Table of Contents s532

Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum Chapter Ten: Death in the World of Childhood

Multiple Choice

1.0. A child's concern and curiosity about death is likely to develop: a. as soon as they experience a loss. b. once they experience a separation, such as parents that divorce. c. regardless of any personal experience with separation, absence, or loss. d. after the loss of a family pet. Difficulty: 2 Page-Reference: 304-305 Answer: c. regardless of any personal experience with separation, absence, or loss.

2.0. Each of the following represents some of the most frequent responses from people who were questioned about the way death was treated in their household as children EXCEPT: a. They sat in dark rooms and became quiet. b. They did not recall any conversations about death with their parents. c. For those who were raised in Christian homes, death was addressed as a concept and limited to an afterlife. d. Death was discussed by adults in front of children, but as if they were not present. Difficulty: 2 Page-Reference: 304 Answer: d. death was discussed by adults in front of children, but as if they were not present.

3.0. Freud thought that, having lost ones’ own childhood innocence, as adults, parents want to: a. fully expose their children to death in order to shake them out of their fairy-tale world. b. fully expose their children to death in order to sharpen their defense mechanisms and survival instincts. c. partially expose their children to death by allowing them to see dead animals but not dead people. d. safeguard their children from reality and let them live in a fairy-tale world. Difficulty: 2 Page-Reference: 305 Answer: d. safeguard their children from reality and let them live in a fairy-tale world.

4.0. Which of the following statements is the most accurate? a. "Ring-Around-the-Rosie" became a popular game in the fourteenth century because it enabled children to deal with their death fears during the plague years. b. "Dead Man Arise" was a popular Czechoslovakian song, sung by the children’s choir at Easter time to celebrate the miracle of Jesus' return to life. c. Children rarely think of death until about age 10. d. Adults very seldom recall death-related experiences from early childhood. Difficulty: 2 Page-Reference: 307 Answer: a. "Ring-Around-the-Rosie" became a popular game in the fourteenth century because it enabled children to deal with their death fears during the plague years.

5.0. Which of the following statements is NOT supported by the research presented through the mother-child death communication case histories presented in the text? a. Children are concerned more with the deaths of particular people or animals rather than with the topic of death in general. b. Children do not recognize that death is a threat to their own relationships and security.

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum c. There may be several different orientations toward death within the same household. d. There is now a transitional generation of parents who are trying to communicate in an open manner with their children, although their own experience was of family silence about death. Difficulty: 2 Page-Reference: 313 Answer: b. Children do not recognize that death is a threat to their own relationships and security.

6.0. One way in which death anxiety is perpetuated for another generation starts with: a. parents whose own discomfort interferes with their ability to respond to a child's death-related curiosity in a simple and naturalistic way. b. parents who provide concrete details of dying and death. c. parents who use euphemisms such as "the great sleep" to explain death to children. d. none of the above Difficulty: 2 Page-Reference: 313 Answer: a. parents whose own discomfort interferes with their ability to a child’s death-related curiosity in a simple and naturalistic way.

7.0. According to Nagy’s research, which of the following statements best describes the first stage of the child's understanding of death? a. Death is a person that makes people dead. b. Death is separation. c. Death is personal, universal, and inevitable. d. Death is final – but one can escape it.

Difficulty: 2 Page-Reference: 314 Answer: b. Death is separation.

8.0. Preschool-age children studied by Nagy: a. did not want to talk or think about death. b. were full of questions about funerals, coffins, and cemeteries. c. showed no anxiety or negative feelings about death. d. expressed fears about death. Difficulty: 2 Page-Reference: 314 Answer: b. were full of questions about funerals, coffins, and cemeteries.

9.0. Compared with Nagy's findings, children today: a. tend to personify death more frequently. b. tend to personify death less frequently. c. move through the stages of understanding death more slowly. d. none of the above. Difficulty: 2 Page-Reference: 315 Answer: b. tend to personify death less frequently.

10.0. According to Kenyon (2001), which of the following factors had the most influence with regard to whom was more likely to demonstrate more advanced concepts of death? a. girls in general. b. boys in general c. children of either gender with superior intellectual and verbal skills d. girls with superior emotional skills Difficulty: 3

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum Page-Reference: 317 Answer: c. children of either gender with superior intellectual and verbal skills

11.0. Which of the following factors has the most influence in lowering children’s levels of death anxiety? a. Younger children display separation anxiety in their views on death. b. Older children were more likely to depict death as scary. c. Children with more mature levels of understanding have lower levels of death anxiety. d. none of the above Difficulty: 2 Page-Reference: 317 Answer: c. Children with more mature levels of understanding have lower levels of death anxiety.

