Citation
Children's attitudes toward death

Material Information

Title:
Children's attitudes toward death
Creator:
Engel, Bonnie Andersen, 1946-
Publication Date:
Language:
English
Physical Description:
viii, 109 leaves : ; 28 cm.

Subjects

Subjects / Keywords:
Anxiety ( jstor )
Attitudes toward death ( jstor )
Child psychology ( jstor )
Children ( jstor )
Death ( jstor )
Diseases ( jstor )
Fear ( jstor )
Parents ( jstor )
Pets ( jstor )
Psychological attitudes ( jstor )
Children and death ( lcsh )
Death ( lcsh )
Genre:
bibliography ( marcgt )
non-fiction ( marcgt )

Notes

Thesis:
Thesis (Ph. D.)--University of Florida, 1981.
Bibliography:
Includes bibliographical references (leaves 100-107).
General Note:
Typescript.
General Note:
Vita.
Statement of Responsibility:
by Bonnie Andersen Engel.

Record Information

Source Institution:
University of Florida
Holding Location:
University of Florida
Rights Management:
Copyright [name of dissertation author]. Permission granted to the University of Florida to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
Resource Identifier:
07846425 ( OCLC )
ocm07846425
00295104 ( ALEPH )

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Full Text















CHILDREN'S ATTITUDES TOWARD DEATH


BY

BONNIE ANDERSEN ENGEL









A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL
OF THE UNIVERSITY OF FLORIDA IN
PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR
THE DEGREE OF DOCTOR OF PHILOSOPHY


UNIVERSITY OF FLORIDA


1981




























Copyright 1981

by

Bonnie Andersen Engel




























The energy and form of this

dissertation are dedicated to Ram.












ACKNOWLEDGMENTS


Warm appreciation is expressed

to Dr. Janet Larsen, committee chairperson,

Dr. Larry Loesch,

Dr. Michael Resnick, and

Dr. William Brievogel

for their unending support and guidance;

to Cathy, Carl, Jo Dolley, Bob A., Jim E., Henry, Geraldine, Lee,

Linda, Don, and Frank.

for their abundance of encouragement;

to my parents and professors

for providing the firm foundation of both vision and

determination;

to Mickey Singer and Amrit

for reminding me of love, perfection, and clarity of

perspective;

to the fourth and fifth grade students, their parents and teachers,

Mr. Glanzer and Mrs Marcos, assistant principals, and especially

Dr. Lee Rowell of Marion County Public Schools

for so willingly participating in this research endeavor;

to Leila Cantara

for excellence in typing services and warm sensitivity in

the fragile finalities.
















TABLE OF CONTENTS



ACKNOWLEDGMENTS . . .. iv

ABSTRACT .. . . vii

CHAPTER I

INTRODUCTION . . 1

Background . . .. .. 1.
Need for the Study . ........ 7
Purpose ... . .. 9
Rationale . . . 10
Definition of Terms . . 11

CHAPTER II

REVIEW OF RELATED LITERATURE . .. 13

Children's Concepts of Death From a Developmental View 13
The Influence of Various Factors Concerning Children's
Concepts of Death .. .......... 29
Children's Attitudes Toward Death ....... ... 34
Research Concerning Suicide and Children . 39

CHAPTER III

METHODOLOGY . . 44

Sample Selection . . .. 44
Procedure. . .. 46
Data Collection . . 47
Nature of the Data . . .. 48
Data Analysis . . 49
Validity . . . 50
Reliability . . 51
Methodological Limitations . .. 52

CHAPTER IV

RESULTS . . 53

Sampling Procedure . . .. 53










Demographic Data . .. 54
Questions Related to Children's Concepts of Death 56
Questions Related to Children's Attitudes Toward Death 59
Denial . . ... ...... .59
Fear . .... ....... .61
Anxiety . . .. 61
Acceptance . . 62
Comparison of Attitudes Within Personal Death,
Impersonal Death, and the Environment of Death 62
Differential Trends Relative to Sex, Grade, School, GPA,
and Retention . . 63
Influences of Ethnic, Social, and Familial Characteris-
tics . . . 71
Differential Trends Relative to Ownership and
Acquaintance with the Death of a Pet ... .72
Interview Closure Activities . ... 76
Clinical Impressions . .... 79

CHAPTER V

DISCUSSION . ... 82

Limitations Regarding Generalizability ... 82
Conclusions . . 83
Children's Concepts Concerning Causes of Death 83
Children's Views Concerning Conditions After Death 85
Children's Attitudes Toward Death ... 87
Implications . .... ... .88

APPENDIX A PARENT CONSENT . .... 92

B STRUCTURED INTERVIEW . ... .95

REFERENCES . . ... .. 100

BIOGRAPHICAL SKETCH . . .. 108















Abstract of Dissertation Presented to the Graduate
Council of the University of Florida in Partial Fulfillment of
the Requirements for the Degree of Doctor of Philosophy


CHILDREN'S ATTITUDES TOWARD DEATH

By

Bonnie Andersen Engel

June, 1981

Chairperson: Janet J. Larsen
Major Department: Counselor Education

The purpose of this dissertation was to assess and evaluate

normal children's concepts and attitudes toward death. The sample

for the study was composed of 35 fourth grade and 35 fifth grade

students attending one urban and one rural school. Each child

participated in individual structured interviews. Children's views

concerning the causes and events related to personal death (death

of self) and impersonal death (death of another) were explored.

There was also investigation of their attitudes of death denial,

fear, and anxiety; their acceptance regarding personal and impersonal

death; and their attitudes toward the environments of death.

The results indicated that these children viewed old age and

illness as the primary causes of death. Almost 80 percent of the

children expressed denial (i.e., aversion) regarding the environment










of death and personal. death. They also expressed anxiety concerning

impersonal death (e.g., death of a friend). Approximately half the

children expressed some fears relating to personal and impersonal

death. Psychological "acceptance" of personal and impersonal death

was expressed by approximately 65 percent of the children. A pre-

ponderance of children expressed a mixture of all the measured

attitudes of denial, fear, anxiety, and acceptance in regard to the

death of a friend. These attitudes were consistently expressed

significantly more concerning impersonal death as compared to

personal death. Forty percent expressed "acceptance" of the environ-

ment of death.

