In order to better support the needs of our clients and their families, we frequently post articles and other information of interest on this page.
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INDEX OF ARTICLES & RESOURCES |
DATE POSTED |
| What is a Developmental Psychologist? | August 2015 |
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April 2015
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Jan. 2015
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October 2014
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August 2014
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WHAT IS A DEVELOPMENTAL PSYCHOLOGIST?
1. Knowledge of the Developmental Goalposts for Children and Teenagers
When a child or teenager comes to the Morgan Center there is typically one central issue that the parent is concerned about. Whether it is anxiety, school achievement, or behavior, parents come to us for guidance on how to help their children. As a developmental psychologist, I know that at each stage of development children have important milestones to achieve such as how infants develop attachment and communication, or how a three year olds use of language helps them develop identity. Children all have a powerful need to achieve and master these goals but then……life happens. A family moves, a child has speech delays, or a teenager has trouble making friends. Life events almost always impact children, positively and negatively and if negatively, the first indicator is typically a behavioral problem.
2. Distinguishing Typical Child Development and Behaviors related to Disabilities
“What is typical for a child this age, and what is behavior related to a disability?” This is a question I hear constantly from parents of children with special needs. As an example, a gifted teenager with Attention Deficit Hyperactivity Disorder was able to excel academically through elementary school , but with the demands of multiple classes and higher work load her grades dropped because she is not doing classwork. This seemingly irresponsible behavior creates turmoil with her parents and brings her to us . At our first meeting, I listen carefully to her parents and to her for indicators of executive function difficulties, but also remain aware that refusal to do classwork may reflect her fear of embarrassment at not being able to do the work. Also, a central need for teenagers is peer acceptance, if unable to break down a problem due to executive function deficits, might this teenager be displaying something other than oppositional behavior? Perhaps refusing to do classwork is a coping strategy ( albeit not an effective one) to avoid risking the humiliation of admitting she doesn’t understand how to interpret a multistep question.
3. How Does A Disability Change Over Time?
Knowledge of child development and knowledge of disabilities provide important foundational pieces in identifying specific developmental needs of children., however it is knowledge of how disabilities express themselves throughout the life span that provides critical information on how this child functions. A Developmental Psychologist in working collaboratively with the parents and child connects knowledge of child development with understanding how a disability has impacted that child’s development.
As an example, Autism is a lifelong disorder that is first diagnosed in early childhood and continues to be apparent throughout a person's life. It is characterized by unevenness in development that changes over the life span of the individual. Studying a child within a developmental framework provides a benchmark for understanding the severity or quality of delays. Autism symptoms are usually at their worst in preschool and may substantially improve over time. Children who have very poor eye contact and make few social initiations at this age may have very different social symptoms when they are teenagers. They may be relatively interested in social engagement by this later stage and may have acquired some more advanced social skills. Their social difficulties may be manifested as awkwardness or inappropriate behavior rather than the lack of interest seen in young childhood. Thus, the form and quality of symptoms change with age. As a Developmental Psychologist, I believe that to develop a child’s skills, one first needs to identify where that child functions developmentally, across all areas of development.
4. Parent Educations and Collaboration
A kind but knowledgeable approach goes a long way in establishing parent’s trust in us and is essential for parent’s just beginning the process of understanding how to help their child. I am keenly aware of how anxiety provoking it must be to call a mental health provider to ask for help. It is for this reason that I talk to parent’s personally before they make an appointment to answer questions, listen and provide them with an opportunity to share information about their child.
I believe that a family centered approach empowers parents as part of the team, facilitates the process and reduces the likelihood that the child feels like the identified problem.
In closing, a developmental psychologists of child and adolescent development provides valuable information on areas of cognitive, social, emotional and language needs. This information then becomes the template for treatment goals that help the child and teenager develop skills that are based on what they need to be able to achieve, not the behavior that describes him.
When a child or teenager comes to the Morgan Center there is typically one central issue that the parent is concerned about. Whether it is anxiety, school achievement, or behavior, parents come to us for guidance on how to help their children. As a developmental psychologist, I know that at each stage of development children have important milestones to achieve such as how infants develop attachment and communication, or how a three year olds use of language helps them develop identity. Children all have a powerful need to achieve and master these goals but then……life happens. A family moves, a child has speech delays, or a teenager has trouble making friends. Life events almost always impact children, positively and negatively and if negatively, the first indicator is typically a behavioral problem.