12.0. When it comes to cultural influences on children’s concepts of death: a. Children in Sweden and the United States have similar concepts of death at the same age. b. Muslim children are more likely to pray for the dead. c. Taiwanese children are exposed to violent images of death. d. all of the above Difficulty: 2 Page-Reference: 318-319 Answer: d. all of the above.

13.0. According to Kastenbaum and Fox (2007), the concept of an “imaginary friend” (IF) emerges during: a. preschool years and exits during middle childhood (by age 10). b. middle-childhood years (age 8-10) and exits around the onset of adolescence (12-13). c. preschool years and exits around the time of entry into kindergarten (age 5-6). d. none of the above Difficulty: 2 Page-Reference: 320-321 Answer: c. preschool years and exits around the time of entry into kindergarten (age 5-6).

14.0. Some ways in which children who have “imaginary friends” may exit this relationship include that the IF may: a. just fade away as new friends and activities play more of a role in the child’s life. b. experience death as the result of an accident, error, disaster, or bad luck. c. experience death as a result of something the child perceived he or she did or failed to do. d. all of the above e. a. and b. only Difficulty: 3 Page-Reference: 320-321 Answer: d. all of the above.

15.0. When experiencing a death in the family, it is often more difficult for family members to accept a child's response when it involves: a. anger. b. sadness. c. frustration. d. confusion. Difficulty: 2 Page-Reference: 323 Answer: a. anger.

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16.0. Children who are dealing with bereavement due to the loss of a parent: a. tend to be more aggressive. b. show a higher frequency of delinquent and criminal behavior. c. tend to be over-achievers. d. all of the above Difficulty: 3 Page-Reference: 323 Answer: b. show a higher frequency of delinquent behavior.

17.0. Post-traumatic stress disorder (PTSD) in children is often expressed by: a. difficulties in establishing friendships. b. difficulty paying attention. c. difficulties in concentrating. d. all of the above Difficulty: 2 Page-Reference: 324 Answer: d. all of the above

18.0. For girls who lost their mother during childhood, the long-term effects of bereavement are more likely to include: a. As mothers, such women showed symptoms of depression, worried about their own deaths, were overprotective, and were perfectionists. b. These women often proved to be effective mothers themselves despite the impact of the loss of a mother during childhood. c. These women were more likely not to have children themselves out of fear that their own children would be more likely to have to deal with possible loss of a parent during childhood. d. a. and b. only Difficulty: 3 Page-Reference: 325 Answer: d. a. and b. only

19.0. Based on his own childhood experience with the loss of a parent, Charles Darwin: a. remained steadfast in his belief in life after death despite his own research and theories. b. devoted his last studies to the possibility of reincarnation. c. developed a keen interest in the evolution and survival of life forms. d. lived with an intense fear of growing old. Difficulty: 2 Page Reference: 325 Answer: c. developed a keen interest in the evolution and survival of life forms.

20.0. Which of the following is NOT recommended as advisable when considering the involvement of children in a funeral? a. Suggestions should be solicited from children about how the funeral may be structured. b. Children should be included in the family interactions surrounding the funeral. c. Children should be required to attend, as they may regret not attending later in life. d. Children should be acknowledged as legitimate mourners. Difficulty: 2 Page-Reference: 326 Answer: c. Children should be required to attend, as they may regret not attending later in life.

21.0. When considering strategies for helping children to cope with bereavement, which of the following WOULD NOT be considered as advisable? a. Develop and maintain an open communication pattern.

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum b. Avoid direct discussion of what the child may be thinking and feeling about the death. c. Provide continuing reassurance that there will always be someone to love and look after the child. d. If a therapeutic intervention is needed, consider both individual and group counseling as possibilities, depending on the circumstances and the individual child. Difficulty: 3 Page-Reference: 325-327 Answer: b. Avoid direct discussion of what the child may be thinking and feeling about the death.