The results were also analyzed relative to sex, grade level,

urban-rural setting, grade point average, retention in grade, pet

ownership, and acquaintance with death of a pet. Approximately 15

percent more females than males consistently expressed fear and denial

of death. More rural children expressed denial of death than did

urban children. Also, significantly more urban children than rural

children expressed psychological acceptance of death. Children with

decreasing grade point averages expressed denial and anxiety of death

increasingly more often.

The results of this study indicate that normal children expressed

a wide variety of attitudes toward death. These were primarily

characterized as denial or acceptance. It was also noted that there

was relatively little fear and anxiety of death expressed by these

children.


viii















CHAPTER I

INTRODUCTION


Background


The view of children's attitudes toward death as a developmental

concept has received relatively little attention in the professional

literature. Only in the last ten years or so has the topic of

"death and dying" emerged as a significant area of research in the

scientific community and as a "visible" topic of interest in popular

literature. While there has been a rather sudden proliferation of

books and articles on death in response to the needs and interests

of adults, there has been very limited generation of material

addressing this area as it relates to children. A close scrutiny

of both professional and popular literature yields rather limited

information or guidance for parents or professionals concerning

children's concepts, views, or attitudes concerning death. Further,

little of the information has been based on scientific investigation,

as compared to the singular or collective opinions of professionals

in the varied fields of education, psychology, medicine, sociology,

anthropology, religion, and philosophy. Some authors (Fauquet, 1980;

Kubler-Ross, 1975; Moody, 1975; Wass, 1976) have asserted that the

topic of death has been characteristically ignored, denied, or evaded










in our society for a rather long period of time. However, interest in

this topic through bona fide scientific investigation has clearly

emerged. Moreover, serious researchers have become increasingly

aware of the opportunity to examine children's concepts and attitudes

toward death as a fundamental and significant area of inquiry and

clarification.

The first investigations concerning children's concepts of death

occurred approximately four decades ago. Although Schilder and

Wechsler (1934), Bender and Schilder (1937), and Anthony (1940)

presented articles mainly of case report and theoretical nature,

Maria Nagy (1948) pioneered the first comprehensive study of children's

views concerning the nature of death through individual interviews

with a large number of subjects (n = 378). Using adjusted formats

of written composition, drawing, and/or structured interviews, Nagy

assembled 484 protocols from Hungarian children 3 to 10 years of age

in Budapest, Hungary,and its environs. Nagy found evidence for

differential stages in children's understanding of death. Children

3 to 5 years of age generally denied death as a regular and final

process. They viewed it as a temporary state, with varying "degrees"

of death. The children were aware that they were alive, but they

also imagined that dead people were alive. Children 5 to 9 years of

age tended to personify death. Death was viewed as a person walking

around trying to catch people and carry them off. Children 9 to 10

years of age tended to view death as a permanent, inevitable,

irreversible, and internal process.










Rochlin (1959, 1965) later corraborated these findings with

American children 3 to 5 years of age. Rochlin (1965) theorized

that in response to their overwhelming fear of death, children

construct elaborate defenses such as the ideas of reversibility,

temporariness, and continuing existence in places like heaven or

hell.

Kastenbaum (1965) similarly interpreted the personification of

death by 5 to 9 year olds as a necessary emotional compromise. He

stated that the person or image of death is created by the children and

modified by culture in order to make death more remote or more con-

trollable. Weininger (1979) also speculated that the data obtained

from the older children in Nagy's (1948) research was strongly

affected by the cultural conditions of World War II Hungary.

On the other hand, Gartley and Bernasconi (1967), who studied

60 American Catholic children 5.1/2 to 14 years of age, did not observe

the concepts of reversibility or personification of death. These

researchers speculated that "early religious teaching and television

may acquaint the child with the facts of death earlier than was

usual in times past" (Gartley & Bernasconi, 1967, p. 85). Like the

other studies, the children's concepts of death did seem to solidify

and standardize with increasing age. McIntire, Angle, and Struempler

(1972) found no differences in children's avowed concepts of death

as related to total hours a week of television watching or type of

favorite program (aggression, fantasy, or reality). Rochlin (1965)

also commented that children's concepts of life after death or places

people go after death seem to arise spontaneously and without

necessarily any formal religious education.










Consistent with the research concerning concepts of death since

Nagy (1948), much of the recent research in the field further yielded

evidence for stages of development in children's concepts of death.

Mclntire, Angle, and Struempler (1972) attempted to measure the views

of causes, images, and finality of death in children 5 to 18 years of

age of three different religious affiliations: Catholic, Protestant,

and Jewish. Children up to the age of approximately 6 years viewed

death as reversible, and viewed dead pets or persons as having

cognizance. Seven to 9 year olds viewed death as irreversible and

considerably fewer children believed in cognizance after death. A

second drop in the percentage of children who accepted cognizance was

evident in 13 year olds. It was also noted that death was not viewed

as a total cessation of life activities until the children were 7

years old.

Weininger (1979) used the techniques of structured interview

and structured play with 4 to 9 year olds to examine the relationship

of children's concepts of death as expressed verbally and as expressed

in play. In this study, the children evidenced increasing accuracy

in their understanding of death and dying with increasing age.

However, the data indicated that corresponding continuity between

play expression and verbal expression regarding these concepts was

not evident until the children were 8 to 9 years of age.

