Transcript Bereavement Support Services for Children and Young People www

The impact of Grief on
children and young people
with SEND
4th February 2013
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Housekeeping
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Aims
•To consider the general bereavement needs of SEND
children
•To consider specific issues for various types of SEND
•To build confidence to support bereaved C&YP with SEND
•To develop and enhance existing skills
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Introductions
1. Why have you come today?
2. What do you hope to get out of the workshop?
3. What is your involvement with C&YP and families
with SEND?
4. What do you feel you can bring and contribute to
the workshop?
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Core Principles
‘All children and young people, regardless of their
circumstances, have a right to have their grief
recognised, hear the trust, and to be given
opportunities to express their feelings and emotions.’
Child Bereavement Trust
‘Children with learning difficulties do not exist in isolation. They have the
same need for understanding, love and support in times of crisis as any
child. They are not separate from the world and its effects. Their needs,
however, can appear so overwhelming that caring families and
professionals can them elves feel disabled.’
Judy Sanderson, Interventions with bereaved children, 1998
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Special Educational Needs or Disabilities
(SEND)
•Regardless of age, some people have needs or
disabilities that affect their ability to learn or
function in life.
For example:
•Behavioural/social/communication
•Reading and writing
•Understanding things
•Concentrating
•Physical needs or impairments
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Recognising the context
Some children have difficulties in more than one are of
SEN or disability
Some children have greater levels of SEN than others:
•Moderate
•Severe
•Profound
Some children have parents or carers who also have
some level of SEN or disability
Not all children have a formal diagnosis or recognition
of the SEN
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Considering their viewpoint
All grieving children have individual stories and response
that can be influenced by:
•Family background and circumstances
•Nature and circumstances of death
•Level of knowledge about death and family beliefs
•Individual ability to process and understand
information
•Difficulties in recognising emotional states in
themselves and others
•Difficulties in processing information
•Physical illness or life limiting conditions
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Understanding death and dying
Young people quickly pick up on our anxieties, spoken
and unspoken.
What is your understanding of what happens in death
and dying?
What are your concerns about working with bereaved
SEND children?
Can you find more than 1 way to explain this to the
person sitting next to you?
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Children’s Bereavement needs
All children and young people have a need to:
•Understand what has happened
•Understand the permanence of death
•Express emotions
•Remember the deceased in meaningful ways
•Develop ways to manage the negative aspects of
grieving
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Barriers to communication and understanding
Children with learning difficulties are sometimes assumed to
need protection from death and dying more than most or not
have the capacity to understand.
We underestimate their ability to cope with the difficult
things in life.
They need us to be able to be:
•Honest and clear in our explanations.
•Pay attention to the language we use.
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Communicating truthfully
Where the family allows:
•Tell them the truth about what has happened
•Use ‘real words’ like dead or died – not euphemism
such as ‘lost’
•Be prepared to use drawings and pictures, timelines,
flow charts to help them understand what is happening
•Use as many real life examples as possible .... Pictures,
photos.
•Get them to tell you what they think is happening.
•Check out their understanding.
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Understanding death
All children struggle with the concept of death and its
permanence.
Children with learning difficulties may find this
particularly difficult to grasp, especially the permanence,
and benefit from simple, practical examples to illustrate
the difference between dead and living things.
Activity: Can you think of any?
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Suggestions
•Buy a bunch of flowers, put them in a vase and observe them wilt, wither
and die. Compare a fresh bunch of the same type. If kept, the dead
flowers will illustrate that death is permanent, the flowers do not return
to life.
•Purchase a dead fish from the supermarket and compare it to a live one.
Even when put into a bowl of water the dead one will not move, breathe,
eat or swim.
•Give the dead fish a burial that replication as far as possible a real one.
Explain a cremation by burning leaves and mixing the resulting ashes with
some earth.
•Take photographs of the above and put into a book. This will act as a
visual reminder of the many times when the explanation will need to be
repeated.
Child Bereavement Trust
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Understanding what happened
Think about a young person with SEND that you have
contact with.
How do they understand new information?
What of things help support this understanding?
e.g. Use of symbols, key words
Activity: How could you adapt their strategies to help
them understand what happened?