22.0. In her studies of terminally ill children, Bluebond-Langner found that they tended to move through five stages in the acquisition of information. The first stage can best be described by the statement: a. "I know this won't go on forever." b. "I am not really sick. This is a mistake or a bad dream." c. "I have a serious illness." d. "The medicines don't work all the time." Difficulty: 1 Page-Reference: 328 Answer: c. "I have a serious illness."

23.0. The episode of the terminally ill three-year-old boy and stuffed duck toy he played with each time he was hospitalized suggests that: a. very young children can understand death more acutely than adults would like to believe. b. magical thinking keeps very young children from recognizing that they can die. c. young children withdraw and become profoundly depressed when they become aware of their impending death. d. none of the above Difficulty: 1 Page-Reference: 328 Answer: a. very young children can understand death more acutely than adults would like to believe.

24.0. It is recommended that dying children be given: a. the opportunity to express their concerns through any modality that is natural and effective for them. b. confirmation that they are still normal and valuable people. c. assurance that they will not be abandoned. d. all of the above Difficulty: 1 Page-Reference: 329 Answer: d. all of the above

25.0. Often dying children fear that: a. they will not make it into heaven. b. their siblings will not get significant attention once they are gone. c. they will not be a part of what will happen in the family when they are gone. d. the memory of them will not be an adequate depiction of who they were. e. all of the above Difficulty: 2 Page-Reference: 329 Answer: c. they will not be a part of what will happen in the family when they are gone.

26.0. Which of the following is NOT typical of the experiences of SIBLINGS of dying children?

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum a. receiving too much attention from their parents to compensate for time given to their dying sibling b. confusion about what role they are supposed to play in the family c. feelings of guilt and ambivalence d. uncertainty about the future Difficulty: 2 Page-Reference: 330 Answer: a. receiving too much attention from their parents to compensate for time given to their dying sibling

27.0. According to Papadatou, nurses and physicians whom commonly work with terminally ill children experience a condition known as “the wounded healer.” This condition is considered to be a form of: a. burnout. b. disenfranchised grief. c. compassion fatigue. d. death anxiety. Difficulty: 3 Page-Reference: 330 Answer: b. disenfranchised grief.

28.0. Which of the following is NOT one of the recommended ways of approaching a child who has concerns about his or her own impending death? a. Use simple and direct language. b. Help the child remain secure as part of the family. c. Convey a sense of urgency about the need for the child's responses to be immediate. d. Be a good observer. Difficulty: 2 Page-Reference: 331-332 Answer: c. Convey a sense of urgency about the need for the child's responses to be immediate.

29.0. One complication parents experience as a result of their attempts to keep the relationship with their dying child alive is that of: a. misunderstanding the medical condition afflicting their child. b. difficulties with being open to learning about the dying child’s own responses to death. c. being consumed by their own feelings about the child's impending death. d. none of the above. Difficulty: 2 Page-Reference: 332 Answer: b. difficulties with being open to learning about the dying child’s own responses to death.

30.0. The concept of a legally "competent child" with the right to make decisions about his or her own health care has been: a. affirmed by major court decisions. b. affirmed by legislation in several states. c. neither a. nor b. since children, as a class, are not considered to be competent. d. both a. and b Difficulty: 2 Page-Reference: 332 Answer: c. neither a. nor b. since children, as a class, are not considered to be competent.

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum True/False

1.0. Children are seldom given the opportunity to participate in open discussions on death-related topics because families tend to follow the rule of silence. a. true b. false Difficulty: 1 Page-Reference: 305 Answer: a. true

2.0. Studies indicate that college students have very little recollection of their childhood experiences with death. a. true b. false Difficulty: 1 Page-Reference: 306 Answer: b. false

3.0. Historical observations strongly suggest that concern with death is a recent theme in children's play. a. true b. false Difficulty: 1 Page-Reference: 307 Answer: b. false

4.0. The research case history sample provided was based on structured interviews with the mothers of schoolchildren because the fathers declined to discuss this subject. a. true b. false Difficulty: 1 Page-Reference: 313 Answer: a. true

5.0. In her research on the stages of death comprehension in childhood, Nagy found that children in Stage 1, from 3 to 5 years old, have not yet learned to attribute negative emotions to death, and so death does not arouse anxiety for these children. a. true b. false Difficulty: 2 Page-Reference: 314 Answer: b. false

6.0. There seems to be a tendency for children in America today to move through the stages at an earlier age than the children studied by Nagy. a. true b. false Difficulty: 2 Page-Reference: 316 Answer: a. true

7.0. Kenyon (2001) found that children with superior intellectual ability and verbal ability tend to rationalize more than other children and as a result, are more likely to develop a less sophisticated death concept.

