Most children are too busy growing, playing, and exploring life to be much concerned about death, but their conceptions of it change as they get older. Some psychologists believe that children's conceptions of death begin forming in the first year of life, when the child becomes aware of absence, departure, and separation from people and things (Pattison, 1977). According to Wass and Stillion (1988), separation anxiety is closely related to death anxiety in young children and is the forerunner of fears of death in adulthood. Stimulated by Jean Piaget's conception of stages in cognitive development of children, Nagy (1948) observed and interviewed several hundred Hungarian children and then proposed a three-stage theory of the development of children's ideas about death. According to Nagy, children in the first stage (ages 3-5) do not distinguish between death and separation, and view death as a temporary departure or sleep. Children in the second stage (ages 5-91, which is parallel to Piaget's period of concrete operations, conceive of death as something that happens to old people, irreversible but avoidable. At this stage, death is personified as someone who mutilates people and carries them away. By the third stage (ages 9+), children have developed a more realistic, adultlike view of death and see it as inevitable, universal, and irreversible.
Some of Nagy's conclusions, for example, that appreciation of the finality and universality of death is related to chronological age, have been confirmed by later research, but nationality, cultural, and social-class differences also affect a child's conceptions of death. Bluebond-Langner's (1977, 1978) research with terminally ill children indicates that, rather than being restricted to a specific chronological age range, all views of death are present at every stage of development. In any event, the presence and support of people with whom they are familiar helps children cope with their fears of death.
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