、ldrens under-standing of death was carried out by investigatorsworking from a psychoanalytic perspective.Thesestudies were primarily descriptive,employing open-ended interview techniques and projective methodssuchas story-tellingor drawing,to encouragechildren to express their knowledge freely about

9、death.Given the psychoanalytic orientation of theseauthors,these early studies of childrens knowledgeabout death focused primarily on childrens emo-tional responses to death,but also gauged theirconceptualisations of death.The early research revealed two insights:first,notsurprisingly,that children

10、find death to be an emo-tionally charged issue,and the thrust of the emotionalresponse is sadness,anxiety and fear over the sepa-ration inherent in death(Anthony,1940;Nagy,1948;Von Hug-Hellmuth,1964).These emotions are,ofcourse,similar to those that adults feel.The secondinsight is that young childr

11、ens understanding of deathisquitedifferentfromthatofadults,andthisdifferencemay intensify childrens emotional responses.Whilethere are individual differences in childrens personalconceptualisations of death,the general form of theirmisunderstandings(that is,misunderstanding froman adult perspective)

12、is fairly consistent.The early investigators reported that for childrenunder the age of 10 years or so,the separation ofdeath was understood in terms of more familiarpartings;death was seen as going away,either toheaven or to some place designated especially fordead people(the cemetery,the coffin)an

13、d the deadwere conceptualised as continuing to live in that otherCorrespondence:Virginia Slaughter,Early Cognitive Development Unit,School of Psychology,University of Queensland,Brisbane 4072,Australia.E-mail:vpspsy.uq.edu.auAustralian Psychologist,November 2005;40(3):179186ISSN 0005-0067 print/ISSN

14、 1742-9544 online?2005 Australian Psychological Society LtdPublished by Taylor&FrancisDOI:10.1080/00050060500243426place(Nagy,1948;Von Hug-Hellmuth,1964).Children understood that the dead were unlikely toreturn,but rationalised the permanence of the sepa-ration as the dead being unable to get back,b

15、ecauseheaven is too far away for instance,or because thecoffin is nailed shut.Some children further assimi-lated death to sleep,imagining death as a permanentsleeping state,from which a person cannot wake(Anthony,1940;Nagy,1948).To explain the causesof death,children often personified death,imaginin

16、ga grim reaper or a bogey man who caused somepeople(the old,the sick)to die.Some children alsoreported that death was a punishment for evildoing(Nagy,1948;Von Hug-Hellmuth,1964;see alsoWhite,Elsom&Prawat,1978).The psychoanalytic researchers concluded thatyoung childrens capacity to understand and ac

17、ceptdeath was limited by their cognitive and emotionalimmaturity,and that childrens misapprehensionsabout death were likely to fuel their anxieties.Thenext wave of research on childrens death conceptswasmoresystematicandcognitivelyoriented,although the observations of the early psychoanalyticresearc

18、hers have been upheld.It is notable that someof the early researchers remarked that childrensmisunderstandingofdeathderivedfromtheirinability to recognise death as a biological concept.Piagetian researchA second wave of research on childrens under-standing of death came in the 1960s and 1970s froma

19、primarily Piagetian perspective.This researchfocusedoncognitive,ratherthanemotionalaspects of childrens understanding,and tried to tiedevelopments in death understanding to develop-ments in other cognitive skills that were taken asmarkers of the Piagetian stages of cognitive develop-ment(Kane,1979;K

20、oocher,1973;Safier,1964;Speece&Brent,1985;White et al.,1978).In linewith that perspective,this research tradition refinedmethods for accessing and measuring childrensconceptual understanding of death.The exclusiveapproach was to carry out structured interviews withchildren and,recognising the comple

21、xity of theconcept,researchers delineated subcomponents ofdeath understanding and evaluated childrens capa-city to answer questions correctly that tapped thesevarious elements of the concept of death.Individualresearchers identified different sets of subcompo-nents,although they largely overlapped.A