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum a. true b. false Difficulty: 2 Page-Reference: 317 Answer: b. false

8.0. Stranger anxiety is a factor in younger children's understanding and response to death. a. true b. false Difficulty: 2 Page-Reference: 318 Answer: b. false

9.0. Older children focus more on their own possible death than younger children. a. true b. false Difficulty: 2 Page-Reference: 318 Answer: a. true

10.0. In both American and Japanese cultures, life and death are viewed as categories that need to be kept separate rather than as part of a broader totality that also includes the afterlife. a. true b. false Difficulty: 3 Page-Reference: 319 Answer: b. false

11.0. The realization that death is universal and inevitable seems to be grasped at an earlier age by Muslim children. a. true b. false Difficulty: 2 Page-Reference: 319 Answer: a. true

12.0. Kastenbaum's research shows that some children allow their imaginary friends to die as a way to explore grief and bereavement. a. true b. false Difficulty: 2 Page-Reference: 321 Answer: a. true

13.0. Children are too young to experience post-traumatic stress disorder (PTSD). a. true b. false Difficulty: 2 Page-Reference: 324 Answer: b. false

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum 14.0. Major physical illnesses occur more often in the adult lives of those who were bereaved as children. a. true b. false Difficulty: 2 Page-Reference: 325 Answer: a. true

15.0. Mental illnesses occur more often in the adult lives of those who were bereaved as children. a. true b. false Difficulty: 2 Page-Reference: 325 Answer: a. true

16.0. Bluebond-Langner found that seriously ill young children paid little attention to the hospital routines or the staff and knew very little about their treatment regiments. a. true b. false Difficulty: 2 Page-Reference: 328 Answer: b. false

17.0. According to Bluebond-Langer's research, some well siblings were concerned about being "assistant parents." a. true b. false Difficulty: 2 Page-Reference: 330 Answer: a. true

18.0. Padadatou believes that the medical profession’s traditional emphasis on diagnosis and treatment of disease is what has led to a better understanding of how to treat dying children. a. true b. false Difficulty: 3 Page-Reference: 331 Answer: b. false

19.0. Papadatou found that the best support systems for pediatric nurses who work with terminally ill children are friends and family. a. true b. false Difficulty: 2 Page-Reference: 331 Answer: b. false

20.0. The National Commission for Protection of Human Subjects of Biomedical and Behavioral Research has proposed that by age seven a child should be given the opportunity to accept or reject participation in a research project. a. true b. false

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum Difficulty: 2 Page-Reference: 331 Answer: a. true

Vocabulary

1.0. bereavement Difficulty: 1 Answer: The loss of a loved one through death.

2.0. cystic fibrosis Difficulty: 2 Answer: A hereditary, life-threatening disorder in which lungs and other organ systems are blocked by abnormal mucus secretions. A life-threatening condition.

3.0. death anxiety Difficulty: 2 Answer: Emotional distress and insecurity aroused by encounters with dead bodies, grieving people, or other reminders of mortality, including one's own thoughts.

4.0. imaginary companion Difficulty: 2 Answer: A "pretend friend" that is real to the child but does not exist in objective reality.

5.0. Inochi Difficulty: 2 Answer: (Japanese) Life, as a gift from God to the embryo.

6.0. leukemia Difficulty: 2 Answer: A progressive disease that produces distorted and dysfunctional white blood cells, increasing susceptibility to infection, bleeding, and anemia. Sometimes a life-threatening disease.

7.0. neonatologist Difficulty: 2 Answer: Health care professional who work with newborn infants.

8.0. personification Difficulty: 1 Answer: Representing an idea or feeling as a human or humanlike form.

9.0. plague Difficulty: 1 Answer: A virulent contagion that resulted in the deaths of at least one fourth of the population in the late fourteenth century and that is generally considered to have been bubonic disease, carried by rats and fleas as well as stricken humans. Also known as "The Black Death."

10.0. post-traumatic stress disorder Difficulty: 2 Answer: A delayed response to a death that has occurred under highly stressful conditions. The traumatic event is re-experienced repeatedly, and other disturbances of feeling, thought, and behavior are also likely to occur

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum 11.0. separation anxiety Difficulty: 2 Answer: Emotional distress and insecurity aroused by loss of contact with a valued and protective person (also observed in animal behavior).