2. Distinguishing Typical Child Development and Behaviors related to Disabilities
“What is typical for a child this age, and what is behavior related to a disability?” This is a question I hear constantly from parents of children with special needs. As an example, a gifted teenager with Attention Deficit Hyperactivity Disorder was able to excel academically through elementary school , but with the demands of multiple classes and higher work load her grades dropped because she is not doing classwork. This seemingly irresponsible behavior creates turmoil with her parents and brings her to us . At our first meeting, I listen carefully to her parents and to her for indicators of executive function difficulties, but also remain aware that refusal to do classwork may reflect her fear of embarrassment at not being able to do the work. Also, a central need for teenagers is peer acceptance, if unable to break down a problem due to executive function deficits, might this teenager be displaying something other than oppositional behavior? Perhaps refusing to do classwork is a coping strategy ( albeit not an effective one) to avoid risking the humiliation of admitting she doesn’t understand how to interpret a multistep question.
3. How Does A Disability Change Over Time?
Knowledge of child development and knowledge of disabilities provide important foundational pieces in identifying specific developmental needs of children., however it is knowledge of how disabilities express themselves throughout the life span that provides critical information on how this child functions. A Developmental Psychologist in working collaboratively with the parents and child connects knowledge of child development with understanding how a disability has impacted that child’s development.
As an example, Autism is a lifelong disorder that is first diagnosed in early childhood and continues to be apparent throughout a person's life. It is characterized by unevenness in development that changes over the life span of the individual. Studying a child within a developmental framework provides a benchmark for understanding the severity or quality of delays. Autism symptoms are usually at their worst in preschool and may substantially improve over time. Children who have very poor eye contact and make few social initiations at this age may have very different social symptoms when they are teenagers. They may be relatively interested in social engagement by this later stage and may have acquired some more advanced social skills. Their social difficulties may be manifested as awkwardness or inappropriate behavior rather than the lack of interest seen in young childhood. Thus, the form and quality of symptoms change with age. As a Developmental Psychologist, I believe that to develop a child’s skills, one first needs to identify where that child functions developmentally, across all areas of development.
4. Parent Educations and Collaboration
A kind but knowledgeable approach goes a long way in establishing parent’s trust in us and is essential for parent’s just beginning the process of understanding how to help their child. I am keenly aware of how anxiety provoking it must be to call a mental health provider to ask for help. It is for this reason that I talk to parent’s personally before they make an appointment to answer questions, listen and provide them with an opportunity to share information about their child.
I believe that a family centered approach empowers parents as part of the team, facilitates the process and reduces the likelihood that the child feels like the identified problem.
In closing, a developmental psychologists of child and adolescent development provides valuable information on areas of cognitive, social, emotional and language needs. This information then becomes the template for treatment goals that help the child and teenager develop skills that are based on what they need to be able to achieve, not the behavior that describes him.
CHILDREN AND DIVORCE
Many families in the United States are touched by divorce. The current divorce rate is calculated to be between 40 and 60% for those recently married and up to 10% higher for remarriages. A majority of divorces occur in families with children under the a ge of 18.
Divorce propels adults and children into numerous adjustments and challenges. While great diversity exists in children’s adjustment to divorce, and a majority of children weather the transition and become competent adults, up to a quarter of children whose parents divorce experience ongoing emotional and behavior difficulties (as compa red to 10% of children whose parents do not divorce).
Divorce propels adults and children into numerous adjustments and challenges. While great diversity exists in children’s adjustment to divorce, and a majority of children weather the transition and become competent adults, up to a quarter of children whose parents divorce experience ongoing emotional and behavior difficulties (as compa red to 10% of children whose parents do not divorce).
Spouses divorce each other, but they do not divorce their children. A majority of former spouses are able to establish a relatively conflict-free parenting relationship for the benefit of their children. However, about a third have difficulty in establishing a workable parenting relationship, even years after the divorce.
While counseling frequently helps couples to make their marriages more satisfying, there are also times when counseling can help a couple to see that they need time apart to better understand themselves and their relationship, or that they need to bring their marriage to an end.
Sometimes people learn in the process of therapy that aspects of their relationship are making it difficult for them to understand their separate needs as individuals or to communicate about them in a constructive ways. There are some situations in which a carefully considered separation, in which goals and communication are clear, give a couple a chance to get a better perspective on their relationship.