22、crossstudies,subcomponents of the complex concept ofdeath include:(a)irreversibility or finality,theunderstanding that the dead cannot come back tolife;(b)universality or applicability,the understand-ing that all living things(and only living things)dieand related(c)personal mortality,the understand

23、ingthatdeathappliestooneself;(d)inevitability,the understanding that all living things must dieeventually;(e)cessation or non-functionality,theunderstanding that bodily and mental functionscease after death;(f)causality,the understandingthat death is ultimately caused by a breakdown ofbodily functio

24、n;(g)unpredictability,the under-standing that the timing of(natural)death is notknowable in advance.Using these subcomponents allowed researchers tobe more specific about which aspects of deathchildren understood,and to chart a more precisedevelopmental trajectory for the development ofthe death con

25、cept.Further,a mature understandingof death was defined as mastery of all subcompo-nents of the death concept;however,it should benoted that different researchers identified differentsubcomponents,and none included all seven listedabove in a single study.Across studies,a fairlyconsistentdevelopmenta

26、lpatternemerged.Thesubcomponents of universality and irreversibilityare acquired first,by age 5 or 6 years(Kastenbaum,1967;Koocher,1973;Speece&Brent,1992).Thuschildren first recognise that death happens to every-one and that the dead cannot come back to life.Thefinal subcomponents to be mastered are

27、 cessationandcausality:theunderstandingthatdeathischaracterised by the breakdown of bodily function-ing,and knowledge about the causes of that ultimatebreakdown(Koocher,1973;Lazar&Torney-Purta,1991;Orbach et al.,1985).It was proposed that thedevelopmental progression of subcomponent acqui-sition ref

28、lected general aspects of childrens cognitivedevelopment(Koocher,1973;Speece&Brent,1985;Hoffman&Strauss,1985;White et al.,1978)withthe moreconcrete,clearlydefinedsubcomponents(death happens to everyone andonce it happens there is no going back to life)beingacquired before the relatively more complex

29、 andabstract subcomponents(the internal working of thebody is invisible and therefore abstract for youngchildren,and the causes of death are multiple).Researchers in this tradition concluded that childrendo not grasp all the subcomponents of death,andtherefore lack a full understanding of death,befo

30、reage 7 at the earliest(see Speece&Brent,1996 for arecent review).As well as tracking the acquisition of subcompo-nents,the Piagetian research characterised childrensconcepts of death in terms of general cognitivedevelopmental trends:younger childrens under-standing was seen as egocentric and animis

31、tic,while older childrens concepts were consideredrelativelyconsistentandlogical(Kane,1979;Koocher,1973).These characterisations,like theobservations of the early psychoanalytic researchers,are still relevant.In the first stage(Preoperational),180V.Slaughterchildren think of death as a temporary or

32、reversiblestate,and tend to characterise death with respect toconcrete behaviours such as being still or havingclosed eyes,or departing.In the second stage(Concrete Operational),children recognise that allliving things must die and that death is irreversible;however,they consider death to be caused

33、byconcrete elements originating from outside the bodyand do not recognise death as an intrinsic andnatural part of the life cycle(guns,accidents and badgerms cause death,but there is no understanding ofhow this comes about).In the final stage(FormalOperational),children hold an adult view of death a

34、san inevitable,universal final stage in the life cycle ofall living things,characterised by the cessation ofbodily function.The adult view is Formal Opera-tional,these authors claim,because it is abstract andreflects theoretical(actually,biological)knowledge.While more modern researchers have questi

35、oned theutility of assimilating developmental changes indeath understanding to Piagetian stages(e.g.Carey,1985;see also Speece&Brent,1996),the data fromthesestudies,likethoseofthepsychoanalyticresearch,generated a remarkably consistent depic-tion of the content of childrens concepts of death atdiffe

36、rent ages.Research on individual differences onchildrens developing death conceptThePiagetianresearchdocumentingconsistentstagesofdeathunderstandingestablishedthatchildrens understanding of death is closely tied tocognitive developmental maturation.This conclu-sion is supported further by studies su