Essay Questions

1.0. Provide two examples of ways in which early experiences with death in childhood can affect one’s current experiences as an adult, and explain how reflection on these experiences could provide valuable insight into current feelings and/or behaviors. Difficulty: 3 Answer: One of America's first distinguished psychologists, G. Stanley Hall (1922) and his student, Colin Scott, asked adults to recall their earliest experiences with death and found that these childhood experiences were recalled in vivid detail. Funeral and burial scenes often were the very earliest of all memories.

More recent studies have also found death experiences to be common among adults’ earliest memories. For example, an Italian-American butcher shared his earliest memory with death that involved lots of crying, but more importantly the memory of being expected to give his dead grandmother a kiss. He could still recall her face and feel her cold, dead face against his lips. Although this man was the owner and chief butcher of a specialty meat shop, he experienced panic when he was in the presence of a human corpse. The early childhood experience with death had somehow become part of his adult personality. In other research, it was determined that among older adults the earliest childhood memories went back sixty years and sometimes more than eighty years. More than one person in three reported an earliest memory that conveyed some encounter with death, loss, or separation such as "the green chair nobody sat in any more" or the horse pulling a cart that was shot in public after an accident.

Another example from a college student involved gift-giving at Easter. Each Easter this student would receive ducks and chickens as a present and would enjoy watching them grow into adults. One Sunday dinner the main course was fried chicken, and after several minutes passed, the student realized just what had happened. He was devastated and to this day, this student will not eat chicken.

In a follow-up study, Dickinson (1992) found that college students still had intense memories of their early childhood experiences with death. Some were angry or even had continued hatred toward a parent who had killed a pet, even if they had accidentally done so. These students often felt that the explanations their parents gave them in childhood were unsatisfactory. Most often the children had been told that a deceased person had gone to heaven. Some had been reassured because heaven was said to be a happy place. One 4-year-old girl, however, became upset when her father told her that her kitten "went to heaven to be with God." She responded: "Why does God want a dead kitten?" Not only are young children affected by death-related events, but they may recall these experiences with intense emotions many years later.

2.0. Describe one of the children's games discussed in the text with an emphasis on the death theme within the game. Difficulty: 3 Answer: Ring Around the Rosie - popular during peak years of the plague in fourteenth-century Europe. The “rosies” referred both to a symptom of the disease and the flower petals that people hoped would protect them. Dead Man Arise - many versions. In Sicily, one child laid down pretending to be dead while others sang around him or her and occasionally grabbed a leg or an arm to determine if the child was

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum dead. Then suddenly the child playing dead would jump up and attempt to mount the back of another child. It - In tag games, "it" did not peek or move while other players concealed themselves. Getting tagged instantly transformed one from lively participant to death personified. Cops and Robbers - children armed themselves with toys or imaginary weapons of choice and enacted the roles of killer and slain.

3.0. List three themes identified in the research case histories derived from structured interviews with mothers of schoolchildren. Difficulty: 3 Answer:  It is the death of particular people or animals that enlists the child's concern  Death-related experiences, attitudes and behaviors are part of the intimate flow of life between children and their parents.  There may be several different orientations toward death within the same household.  Parents whose own discomfort interferes with their responses to their children's death-related curiosity are likely to perpetuate these anxieties for another generation.  There is now a transitional generation of parents who are trying to communicate in an open manner with their children.

4.0. Summarize the progression of understanding as children move through Nagy's three stages. Discuss the usefulness of these findings given that more recent studies have been conducted. Difficulty: 3 Answer: Nagy identified the basic components that children must address in order to comprehend death as the following: inevitability, non-reversibility, universality, and personal inclusion ("I will die, too"). Later studies added cessation and causation. Children come to understand that in death the body no longer can perform its functions (cessation), and that it is this loss of function that results in death (causation). Children do not address each of these components all at once, but, rather, progress through a series of age-related stages as follows:

Stage 1 - Children ages 3-5 view death as being less alive. Death represents separation and the combination of what the child knows and does not know can arouse anxiety. Children are very curious and full of questions. Stage 2 - Children ages 5-9 view death as being final. Many children personified death. However, children tended to understand death as an outside force that could possibly be avoided, if the child were cautious. Stage 3 - Children ages 9 or 10 now understand that death is personal, universal, and inevitable as well as final. This new awareness is compatible with belief in some form of afterlife. There is general agreement that basic understanding of death is usually achieved by about age 9 or 10.