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Suggestions
•Make it visual and concrete
•‘What happened’ story line/storyboard
•Before, during, after activity
•Make it into a story
•Act it out with models/toys/puppets
•Build knowledge up in layers to aid understanding’
,scaffold,
•Allow time to revisit frequently and ask same
questions
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Comfort Break
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Impact of SEND on C&YP’s
grief
4th February 2013
Part 2
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
RECAP
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Making sense of their story
All children and young people have a need to answer key questions
about the bereavement such as:
•How do we die? Why do we die?
•What/who makes us die?
•Can I make someone die?
•Did it hurt? What did it feel like?
•Why couldn’t someone help?
•What about me?
•Where are they now?
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Making sense cont....
They also have questions such as:
•Are they (the deceased) angry with me?
•Who else will die ... How will I know?
•Why am I feeling like this?
•How will I remember them?
•Why will no-one listen to me now.....?
•Am I the only one feeling like this?
•Will I make it worse by upsetting them (family)?
•When will it end?
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Expressing emotions
Children do not need protection from the feelings and
emotions associated with grief
They need support to recognise them, in themselves and
others and help in expressing them safely.
They need reassurance that these sometimes powerful and
overwhelming emotions are normal and necessary.
This is even more the case for children with SEND.
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Expressing emotions
Be prepared to ‘teach’ or ‘model’ the emotions associated
with grief for instance by using:
•Stories, videos or others who are grieving
•Worksheets to help reinforce and give visual record
•Emotion card games to help recognition
•Puppets to act out and model reactions
•Paint and clay etc for free expression
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
For example..........
Talk in pairs – what would you use?
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Remembering the dead person
All bereaved people have a need to make meaningful
memories of the deceased.
Many young people with SEND have difficulties with
concentration and memory recall.
What is your understanding of the ability to recall
information easily or accurately of the young person you
work with?
What particular issues do you think this may cause the young
people you work with?
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Making enduring memories
SEND C&YP will often need additional help to place the memory
in context and to have associated sensory memories validated not
just cognitive ones.
Smells, colours and sounds can all strengthen the memory trace
and aid subsequent recall.
SEND C&YP will often need more memory prompts:
•Shiny stone for good/happy memory
•Smooth but plain stone for ‘ordinary memory’ – person doing
something routine perhaps
•Black or rough stone for difficult memory
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Tough or ‘tricky’ memories
Many C&YP with or without SEND will want to avoid unpleasant
memories.
They will extra explanation about what happens to our bodies
when we think about things that we don’t like or are frightened
of.
They will also need good simple appropriate explanations for
what was happening in the bad memory- e.g. Memories about
hospital visits or the way the person changed during their illness.
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Bringing it all together........
Thinking again of a young person with SEND that
you have contact with:
How would you plan to support them now?
Where would you begin?
What might you need to do, who might you
need to speak to first?
What types of activities might you use?
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Bringing it all together............
When talking about death and bereavement with a child with
SEND it might be helpful to consider:WHO should be the key worker working with this child and family
– inform parents who this person will be and keep in contact.
WHERE is the child most receptive to new ideas?- Quiet room,
pool, outside.
Use this space for talking with the child.
WHAT should be talked about? ( as agreed with parents)
Ensure that you use the same language and ideas as the family to
avoid confusing the child.
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
HOW is new information normally given? (signs, symbols,
verbally, pictures). Use the same format to talk about illness
and death.
HOW is new information normally backed up? –You will
probably need to repeat information a number of times over a
long period.
PROCEED at a level, speed and language appropriate to the
child.
BUILD on information given – small bites of the whole, given
gradually will be easier to absorb.
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
REPEAT information as often as needed.
WATCH for reactions to show the child understands –
modify and repeat as needed.
FOLLOW child’s lead- if indicating a need to talk or have
feelings acknowledged, encourage as appropriate.
WATCH for changes in behaviour to indicate the child is
struggling more than they can say and offer support as
needed.
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
LIAISE with other agencies involved with the
child to ensure accuracy and continuity if
information.
REFRESH your understanding of the extent
or nature of the SEND.
SEEK advice if you feel that the child or
young person is not pr0gressing or is giving
cause for concern in new behaviours that
persist over time.
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk
Wrap up
Questions?
Bereavement Support Services for Children and
Young People
www.talktostars.org.uk