37、ggesting thatthe effects of individual experiences and socio-culturalvariables areminimal.While it seemsreasonable to hypothesise that childrens uniquebackgrounds and experiences may affect their under-standing of death,the research offers only weaksupport for that hypothesis.Across studies,thefindi

38、ngs on individual difference effects are oftencontradictory,and the bulk of research suggests thatindividual differences in childrens backgrounds andexperiences,iftheyhaveaneffect,mayonlyinfluence the rate of acquisition of specific,relevantsubcomponents(see Kenyon,2001 and Speece&Brent,1996 for rec

39、ent reviews).Several studies sought to investigate whether andhow personal experience of death affected childrensunderstanding of the concept,the idea being thatchildren who are forced to think about death maydevelop a mature understanding sooner than theirpeers.These studies did provide evidence th

40、atchildren who have direct,personal experience ofdeath show relatively advanced understanding,butonly of the subcomponent of universality of death(Jay et al.,1987;Kane,1979;but see Cotton&Range,1990;Townley&Thornburg,1980).Otherstudies showed that children who have sufferedprotracted illness and/or

41、hospitalisation may beaccelerated in the acquisition of the subcomponentsof irreversibility,cessation or causation,reflecting arelativelyearlyunderstandingofthemedical/biologicalnatureofdeath(Jayetal.,1987;OHalloran&Altmaier,1996;Spinetta,1974).Other studies looked at socio-cultural variables inrela

42、tion to the developing understanding of death.A central issue in this research was the extent towhich religious beliefs influenced childrens deathunderstanding.The data on religiosity are incon-sistent,with some reports suggesting that highlyreligious children showed a less mature understand-ing of

43、the irreversibility of death compared to theirpeers(Candy-Gibbs,Sharp&Petrum,1985),butotherstudiesrevealingnoeffectofreligiosity(McIntire,Angle&Struppler,1972).Given the emotional impact of the concept ofdeath,researchers have also investigated whetherchildrens death understanding interacts with the

44、irlevels of anxiety.There is some evidence that anxiouschildren are more likely than their peers to deny theuniversality of death(Cotton&Range,1990;Orbachet al.,1986),but it has been suggested that thisdevelopmental difference is likely to result not fromthose children misunderstanding that death ap

45、pliesto all living things,but from their tendency to defendagainstthatanxiety-provokingnotion(Kenyon,2001;Orbach et al.,1986).Thus,the conclusion from the bulk of individualdifference studies is that childrens understanding ofspecific subcomponents of death may be influencedby their socio-cultural b

46、ackground or unique lifeexperiences,but overall the developmental trajectoryof the understanding of death is highly robust.Thedevelopment of an understanding of death thusappears to be most strongly influenced by childrensdeveloping cognitive competency.Studies of death as a biological conceptIn the

47、 last decade or so,a new approach to under-standing childrens concept learning has emerged incognitive developmental research and theorising.Thisnewapproachemphasisesdomain-specificconceptual acquisition over domain-general devel-opment,and further assumes that young childrenactively construct naive

48、,or folk theories about theworld.This model of cognitive development empha-sisestheroleofcausal-explanatorymodelsinorganising childrens knowledge and driving learningabout different domains of experience,and recog-nises the existence and importance of conceptualchange in childrens learning(Carey,198

49、5;GopnikChildrens death concept181&Meltzoff,1997;Inagaki&Hatano,2002;Wellman&Gelman,1992).One of the seminal works in this new traditionanalysed the development of young childrens con-ceptions of the biological world(Carey,1985).Thiswork presented a series of studies on childrensinductive reasoning,

50、in which children of variousages were asked to judge the extent to which differententities(including people,various animals,insectsand inanimate objects)possessed biological proper-ties(such as the capacity to eat,breathe,feelemotion,reproduce,die,etc.).The pattern of datafrom this now-classic serie