There are also relationships in which unresolved conflicts have been left unaddressed for so long that the damage th ey have caused can no longer be repaired. In other cases there may be true incompatibility in some fundamental aspect of the marriage that precludes a functioning partnership. When a marriage ends after sober reflection and careful consideration of the options, important decisions need to be made that have far-ranging ramifications, both emotionally and financially, for the partners and for their children. Every member of the re-organizing family will be profoundly affected by how the separating spouses each handle the emotional journey of divorce, by the access the children will have to both of their parents in the new two-household family, and by the financial arrangement made by the adults for their own care and that of their children. This period is a very vulnerable one in the life of the family; the importance of making healthy decisions that are guided by the overall well-being of all of its members can not be overstated.
Most parents who have a difficult relationship with their ex-spouse but who want to coparent start out with "parallel parenting." In this arrangement, each parent assumes total responsibility for the children during the time they are together; there is no expectation of flexibility and little contact with the other parent. As time goes on and anger dissipates, parents may develop some version of "cooperative parenting." In this arrangement, parents communicate directly and in a business-like manner regarding the children and coparenting schedules. Marriage and family therapists can be helpful to families as they formulate or define their post-divorce parenting relationships. Parental conflict can hinder children’s adjustment and good coparenting skills are very important to a child's adjustment.
How can you help your children?
- Tell children about the divorce together, if possible.
- Answer children’s questions honestly, avoiding unnecessary details.
- Reassure children they are not to blame for divorce.
- Tell children they are loved and will be taken care of.
- Include the other parent in school and other activities.
- Be consistent and on time to pick up and return children.
- Develop a workable parenting plan that gives children access to both parents.
- Guard against canceling plans with children.
- Give children permission to have a loving, satisfying relationship with other parent.
- Avoid putting children in the middle and in the position of having to take sides.
- Avoid pumping children for information about the other parent.
- Avoid arguing and discussing child support issues in front of children.
- Avoid speaking negatively about the other parent or using the child a s a pawn to hurt the other parent.
How do you know when to seek help?
When you or your partner begins to :
- use the legal system to fight with each other
- put down or badmouth the other parent
- use the children as message carriers or to spy on the other parent
- (children feel caught in the middle)
- experience high levels of conflict and children repeatedly try to stop the fighting
- rely on the children for a high level of emotional support and major responsibilities in the home experience
- depression or anxiety
What help is available for divorcing parents and their children?
Court-connected divorce education programs for parents and children
Programs for parents and, sometimes, children are recommended or required in over half of the counties in the United States.
School programs for children
Some school systems offer small groups for children during the day or after school. In these groups children learn that they are not alone in their experience of divorce and learn coping strategies.
Family therapy
(available through public and private mental health centers and university family therapy centers)
REFERENCES
Ahrons, C. R. (1994). The good divorce: Keeping your family together when your marriage comes apart. New York: HarperCollins
The point of the Ahrons book is not that divorce is good, but that there is such a thing as a good divorce, in which couples part without destroying each other and their children. She concludes that about 50% of couples had cooperative coparental relationships one year post-divorce.
Blau, M. (1993). Families apart: Ten keys to successful co-parenting. New York: G. P. Putnam’s Sons
This book focuses on what separating parents need to know if they are thinking about coparenting. Blau identifies ten "keys" to good parenting after a divorce; chapters are organized around these keys. Blau lists many resources for parents and age-appropriate books for children.
Everett, C., & Everett, S. V. (1994). Healthy divorce. San Francisco: Jossey-Bass. This book describes 14 stages of adjustment from marital erosion through separation, mediation, and remarriage. Helpful ideas given for coparenting and mediating.
Gold, L. (1992). Between love and hate: A guide to civilized divorce. New York: Plenum Press
This hands-on guide to the divorce process provides assessments and exercises that help parents learn to resolve conflict, improve communication, and avoid costly legal battles.
Lansky, V. (1991). Vicki Lansky’s divorce book for parents . New York: Signet
This inexpensive paperback book is a comprehensive guide that includes such topics as: telling the children, talking with your ex-spouse, dealing with support payments, dating, sex and the single parent, knowing when to get professional help, and handling holidays.
How Can I Help My Child Deal
With Stress?
By Felicia Goldberg, Ph.D.
Executive Director, The Morgan Center
With Stress?
By Felicia Goldberg, Ph.D.
Executive Director, The Morgan Center
In recent weeks I have had a number of parents ask me how to help their children deal with stress. One theory worthy of consideration in dealing with stress is attachment theory. Throughout life, young children are more resilient if they have become attached to at least one significant adult. Being able to trust at least one adult pulls them through stressful times. Secure attachment provides a foundation for healthy development and healthy mental functioning.