Nagy's findings remain useful today, although according to more recent studies, the tendency for children between ages 5 and 9 to personify death seems to have diminished greatly. Perhaps this is a change wrought by current children’s exposure to mass media and high technology. There also seems to be a tendency for children in America today to move through the stages at an earlier age than what was found by Nagy. It is also probable, as Deveau has suggested, that the stages are not absolute and fixed, but, rather, represent temporary "resting places" in the child's continuing attempt to come to terms with death both cognitively and emotionally.

5.0. Discuss post-traumatic stress disorder (PTSD). Include in your discussion a definition of PTSD, brief background on its development, factors that can lead to its development in children, and the impact that events such as the Oklahoma City bombing and September 11th terrorist attacks have had on children.

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum Difficulty: 3 Answer: PTSD results when an individual experiences a delayed emotional response to a sudden, unexpected death. The traumatic event is re-experienced repeatedly and leads to other disturbances of feeling, thought, and behavior. This impact influences both children and adults and can be further intensified by threatening features of the death--for example, a drive-by shooting, a suicide, or mutilation of the corpse in an accident. During episodes, the individual behaves in seemingly irrational, bizarre, and perhaps dangerous ways-not at all in keeping with his or her previous personality. These episodes often are frightening to family, friends, and the individual experiencing them. A person comes through extremely stressful situations and at a later time, suffers "flashbacks of the experience.

Today, there is more professional and public awareness of the syndrome that was officially recognized as a diagnostic entity in 1980. It became salient during the Vietnam War, and again currently in people serving in Afghanistan or Iraq. Until recently, the recognition of PTSD in children who have experienced traumatic bereavements or other encounters with death was somewhat overlooked or underestimated. Fortunately, our attitudes have changed, and now, some teachers and school systems have already developed programs and techniques for reaching out to children who have been exposed to traumatic death.

Children with PTSD are more likely than others to have difficulty paying attention, concentrating, and making and keeping friends. Such a dysfunctional pattern is especially harmful in childhood, when so many basic personal and interpersonal skills are being developed. The child with PTSD is also likely to be frightened, especially as a result of dreaming.

In recent years, it has become evident that children are vulnerable to PTSD as a result of terrorist attacks. Children who had lost a friend or acquaintance in the 1995 Oklahoma City bombing of a federal office building had PTSD symptoms and also watched more television coverage of the disaster. Even children who did not know any of the victims experienced distress and disturbance, though not to the same extent. The 9/11 attack at the World Trade Center affected many children in the New York City area. Nearly one child in five suffered a severe or very severe reaction. Anxiety and depression continue in body as well as mind, Children can be helped to overcome PTSD, but first we must be observant enough to recognize their distress and its possible connection to a disturbing death-related experience. Family counseling and therapy has proven useful for some of these suffering children.

6.0. List four general strategies that Kastenbaum recommends can be utilized to help children cope with bereavement. Difficulty: 3 Answer:  Develop and maintain an open communication pattern with children.  Give children the opportunity to decide about attending the funeral.  Check out what the child is thinking and feeling - do not assume that we know what death means to him or her.  Encourage the expression of feelings.  Provide convincing assurance that there will always be somebody to love and look after the child.  Professional counseling should be considered if the bereaved children are at special risk.  Consider the option of a therapeutic group experience to help bereaved children work through their grief and fear.

7.0. Describe the five stages in the acquisition of information that children with terminal illness move through. Difficulty: 3

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum Answer: 1. I have a serious illness. 2. I know what drugs I am receiving and what they are supposed to do. 3. I know the relationship between my symptoms and the kind of treatment I am getting. 4. I realize now that I am going through a cycle of feeling worse, getting better, then getting worse again. The medicines don't work all the time. 5. I know that this won't go on forever. There's an end to the remissions and the relapses and to the kind of medicine they have for me. When the drugs stop working, I will die pretty soon.