Thus, several studies (Gartley & Bernasconi, 1967; Kastenbaum,

1965; McIntire et al., 1972; Nagy, 1948; Weininger, 1979) consistently

concluded that children's concepts of death develop in relatively

distinctive, identifiable stages. Children up to the age of 6 years






5


viewed death as reversible, temporary, and characterized by life

activities such as feeling, talking, and motion. Children 7 to 10

years of age generally accepted the concept of irreversibility,

although death was not viewed in a personal way. Some studies

(Kastenbaum, 1965; Nagy, 1948; Rochlin, 1959, 1965) suggested that

children 7 to 10 years of age viewed death as like a person who

caught people, while such personification was not evident in other

studies (Gartley & Bernasconi, 1967; Mclntire et al., 1972). At

the age of 10 or 11 years, most children tended to view death as

permanent, irreversible, and inevitable. Commensurate with the

evidence supporting developmental stages in children's views of

death, some studies (Formanek, 1974; Hansen, 1973; Koocher, 1974)

have related Piaget's theory of intellectual development to children's

emerging concepts of death. Thus, there has been general consistency

in the conclusions of researchers concerning children's concepts of

death.

However, there has been minimal research concerning children's

attitudes toward death. Most death attitudes studies have focused

on adult populations, particularly college students. Only two

assessment instruments have been developed to measure death attitudes

at the early adolescent level: the Attitude Toward Death Scale

(Hardt, 1975) and the Early Adolescent Death Attitude Scale (Fauquet,

1980).

In reviewing the literature concerning death attitudes, four

broad divisions seemed to emerge. The most frequently investigated

areas were the fear of death (Bailis & Kennedy, 1977; Bell, 1975;










Boyar, 1964; Gold, 1974; Leviton, 1974; Mueller, 1976; Nelson & Nelson, 1975)

and death anxiety (Alexander & Alderstein, 1959; Nelson &Nelson, 1975)

Rowe & Loesch, 1978; Templer, 1970). Attitudes concerning denial

of death have been investigated by Gold (1974) and Nelson and Nelson (1975).

Attitudes concerning acceptance have been studied by Kurlychek (1976).

Thus, the areas of fear, anxiety, denial, and acceptance which have

received investigation in older populations do not appear to have

been investigated in reference to young children.

There was significant information in the medical literature which

addressed the many issues of caring for the terminally ill child and

the needs of the family. In many cases, there was specificity as to

the child's particular illness, such as cancer, leukemia, or congenital

heart disease. The topic of the sudden traumatic death of children

was also addressed. However, the medical and psychiatric literature

has not yielded research on the attitudes of normal children concern-

ing death and dying.

The topic of bereavement in children has received some attention

in the literature. Stein (1974) reported that "during childhood one

out of every 20 children in the United States will lose a parent to

death and that by the age of 16, one of every five children will

have lost at least one parent." Kastenbaum (1972) stated that the

death of a parent has the "single and longest lasting" effect on

children. He further suggested that "bereavement in early childhood

has been implicated as the underlying cause of depression and suicide

attempts in later life" (Kastenbaum, 1975, p. 186). Moriarity (1967)

reported that his studies suggested that the case histories of a large










number of juvenile delinquents indicated unresolved childhood grief.

Fauquet's (1980) review of the literature revealed that "during

childhood and early adolescence bereavement reactions are similar

to those of adults: disbelief, physiological distress, guilt, fear,

anger, and panic" (p. 7).

Thus, there has been very limited research specifically investigat-

ing normal children's attitudes toward death and factors related to

them. Since there was such a scarcity of information in this area and

since children's concepts of death appeared to be relatively defined

from a developmental point of view, it seemed important to explore the

attitudes of normal children toward death. Therefore, the problem

was:: What are normal children's attitudes toward death? A related

question was: What factors relate to children's death attitudes?


Need for the Study


The increased attention to the factors, needs, and attitudes of

adults concerning death has yielded a proliferation of material,

resources, and programs in a variety of professional fields and

institutions. With increased knowledge as to the attitudes of normal

children concerning death, a number of related possibilities in the

theory, research, training, and practice of counselors and school

psychologists could result.

Increased knowledge of children's attitudes toward death and

related factors could yield further development and possible modifica-

tion in theory, particularly as it may relate to the developmental

point of view. While it appeared that children's concepts of death










emerge in stages over rather identifiable age levels, it was also

important to determine whether children's attitudes toward death

develop and mature over time. While there appeared to be various

attitudes toward death evident in the adult population, it was

important to determine whether a similar variety was manifested in

the population of normal children, or whether the attitudes were

relatively invariant. Furthermore, it seemed useful to ascertain

possible factors related to the emergence, modification, or change of

death attitudes in children. Increased information concerning

children's death attitudes would also better enable one to explore

the implications as they relate to such models as Psychoanalysis,

Piagetian theory, Behaviorism, and others. Thus, several ramifica-

tions would emerge as increased information concerning children's death

attitudes is discovered.

Increased knowledge concerning children's attitudes toward death

would also yield further implications in subsequent research. It

would be important to determine the intensity, stability, or

flexibility of children's death attitudes, and the factors related

to such dimensions. The influence of socioeconomic level, cultural,

ethnic, and religious background also merited investigation. Further

research concerning the influence of traumas on children's attitudes

toward death would need to be pursued. There also would need to be

considerable investigation of the premise that death attitudes may be

related to children's and adolescents' behaviors in such areas as

delinquency, depression, drug usage, and suicide, as suggested by some

researchers (Fauquet, 1980; Kastenbaum, 1975; Klagsbrun, 1976;










Moriarity, 1967; Orbach & Glaubman, 1978; Smith, 1976). Thus, there

are numerous implications for further research related to children's

attitudes toward death.

Increased knowledge of children's attitudes toward death also

would have significant impact on the training and practice of

counseling, school psychology, and other areas of mental health.

If such attitudes were known, it would be possible to "sensitize"

professionals to the characteristics and needs of children concerning

their attitudes toward death. Intervention and facilitation of more

healthy attitudes might also be developed by skillfully trained profes-

sionals. It might also be possible to identify some children who

may be pre-suicidal based in part on their expressed attitudes toward

death. The implementation of formal classes in death education may

also be prudently and appropriately pursued. It would be possible

to provide guidance to parents, teachers, and other caregivers con-

cerning children's attitudes toward death. On occasions when death

of a classmate or a classmate's parent or sibling is experienced, it

would be possible to facilitate an appropriate response based on valid

information regarding children's death attitudes. Thus, there are

multiple practical implications which may occur in the areas of train-

ing and practice based on further knowledge of children's death

attitudes.


