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Old 07-14-2011
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Psyche Progress of Child's Concept of Death

This isn't in First Aid, but I got a question on it in the free 150 usmle questions.
From medline:

Death should be discussed honestly and in language that children can understand at their stage of development. A child's concept of death varies with age, and this must be taken into consideration.
Age 0 - 2 years:
  • Sees death as separation or abandonment
  • Has no cognitive understanding of death
  • Feels despair from disruption of caretaking
Age 2 - 6 years:
  • Often believes that death is reversible, temporary
  • May perceive death as a punishment
  • Engages in magical thinking that wishes come true -- may feel guilt for negative feelings toward the person who died, and think that was the cause of death
Age 6 - 11 years:
  • Shows gradual understanding of irreversibility and finality of death
  • Demonstrates concrete reasoning with ability to comprehend cause and effect relationship
Age 11 years or older:
  • Understands that death is irreversible, universal, and inevitable
  • Has abstract and philosophical thinking
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Old 10-08-2011
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right... but the NBME didn't get the memo about the understanding of finality being a gradual process extending from 6 to 11 years, right?
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Behavioral-Sciences-, Pediatrics-

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