8.0. In addition to the medical, nursing, and support services needed by dying children, emotional and psychological aspects also need to be addressed. Drawing from the information provided in the text, identify three strategies for addressing these needs and provide concrete examples of techniques that can be used to implement each strategy. Difficulty: 3 Answer: Strategy: Provide the opportunity to express their concerns. Examples of techniques: Conversation, play, drawing, modeling clay figures, writing, shared reading – whatever modality is most effective for each child Strategy: Confirm that they are still normal and valuable people, regardless of the impairments and limitations imposed by illness. Examples of techniques: Find ways to strengthen the child’s basis sense of self through involving the child in household activities, plans, and decision-making. One 10-year-old boy, for example, taught his younger sibling how to play chess while he was dying, while another ten-year-old girl kept the statistics and figured the batting averages for her softball team after she herself could no longer play. Strategy: Provide assurance that family members and other important people will not abandon the dying child, no matter what happens. Examples of techniques: Nonverbal behavior is a vital component of interaction that can either affirm or undermine the family’s words of assurance. By their everyday interactions, parents and other caregivers must continue to convey their dedication to the dying child, come what may. Strategy: Reassure the dying child that s/he will never be forgotten. Examples of techniques: In some situations, it may be useful to use mental imaginary exercises to help the child prepare for impending separation and to participate in the future through imagination. Some children may also come up with their own ways of feeling a part of the future. For example, some children may wish to give some favorite toys to a sibling or friend, or to make a video that can be watched on birthdays or other special occasions.

9.0. Provide five guidelines that can be utilized to address a child’s death concerns. For each guideline, give an example of how this guideline might be effectively addressed. Difficulty: 3 Answer: Be a good observer - Notice how the child is behaving. Listen to what he or she is really saying. Do not rush in with explanations, reassurances, or diversions unless there is some overriding necessity to do so. You will be more helpful to the child if you are relaxed, patient, and attentive enough to learn what needs the child actually is expressing rather than those you might assume to be there. For example, the child who suddenly asks a parent, "Are you going to be dead?" might have been thinking about something Grandmother said last week or any number of other happenings that aroused this concern. Taking a moment to learn how this question arose in the child's mind could also help to provide time to think through an appropriate response. Do not wait or plan for "one big tell-all" - Maintain a continuing dialogue with the children in your life as occasions present themselves. The death of pets, scenes in movies, newspaper articles, or television programs - whatever brushes with mortality the children have - all can offer the opportunity for discussion. This does not mean, of course, that parents should remain poised to

full file at http://testbankeasy.com Full file at http://testbankeasy.eu/Test-bank-for-Death,-Society-and-Human- Experience,-11th-Edition---Kastenbaum jump on a death dialogue opportunity. It is more natural and effective to include death as one of the many topics that adults and children can discuss together. Do not expect all of the child's responses to be obvious and immediate - When a death has occurred or is impending, the child's total response is likely to unfold over time and to express itself in many ways. Changes in sleeping habits, mood, relationships with other children, and demands on adults may reflect part of the child's reaction to the death, even though the connection may not be obvious. Be patient; be available. Help the child remain secure as part of the family - Sometimes adults have the panicked impulse to remove children from the scene when death has come too close (e.g., sending them off to a relative or neighbor). Examine such impulses before acting on them. Consider what children might learn from the opportunity to participate in the family's response and what lingering questions, misinterpretations, and fears might remain if they are excluded. Use simple and direct language - Too often what adults say to children becomes a sermon, peppered with words and concepts that mean little to them. Provide children with accurate information. See if they understand what you have said (e.g., by having them explain it back to you) and make sure that you have responded to what they really wanted to know in the first place. Be accessible - The child's sense of comfort will be strengthened by the very fact that you are available to talk about death when the need arises. Your expression of feelings that are natural to the situation (worry, sorrow, perhaps even anger) are not likely to harm the child but rather will provide a basis for sorting out and expressing his or her own feelings. Be aware of all the children in the family – While it is natural to concentrate the family's resources and attentions on the seriously ill child, other children in the family continue to need love and reassurance. and to participate somehow in the total process. Keep the relationship going - How a life-threatened child responds at a particular moment might be disturbing to parents and other adults. We do not want to see or hear certain responses. Losing the closeness and support of important adults is a great danger to the child. This, in fact, is one of the reasons why children may not share their thoughts and feelings with us. At the same time, it is important for the child to know that we do not have to approve or agree with everything s/he tells us about death and for us to remember that we want to maintain a supportive relationship with that child.

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