Purpose

The purpose of this study was to explore normal children's

attitudes toward death. Specifically, there was investigation of










normal children's general concepts of death as initially structured

by Koocher (1974). Further, there was investigation of death

attitudes of denial, fear, anxiety, and acceptance in reference

to death of self, death of other, and the environment of death.

There was examination of the demographic factors which may relate

to children's death attitudes.


Rationale

The structured interview technique has been used with young

children consistently more than any other type of assessment. From

the early work of Nagy (1948), to the pivotal studies conducted by

Koocher (1973, 1974) and Orbach and Glaubamn (1978, 1979), the

format of self-report concerning questions about death with young

children has been most commonly used. There has been some pairing

with other tasks, such as Piaget's conservation problems, the WISC

Similarities Subtest, or structured play activities, but the indivi-

dual interview procedure seemed to be a key part of sound methodology

with young children in evaluating their concepts and attitudes about

death. Therefore, it was the method of choice for this study.

Recognition had to be given to the special sensitivity of this

topic. In that some authorities (Kubler-Ross, 1975; Moody, 1975;

Wass, 1976) asserted that there has been a tendency for people in this

society to ignore, evade, or deny the topic of death, it seemed

prudent to use a methodology which enabled maximum sensitivity, support,

and response to the child. In that many of today's elementary children

experience periods of leaving the regular classroom for various










activities such as media center instruction, group guidance, music,

speech therapy, etc., the format of individually interviewing

children away from the classroom setting seemed to permit a sense

of routine procedure to the child. Further, the individual interview

situation better enabled the establishment of rapport, privacy, and

personal attention.


Definition of Terms

To clarify the terms and concepts of this study, the following

definitions were used:

Acceptance "A willingness or openness to understand a topic;

to have particular ideas about or to consent to think about a topic"

(Fauquet, 1980, p. 5).

Anxiety A generalized "feeling of apprehension which tends to

be elicited by situations in which the individual feels threatened

. the nature of the threat may or may not be clearly perceived"

(Coleman & Hammen, 1974, p. 124).

Attitude "A relatively enduring system of affective, evaluative

reactions based upon and reflecting the evaluative concepts or beliefs

which have been learned about the characteristics of a social object

or class or social objects" (Shaw & Wright, 1967, p. 10).

Cemetery A place where people are buried.

Children Persons 8 years 6 months to 11 years 0 months of age

as of September 1, 1980.










Concept "A general meaning, an idea, or a property, that can

be predicted of two or more individual items" (English & English,

1966, p. 104).

Denial "Denial is a mental mechanism. Its function is

to dispense with a perceived danger. It is a process requiring

constant revision of facts and constant correction of perceptions.

It nullifies part of a reality and restores a state of previous

harmony" (Weisman, 1972, p. 25).

Environment of Death The setting in which the dying or dead

person is known to be present, such as a cemetery or a hospital in

which a friend or acquaintance is dying.

Fear A specific feeling that is experienced "in the face of a

present, anticipated, or imagined danger or pain. There is a real or

imaginary threat to one's well being or survival" (Wood, 1976, p. 22).

Normal Those children in regular class who are achieving

academically at an A, B, or C level, who have been retained only once

or not at all, and who are determined to exhibit adequate adjustment

in learning, behavioral, and social areas in the professional judgment

of the classroom teacher.

Suicide "The deliberate act of self-injury with the intention

that the injury should kill" (Garfinkel & Golombek, 1974, p. 1278).















CHAPTER II

REVIEW OF RELATED LITERATURE


The review of the literature pertaining to this study concerning

children's attitudes toward death provided a theoretical basis for

the study. Attention was given to research which has investigated

children's concepts of death from a developmental view, particularly

from a Piagetian and a psychoanalytic theoretical basis; research

which has investigated the effects of various factors such as

socio-economic level, race, television viewing, and experience with

death on children's concepts of death; research which has investigated

children's attitudes toward death; and relevant research which has

investigated children's perceptions of death as may be related to

suicide.


Children's Concepts of Death From a Developmental View

Since the first comprehensive study (Nagy, 1948) of children's

concepts of death, developmental stages have been evident consistently

in the literature in this area. Through individual interviews with

378 Hungarian children ages 3 to 10 years, Nagy (1948) found evidence

for differential stages in children's understanding of death.

Children 3 to 5 years of age generally denied death as a regular










and final process, death was viewed as another kind of existence

in changed circumstances. Death was also seen as temporary and in

varying "degrees." The children were aware that they were alive,

and they imagined that dead people were alive also. "Living" and

"lifeless" were not yet distinguished. Thus, a sense of animism

was attributed to the dead.

Other studies (described later) have investigated the child's

concept of animism in detail. Nagy (1948) found that children 5 to

9 years of age tended to personify death. Death was viewed as a

person walking around trying to catch people and carry them off.

Death was also viewed as an eventuality, but the children endeavored

to keep it distant from themselves. Children 9 to 10 years of age

tended to view death as a permanent, inevitable, irreversible, and

internal process. The perceptible result of death was the dissolu-

tion of bodily life. Animism and egocentrism were not characteristic

of this age group.

Rochlin (1959, 1965) corraborated Nagy's findings concerning

young children's concepts of death at the 3 to 5 year age range.

Rochlin (1965) theorized that in response to their overwhelming fear

of death, children constructed elaborate defenses such as the ideas

of reversibility, temporariness, and continuing existence in places

like heaven or hell.

Beauchamp (1974) studied the death perceptions of 3 and 5 year

olds. She found that the two groups differed significantly on the

concepts of universality, irreversibility, causality, and fear of

death. Three year old children did not view death as irreversible










or universal. They exhibited more fear of death than the five year

olds, and attributed death to such causes as anger, naughtiness,

and wishful thinking. On the other hand, the five year olds viewed

death as universal, irreversible, and due to more realistic causes.