Although attachment exists all of the time, it is particularly evident when a child is ill, tired, or afraid. A child searches out that person who makes them feel safe and secure. Stress occurs when that person is not available...in proximity or emotionally.
Separation is the flip side of attachment. Any indication that separation may occur causes stress. Children going into a new child care situation, to a new class, or to spend the night away from home (even to camp); can be stressed due to separation. Children can bring an attachment item along (blanket, bear) to child care, to ease the separation from parents.
You are not spoiling their child by responding to their fright. If feelings are not recognized, they will be buried and later may surface... when the reason is not as evident. Significant adult availability and responsiveness is of great importance to move through the stressful time.
Helping Children Handle Stress-Related Anxiety
PRE-SCHOOL AGE CHILDREN
Behavior such as bedwetting, thumb sucking, baby talk, or a fear of sleeping alone may intensify in some younger children, or reappear in children who had previously outgrown them. They may complain of very real stomach cramps or headaches, and be reluctant to go to school. It's important to remember that these children are not "being bad". They are afraid. Here are some suggestions to help them cope with their fears:
Reassure pre-schoolers that they're safe. Provide extra comfort and contact by discussing your child's fears at night, by telephoning during the day and with extra physical comforting.
Get a better understanding of a child's feelings about their fears. Encouraging children to draw pictures about their fears, and then discussing them, will offer insight into your child's particular fears and concerns. You can work to structure children's play so that it remains constructive, serving as an outlet for expressing fear or anger.
SCHOOL AGE CHILDREN
False reassurance does not help this age group. Be honest and recognize their feelings. Often parents in an effort to calm their child’s fears do not “hear” what they are trying to say. For example, if a child says “I hate school!” Don't say “Things will be better next year”, what they are trying to do is have you recognize a feeling they can’t quite articulate. Instead, try and draw them out by reflecting back the emotion they are displaying as well as their question, such as “Wow you seem really angry, what is it about school you hate so much?”
Allow them to express themselves through play or drawing. As with younger children, school-age children sometimes find comfort in expressing themselves through playing games or drawing what is making them anxious. Allowing them to do so and then talking about it gives you the story they have expressed in pictures and a starting point for communicating with them.
ADOLESCENTS
Encourage teenagers to work out their concerns about their stress. Adolescents may try to downplay their worries. It is generally a good idea to talk about these issues, keeping the lines of communication open and remaining honest. They need the opportunity to vent as well as to normalize the extreme emotions that come up for them. A good way to stimulate such a discussion is for you to share your own personal experience to a similar stressor. They may need considerable reassurance that even extreme emotions and "crazy thoughts" are normal at times.
It is important to end such discussions on a positive note (e.g., what do you think a good plan of action is?). Adolescents also are typically are going through an identity phase of development. Their sense of "who they are" at this point in their lives may be tied to possessions and friends. This can be helpful in repairing a sense of mastery and security, as well as having practical merit.
General Guidelines for Parents
Reassure children who are having difficulty separating. Children can be expected to have greater difficulty with times of separation (school drop-offs, bedtime) so extra reassurance is important. Let your child know where you are. Daytime phone calls may be increased.
Monitor you child's viewing of television and other media. Pre-school children view even make-believe violence as real, so with younger children it is important to keep an eye out to what they are exposed to.
Greet each child positively each day. That transition from parent to teacher is an important one. Often mornings are extremely stressful for families. A warm smile or hug as a child walks out the door can go a long way to help a child feel accepted and wanted.
Spend time with your child every day. Even if it's just for one or two minutes, get down on the child's level, make eye contact, listen, and watch.
Value each child. Children learn to value themselves through the eyes (and words) of others. What you say (or don't say) to a child has tremendous impact.
How to Help your Anxious Child
Parents can help children develop the skills and confidence to overcome fears so that they don't evolve into phobic reactions. The following steps will guide you in helping your child deal with fear and anxiety.
Recognize that the fear is real. As trivial as a fear may seem, it feels real to the child and it is causing him to feel anxious and afraid. Being able to talk about fears can help, words often take some of the power out of emotion; if you can give the fear a name it becomes more manageable. As with any negative feeling, the more you talk about it, the more it becomes less powerful.
Never belittle the fear as a way of forcing the child to overcome it. Telling a child, "Don't be ridiculous! There are no monsters in your closet!" may get him to go to bed, but it won't make the fear go away.