Swain (1976) studied the concepts of death of children 2 years

to 16 years of age through a semi-structured individual interview

format. The 2 to 4 year olds viewed death as reversible rather than

final, improbably or escapable rather than inevitable, and not

personally applicable to them. Children 5 to 7 years old expressed

the belief that death was inevitable and applicable to them personally,

but at a time remote from today. Like the younger children the 5 to

7 year olds tended to emphasize the accidental and punishing nature

of death. In general, the 5 to 7 year old children also demonstrated

less magical thinking and a greater reliance on biological and social

reality.

Anthony (1940) summarized a series of investigations of children

3 to 13 years of age in England over a two year period. Anthony

found that thoughts of death were frequent in children's fantasies.

For example, approximately 50 percent of the children in a story

completion task made reference to death in completing the story even

though the concept did not appear in the story stem. Anthony (1940)

distinguished five stages in children's concepts of death from

ignorance of the meaning of the word to a clear definition in logical

or biologically essential terms. Anthony (1940) observed differen-

tial stages in children's concepts of death which generally parallelled

Piaget's theory on the development of children's understanding of

causality.










Several other studies (Hansen, 1973; Kalmbach, 1979; Kane,

1979; Koocher, 1973; Nass, 1956; White, Elsom, & Prawat, 1978)

have specifically investigated children's concepts of death in the

context of Piagetian theory of intellectual development. Children's

concepts of death seem to evolve in sequential stages generally

consistent with Piaget's stages of preoperational thought, concrete

operations, and formal operations. Hansen (1973) asserts that "the

notions of classification, conservation, time and age acquired in

the concrete operational stages seem to be necessary elements for

grasping death as a definitive and universal event" (p. 110).

Although Hansen's data was generally consistent with Piaget's

stages, other evidence suggested that 7 to 8 year olds tend to view

death as an internal process. This concept seemed to be grasped at

an age earlier than Hansen (1973) predicted and earlier than what

is stated in the literature. Formanek (1974) reported findings

similar to Hansen (1973) in his study of the responses of 300

children. On the other hand, Melear (1973) found evidence which

suggested that children do not develop a realistic view of death

until they are more nearly 10 years old.

Kalmbach (1979), Koocher (1972, 1974), and White (1977) presented

the children with conservation tasks to determine their stage of

intellectual development. The children were then presented with

various questions concerning various concepts of death in an indivi-

dual interview format. He asked 75 children ages 6 to 15 years a

group of four questions about the meaning of death and their expecta-

tions about their own death. The sample was of middle SES status,










of equal representation in sexes, and composed of 20 percent non-

white children. Koocher also sought to obtain an estimate of the

children's intellectual level by administering the Similarities

Subtest of the Wechsler Intelligence Scale for Children. In order

to classify the children according to their level of cognitive

functioning by a Piagetian model, each child was tested with three

conservation tasks (i.e., mass, number, and volume) and one task in

hypothesis formation. Koocher's criteria were the following:

If the child failed one or more of the conservation tasks,
he was placed in the "preoperational" group. If he
passed all three of those, but failed the hypothesis
formation task the child was classified as "concrete-
operational." If the child dealt with all four tasks
successfully, he was classified as "formal operational."
(p. 405)

In an individual interview format, each child was administered the

Similarities subtest, the conservation tasks, and asked the following

questions: "What makes things die?" "How do you make dead things

come back to life?" "When will you die?" "What will happen then?"

Koocher found no statistical differences attributable to race or sex.

The results did, however, reflect developmental differences across

children's ages. Koocher reported that children 7 years of age and

under generally evidenced fantasy reasoning, magical thinking, and

realistic causes of death marked by egocentric reasoning. Death was

viewed as reversible and impermanent by this age group. Children 7

to 12 years of age described the infliction of death with or without

intention, such as through weapons, poison, or assault. Children 12

years of age and older cited relatively abstract clusters of specific

possibilities of death. These included physical deterioration, often










with a recognition of death as a natural process. In response to the

question of what will happen when one dies, Koochergrouped the

responses into the following non-exclusive categories:

references to being buried alive were given by 52% of
the children; references to being judged, going to
heaven or hell, or other hints at any sort of after-
life by 21%; references to having a funeral by 19%;
specific predictions of how death would occur by 10%;
references to some aspect of sleep by 7%; references
to being remembered by others by 5%; references to
reincarnation by 4%; and references to cremation by
3%. (p. 409)

In contrast to the findings of Nagy (1948), Koocher (1974)

found no personification type responses given in reference to what

might happen at the time of death. Weininger (1979) speculated

that Nagy's (1948) findings concerning children's personification of

death perhaps had its source "in specific cultural situations--the

armies, bombs, and threat of imminent death of World War II Hungary"

(p. 397). On the other hand, Kastenbaum (1965) theorized that the

personification of death by 5 to 9 year olds was a necessary emotional

compromise. The children created a person or image of death in order

to make death more controllable.

Kane (1979) investigated the death concepts of 122 mid-America,

middle class white children, ages 3 to 12 years, through 10

components of the death concept which she described as the following:

1. Realization is the awareness of death, of the state of being

deceased, or an event which happens. Death can happen to someone,

or it can be something which makes the living die.

2. Separation deals with the location of the dead and is con-

cerned with the child's idea of where the dead are: i.e., "In the

trees," "Under the ground."










3. Immobility has to do with the child's notions concerning

the movement of the dead. The dead may be seen as totally inactive

or partially or completely active.

4. Irrevocability has to do with the child's idea of death as

permanent and irreversible, or temporary and reversible.

5. Causality is a belief of what brought about the state of

death, whether from internal causes, such as heart attacks or external

causes such as guns or a combination of the two.

6. Dysfunctionality deals with the ideas about bodily functions

other than the senses. A child could believe that the dead are totally

dysfunctional, or that they are partially or completely functional.

7. Universality deals with the child's ideas of mortality. A

child could have notions that everybody dies, or that nobody dies, or

that there are exceptions.

8. Insensivity is a consideration of mental and sensory functions

such as dreaming, feeling, thinking, and hearing. Ideas may be held

that the dead are totally insensate or partially or completely sensate.

9. Appearance is the notion of the way the dead look. Ideas

could be held that a dead person cannot or does not look as though he

were alive or, to the contrary, that he looks the same.

10. Personification is a notion of death as concretized and

reified as a person or thing.

During the course of the study it became apparent that a
child could be aware, recognize, or realize death as
having a substance. The Realization component was seen,
therefore, to include Personification, and Personifica-
tion was dropped as a separate component. (p. 144)










Kane (1979) discerned three stages in the children's concept

development. Stage One was characterized by the presence of the

components of Realization, Separation, and Immobility. Death was

mainly a description: lying down with immobility. Egocentricity

and magical thinking was evident. The children believed they could

make someone dead by their behavior, wish, or label. At Stage Two,

death was viewed as specific, concrete, and dysfunctional. The

beginnings of logical thought were evident. Besides further develop-

ment of the aforenamed components, there was inclusion and development

of the remaining components of Irrevocability, Causality, Dysfunc-

tionality, Universality, Insensitivity, and Appearance. However, the

components were not interrelated. Early in Stage Two, the children

tended to believe that death was externally caused, although internal

causes of death were recognized later. Except for violence, death

was viewed as a part of old age and very far away. At Stage Three,

the children began to interrelate the components. The children's

conceptualizations were more abstract, logical, and reality-based.

Some children considered the existential issues of life and death.

Death was a definition, an internally caused state characterized by

dysfunctionality, inactivity, and insensitivity. The stages were

shown to develop year by year. Kane (1979) further stated that the

stages were related to Piagetian preoperational, concrete operations,

and formal operations stages. The youngest children in Stage One

organized their thinking in terms of structure; those in Stage Two

thought in terms of function; those in Stage Three evidenced abstrac-

tion.










Factor analysis of children's death concepts as defined by

Kane (1979) evidenced an increasing multiplicity in the components

during the early childhood years. In general, children acquired

Realization by age 3; Separation and Immobility be age 5; Irrevoc-

ability, Causality, and Dysfunctionality, and Universality by age

6; Insensivity by age 8; and Appearance was added by age 12. Kane

(1979) emphasized that the addition of components in each cluster

was not in any particular order. Thus, a one-to-one sequence of

component acquisition could not be established.

Kane (1979) also differentiated as to whether the children

were experienced or inexperienced with death. This was established

through postinterview contacts with the parents. The following

criteria were used:

A child was considered to be experienced if, after the
age of 18 months, he had known at least one intimate such
as a parent, sibling, or close friend, or four non-
intimates who had died, or if he had seen at least one
dead person, or had gone to at least one funeral or
funeral home, or had been greatly affected by the death
of a nonintimate. A child was considered to be in-
experienced if he had encountered death before he was
18 months old or had never encountered it. (p. 145)

Kane (1979) found that the experienced 3 to 6 year olds evidenced

the presence of the death components at a significantly greater degree

than the inexperienced peers. Children 7 through 12 years of age

manifested the same concepts whether they were experienced or not.

However, the older children generally evidenced the presence of most

of the concepts anyway, and a differentiation would be more difficult

to establish, if indeed it existed. Bolduc (1972) also found that

children who have had experiences with death evidenced significant










differences in their death concepts as compared to those who had no

experiences with death.

Contrary to Nagy's (1948) results, in which the inevitability

of death occurred to children at age 9, Kane (1979) found this

belief occurring frequently in children by age 6, and consistently

in children 8 years of age and older. Also contrary to Nagy's

(1948) investigations in which personification of death was expressed,

Kane (1979) found no such form of reification. Thus, there appeared

to be some significant differences in the concepts of death as

expressed by American middle class white children in the 1970's as

compared to the concepts of death of Hungarian children of post World

War II.

In studying children in kindergarten through the fourth grade,

White, Elsom, and Prawat (1978) also found that children's concepts

of irrevocability, universality, and cessation of bodily processes

in regard to death were related to the children's age and intellectual

development. White et al. (1978), however, isolated a rather inter-

esting differentiation in their study. After determining the child's

intellectual conceptual level by presenting three conservation tasks

taken from the Concept Assessment Kit by Goldschmid and Bentler

(1968), a story was read to the children. Half of the children

heard a version in which the main character, an elderly woman who

dies, is a kind, likeable, and friendly person who always says "hello"

to children. Half of the children heard a version in which the

elderly woman is unkind, mean to her pets, and yells at children.

The researchers found that the children's understanding of death was










not affected by the story. However, the children's views concerning

the cause of death were influenced. It is reported:

Twenty two percent of the children who heard the story
about the unkind woman attributed her death to some
unkind act she committed. Some children, for example,
claimed she died because she yelled at the school
children and some because she would never laugh.
Of the children who heard the story about the nice
woman, only one subject out of 85 attributed the
woman's death to her own behavior, claiming, perhaps
whimsically, that she died because she laughed too
much. There was, then a significant relationship
between a child's perception of the attractiveness of
the story character and a child's understanding of
the cause of that character's death, x2(1) = 18.36,
p < .001. (p. 309)

Melear (1973) who interviewed 41 children 3 to 12 years of age

in Greeley, Colorado, found children's death concepts to be generally

consistent with those reported in other studies which suggested a

developmental view. Melear (1973) categorized the responses into

four stages. The first stage was characterized by relative ignorance

of the meaning of the word death as evidenced by children 3 and 4

years of age. (However, one may question the limited sample of six

children at this age range from which such a conclusion is drawn.)