However, don't cater to fears. If your child doesn't like dogs, don't cross the street deliberately to avoid one. This will reinforce that dogs should be feared and avoided.
Teach the child
how to rate fear. If your child can visualize the intensity of the fear on a scale of 1 to 10, with 10 being the strongest, he may be able to "see" the fear as less intense than first imagined. Younger children can think about how "full of fear" they are, with being full "up to my knees" as not so scared, "up to my stomach" as more frightened, and "up to my head" as truly petrified.
Teach coping strategies.
Try these easy-to-implement techniques. Using you as "home base," the child can venture out toward the feared object, and then return to you for safety before venturing out again. The child can also learn some positive self-statements, such as "I can do this" and "I will be OK," which he can say to himself when he feels anxious. Relaxation techniques are helpful as well, including visualization (of floating on a cloud or lying on a beach, for example) and deep breathing (imagining that the lungs are balloons and letting them slowly deflate).
The key to resolving fears and anxieties is to overcome them. Using these suggestions, you can help your child better cope with life's situations.
Cognitive-Behavior Therapy (CBT)
CBT is a combination of cognitive therapy, which deals primarily with identifying and changing problematic thoughts and beliefs, and behavior therapy, which works to change maladaptive behaviors. CBT may help your child change his fearful thoughts and subsequent behaviors, in order to begin facing the situations that result in anxiety with more confidence. This is a gradual, step by step approach to overcoming the anxiety-producing situation. Children with anxiety disorders are taught effective skills that they can use when they began feeling anxious. As they apply these skills to stressful situations and begin to reduce the anxiety, their confidence will increase, the overall worry will decrease, and gradually they will be able to remain in control in situations that previously provoked high levels of distress.
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Recognize that the fear is real. As trivial as a fear may seem, it feels real to the child and it is causing him to feel anxious and afraid. Being able to talk about fears can help, words often take some of the power out of emotion; if you can give the fear a name it becomes more manageable. As with any negative feeling, the more you talk about it, the more it becomes less powerful.
Never belittle the fear as a way of forcing the child to overcome it. Telling a child, "Don't be ridiculous! There are no monsters in your closet!" may get him to go to bed, but it won't make the fear go away.
However, don't cater to fears. If your child doesn't like dogs, don't cross the street deliberately to avoid one. This will reinforce that dogs should be feared and avoided.
Teach the child
how to rate fear. If your child can visualize the intensity of the fear on a scale of 1 to 10, with 10 being the strongest, he may be able to "see" the fear as less intense than first imagined. Younger children can think about how "full of fear" they are, with being full "up to my knees" as not so scared, "up to my stomach" as more frightened, and "up to my head" as truly petrified.
Teach coping strategies.
Try these easy-to-implement techniques. Using you as "home base," the child can venture out toward the feared object, and then return to you for safety before venturing out again. The child can also learn some positive self-statements, such as "I can do this" and "I will be OK," which he can say to himself when he feels anxious. Relaxation techniques are helpful as well, including visualization (of floating on a cloud or lying on a beach, for example) and deep breathing (imagining that the lungs are balloons and letting them slowly deflate).
The key to resolving fears and anxieties is to overcome them. Using these suggestions, you can help your child better cope with life's situations.
Cognitive-Behavior Therapy (CBT)
CBT is a combination of cognitive therapy, which deals primarily with identifying and changing problematic thoughts and beliefs, and behavior therapy, which works to change maladaptive behaviors. CBT may help your child change his fearful thoughts and subsequent behaviors, in order to begin facing the situations that result in anxiety with more confidence. This is a gradual, step by step approach to overcoming the anxiety-producing situation. Children with anxiety disorders are taught effective skills that they can use when they began feeling anxious. As they apply these skills to stressful situations and begin to reduce the anxiety, their confidence will increase, the overall worry will decrease, and gradually they will be able to remain in control in situations that previously provoked high levels of distress.
[ back to RESOURCE INDEX ]
How To Help Your Child Deal With The Death Of A Loved One
If death should enter your child's world, whether it is a relative, friend, or a pet, she needs your warmth and patience in order to deal with the experience in a healthy way. It is important for you to help her come to an understanding of what has happened and to work through the grief of separation. Your natural instinct may be to protect your child from the pain and sorrow, but avoiding the issue does more harm than good. Your child needs to talk about the loved one who has died, perhaps even to see him or her in death in order to process the experience, mourn, and finally let go. In this instance, a child's needs are much like an adult's.