In the second stage, 4 to 7 year olds viewed death as a temporary

state in which the dead can be revived, experience feelings, and

engage in biological functioning. Five to 10 year olds, in the third

stage, viewed death as final, but the dead were able to see, hear,

feel, and in other ways function biologically. (Again, Melear (1973)

reported only four children in this category, and one may question

the size of the sample.) The fourth stage was characterized by the

view that death was final with the cessation of all biological func-

tioning. In other words, a more realistic concept of death was










expressed. It was interesting to review the ages of the children

in this stage as reported by Melear (1973). Of the 21 children,

two were between 4 and 5 years of age, one was between 5 and 6

years, and the remainder were 6 years and older.

Other studies which found children's views of death to be a

developmental phenomenon were those by Anthony (1940), Blum (1976),

Childers and Wimmer (1971), Gartley and Bernasconi (1967), Hornblum

(1978), McIntire, Angle, and Struempler (1972), Nass (1956), O'Brien

(1979), Swain (1976), and Weininger (1979).

Some portion of the literature (Buhrmann, 1970; Maurer, 1966;

Plank & Plank, 1978; Schilder & Wechsler, 1934; Schnieder & Schneider,

1977) interpreted children's developmental concepts of death based

on Psychoanalytic Theory. For example, Plank and Plank (1978)

examined children's art and autobiographies to discern the process

of building up defenses, the rejection and denial of death, and

children's reactions to catastrophes. In Maturation of Concepts of

Death, Maurer (1966) outlined 12 developmental steps illustrated by

quotations from various essays. Briefly, the maturational steps

were the following:

1. Awareness. The primal terror was there, less among the

brighter and so great among the dull that they feared direct mention

of it. "When I think of death, right away I am horrified.

Sometimes when I see a dead person, they seem so unreal."

2. Denial. This may take many forms: childlike whistling in

the dark ("My grandfather ain't never going to die"); reversals

("Death is a triumph"); clinging to attributes of life ("All I want










to know is what it feels like"); or refusing to think ("I think it

is a word that should be thought only when it occurs").

3. Projection. The death of an "other" leaves one grateful

for one's own life, indeed more fully alive.

4. Curiosity. Questions do not cease and some remain silly

even in adolescence. Wrote one: "I think it is the fear of the

unknown. What's going to happen? Will I just be there with no

thoughts, then all of a sudden someone blows a horn and up I come

or will I be conscious every minute? I would like for someone to

tell me what it's like and what happens afterward? Maybe if I trust

God and be a good little girl I will not fear the answers and not ask

so many questions."

5. Personification. "Will death call your name to go?"

6. Propitation. The death of the self being too traumatic to

express, they could approach it only one step removed. "If I lost

one of my parents, death would probably be hard to accept because I

am close to both of them."

7. Dare-devilry. No mention was made of this, possibly because

it is an action language.

8. Substitution. A remnant of this appeared as: "A new life

is born each day just as an old life dies each day."

9. Contempt with laughter. "I went on a dare one time with this

friend who knows a guy who works at the, you know, morgue. He puts

his lunch right on the body in the cold room to keep it like in an ice

box. He laughed and said: 'It's all right. He won't eat much.' But

I didn't care for that too much."










10. Acceptance of inevitability. "Some people think that it

is best not to know, but I feel you can appreciate life more and get

more out of it."

11. Despair. "When I think of death I think of living. I

think about the things I should have done but didn't, the places I

wanted to see but never did. Ordinary things like I should have

treated my sister and brother better or I should have gotten better

grades in school and the little bad things I did that upset my

mother."

12. Transmutation to idealism. "Death is something most people

hate to think about, but it is also something we have to accept. What

we should do is to make the best of our lives before it is too late."

Other psychoanalytic studies and writings (Ackerly, 1967; Menninger,

1938; Pfeffer, 1978; Pfeffer, Hope, Conte, Plutchik, & Jerrett, 1979;

Ringel, 1976) interpreted concepts of death in reference to suicide.

This topic will be discussed in more detail later in this chapter.

A few studies (Bruce, 1941; Huang & Lee, 1945; Klingberg, 1957;

Klingensmith, 1953; Russell, 1939, 1940a; Safier, 1964) have examined

children's concepts of animism as it relates to their concepts of

death. Piaget (1929) described animism as the mental phenomenon.in

children in which life and consciousness is attributed to certain

inanimate objects. According to Piaget, this was partially due to

the child's view of objects as extensions of himself or herself.

Piaget identified four stages in the development of the concept of

animism. In Stage One, children up to 6 or 7 years of age attributed

life to anything that demonstrated activity in any way. For example,










a stove was alive because "it cooked." In the second stage,

children 6 to 8 years of age attributed life to anything that

moved at the time it was moving. For example, a ball was alive

while it was rolling. Clouds, cars, and bicycles were alive while

they were moving. At Stage Three, children 8 to 11 years of age

attributed life to anything that moved on its own accord, such as

the sun and moon. Mechanical devices were not considered alive

because an operator was required to move them. At Stage Four,

children 11 years of age and older attributed life and consciousness

to animals alone or to plants and animals. The age limits were some-

what indefinite, but Piaget asserted that there was definite model

development in these stages.

Safier (1964) examined the responses of three groups of boys in

San Francisco who were ages 4 to 5, 7 to 8, and 10 to 11. She

administered the following ten stimulus words: dog, ball, tree,

bike, boy, moon, mother, ocean, car, cloud. For each word presented

at random, the following questions were asked:

1. Does a live? Is it a living?

2. Does a hurt when hit?

3. Does a grow up?

4. Does a die?

In the second part of the interview, the children were asked their

rationale for their responses. Two independent judges evaluated the

tape-recorded conversations in reference to the following questions:










1. Is life or death seen as a recurrent process?
2. Does life or death come from the outside to a person
or thing (external process)? Or does it come from
the inside, and is it seen as an internal process?
3. Is there neither basis for considering life or death
either as a recurrent or irrevocable or as an
internal event. (Safier, 1964, p. 288)

Basically, Safier (1964) found a decrease in "animism" and "death"

scores with increase in age. As children's concepts of death improved,

so also did their concepts of life. Safier stated, "The judges'

conclusions seemed to support a common rationale underlying Piaget's

stages of animism and Nagy's stages of death conception" (1964, p.