Both during and after the experience, be open to all of your child's questions. Take them seriously, even if your child appears to be acting silly when he asks them-- this may be due to nervousness or grief or both. Talk together about the person or pet's life and death.
Make a Memory Book. Your child might like to make a memory book. This book can include pictures by your child of special times shared with the deceased and favorite things, such as books, songs, games and foods that they enjoyed together. Let your child choose a favorite photograph of himself and the deceased together for the cover. The process of making a book like this one is usually more meaningful than the end result. Your child may wish to put it away.
Respect her feelings. Since young children have not developed a real sense of time yet, your child may become concerned that you or he will die soon. After all, a deceased relative may have been elderly, but that term has no meaning for her. You are old in comparison to her. It is better to show rather than to tell her that the person or pet in question lived "a long, long time." Make a timeline with your child showing significant times in his own life, yours, and perhaps the lives of her grandparents. Show him what a "long, long time" really looks like.
Share your grief. When you are mourning, share your grief with your child. It helps everyone to talk to someone, and children can be sympathetic listeners. The joy of loving and the pain of parting are both parts of real life--a life we want to help our children live to its fullest.
How to explain death to your preschooler
Don't dodge her questions. It's normal for your preschooler to be curious about death, even if she hasn't yet lost a loved one. In fact, less emotionally fraught times are good opportunities for laying groundwork that will help your child cope when she does lose someone. Answer her questions about death, and don't be afraid to read stories about children whose pets or grandparents die.
Give brief, simple answers. Young children can't handle too much information at once. At this age, it's most helpful to explain death in terms of physical functions that have ceased, rather than launching into a complicated discussion of a particular illness: "Now that Uncle John has died, his body has stopped working. He can't walk or run, or eat or sleep or see anymore, and he doesn't feel any pain." It's also important to help a preschooler understand basics such as who's going to take care of her. "She thinks, 'If Mom dies, who's going to give me my bath?' "
Express your own emotions. Grieving is an important part of healing, for both children and adults. Don't frighten your child with excessive grief, but don't make the subject off-limits, either. Explain that grownups need to cry sometimes, too, and that you feel sad because you miss Grandma. Your preschooler is keenly aware of changes in your mood, and she'll be even more worried if she senses that something is wrong but that you're trying to hide it.
Avoid euphemisms. Common adult phrases for death — "resting in peace," "in eternal sleep" — are confusing for a young child, so don't say that Grandpa is "sleeping" or "has gone away." Your preschooler may worry that going to bed at night means she'll die, too, or that if you leave for the office or the store, you won't come back. State the reasons for the death as simply as possible: "Grandpa was very, very old and his body couldn't work any more." If Grandpa was sick before he died, be sure to reassure your child that if she gets sick from a cold or flu, it doesn't mean she'll die. Explain that there are different ways people get sick, and that we recover from minor illnesses like the ones your child usually has.
Tread carefully when discussing God and heaven. Explanations of death and the afterlife will of course depend on your own religious beliefs. If the concepts of God and heaven will enter into your conversation, think carefully about what you'll say, since words meant to comfort a small child may actually confuse her. If you tell your preschooler, "Janie's happy now, because she's in heaven," for instance, she may worry: How can Janie really be happy if everyone around me is so sad? If you say, "Janie was so good that God wanted her with him," she's likely to think: If God wanted to take Janie, will he take me too? Should I be good so I can be with her in heaven, or bad so I can stay here with Mom and Dad? Something along the lines of, "We're so sad that Janie isn't here with us and we'll miss her very much, but it's comforting to know that she's with God now," will reassure your child without adding to her worries.
Be prepared for a variety of reactions. Children not only feel sorrow over the death of a loved one, they may also feel guilt or anger. Reassure your preschooler that nothing she said or did caused the death, and don't be surprised if she expresses anger toward you, the doctors and nurses, or even the deceased. Also expect that she may have tantrums more often, either as a way to get her own sadness out (though the tantrum may appear to be about something else) or as a reaction to the tension and sadness in your household.
Expect the subject to come up repeatedly. Be ready to field the same questions from your child over and over again, since understanding the permanence of death is a struggle for her. She's also likely to come up with new questions as her awareness of death and her cognitive skills grow, grief counselors say. Don't worry that you didn't explain the death adequately the first time — your child's ongoing questions are normal. Just keep answering them as patiently as you can.