294).

Another approach to clarifying children's concepts of death was

implemented by Weininger (1979) who compared children's verbalizations

about death and dying with their behavior and comments in structured

play situations. Weininger (1979) combined the four questions used by

Koocher (1973, 1974a, 1974b) with two differently structured play

situations to determine the children's perception of death. Weininger

(1979) examined the verbal and play responses of 30 boys and 30 girls

ages 4 to 9 years old living in a middle class urban area. In a

small empty classroom, there was a tape recorder, a small table and

two chairs, and the following play materials: a mother and a father

doll, a child doll, a pretend stethoscope, a pretend hypodermic

needle, candy pills, a pretend thermometer, a blanket, a pillow,

a double bed, a box with a lid, 2 inch glass of water. The play

procedure was described as follows:

the interviewer presented all the materials, saying that
"the doll is very sick and the doll is going to die."
The interviewer gave the child time, and, if necessary,
helped the child to play out the situation, encouraging










the child in a free fashion to play with the materials
and to say what was happening. Following this play,
the interviewer said, "the doll is very sick and is now
dead" and encouraged the child to play out the situation
as the child perceived it. All children were
encouraged to respond both in terms of vocalization and
in terms of play and gesture. (p. 400)

As a preface to asking Koocher's (1974) questions, the interviewer

generally stated, "I would like to find out what children think about

dying, and I wonder if you have ever thought about this." The play

procedure or the interview procedure were done in random fashion.

Weininger (1979) summarized the results as follows:

The children's play indicated increasing accuracy in their
understanding of the concepts of dying and dead. Their
answers to the questions also indicated accuracy increased
with age. There were, however, differences between their
play understanding, and their verbal expressiveness.
Children's play frequently contradicts what they say about
dying and death, sometimes indicating a more complex
understanding than verbal expression would suggest, some-
times reflecting a failure to grasp freely the concepts
they speak about. Concepts of dying and death are hard
for children to understand and accept; the data indicate
that it is not until 8 or 9 years that play and verbal
expressions come to terms with each other. (p. 395)

Thus, there were a number of studies which examined children's

concepts of death in the context of Piaget's stages of logical thinking

through the use of individual interview and structured play format. In

general, the results appeared to be relatively consistent in supporting

a developmental evolution in children's concepts of death throughout the

childhood years.


The Influence of Various Factors Concerning
Children's Concepts of Death

Some studies (Beauchamp, 1974; Bolduc, 1972; Gartley & Bernasconi,

1967; Hornblum, 1978; Mclntire, Angle, & Struempler, 1972; Plotz &










Plotz, 1979) gave attention as to whether factors such as sex, socio-

economic level, religion, and television viewing affected children's

concepts of death. The results tended to be consistent in most of

the measured factors.

Beauchamp (1974) found no differences in children's concepts of

death as a function of sex. On the other hand, Zweig (1977) found

significant sex differences in the death attitudes of children 8 to

12 years old. It was interesting to note that Chasin (1971) who

studied the death attitudes of adults did find sex differences.

Further, this factor was differentially influenced by level of educa-

tion and religious orthodoxy.

Plotz and Plotz (1979) reported that children have many miscon-

ceptions about death which are culturally induced. For example,

there may have been an overemphasis on violence. However, the

researchers suggested that this factor needs further study. Zweig

(1977) also reported some effect from cultural differences as well

as racial differences. On the other hand, Beauchamp (1974) found

no significant differences in children's concepts of death as a

function of social class. Chasin (1971), however, found that higher

income (over $10,000) populations were differentially affected in

their death attitudes as a function of religious orthodoxy. However,

the death attitudes of lower income ($10,000) populations were not

differentially influenced.

Some attention has been given to examining the effects of

children's television viewing on their concepts of death. Although

Gartley and Bernasconi (1967) speculated that television may acquaint










children with the facts of death earlier than was usual in past

times, they did not investigate this variable in their study.

Hornblum (1978) and McIntire et al. (1972) reported no differential

effects of television viewing on children's conceptions of death.

Mclntire et al. (1972) found no significant differences even when

there was factor analysis of the total number of hours of television

viewing and type of favorite program: aggression, fantasy, or

reality. On the other hand, Zweig (1977) reported that her results

indicated that children learn more about death from the media and

reading than from religious training or school.

The matter of the effects of religion on children's concepts of

death has received very little attention in the literature. Gartley

and Bernasconi (1967) speculated on possible effects due to early

religious training, although they did not investigate this factor.

Mclntire et al. (1972) investigated the death concepts of 598

children, ages 5 to 18 years, who attended youth classes at either

a Roman Catholic elementary school, a Protestant Sunday school, or

a Jewish Temple. The children's religious affiliation was found to

be a significant variable in several measured aspects of their

acquaintance and concepts of the cause, imagery, and finality of

death. When asked "Why do people die?" there were significant

differences evident in the responses of the Catholic children at

the 6 year through 11 year range. At the age of 6 years, 33 percent

of the Catholic children gave the cause as "because they are bad."

However, no children in this or any other group attributed a known

death to moral guilt. At the age of 11 years, 22 percent of the










Catholic children stated that selection by God as the reason people

die, although only 2 percent of the Protestant and Jewish children

gave this as a reason. McIntire et al. (1972) also attempted to

determine children's views of what happens after death. The children

who had lost a pet were asked, "Do you think the pet knows you miss

it?" For all children, there was a drop in this belief at 7 years

and at 13 years of age. However, some differences were noted at the

ages of 15 to 16 years. Twenty-eight percent of the Protestant

children and 12 percent of the entire group attributed cognizance

to the pet. Further, at all ages, the belief in cognizance or

awareness after death for self was much less than that attributed

to the pet. McIntire et al. reported the following:

Catholic school children, ages 11 to 12 years, for example,
93% gave the response of spiritual continuation without
cognizance to the pet. Coexistence of these two responses
was interpreted as a belief in personal spiritual continua-
tion. In all four groups, the belief in spiritual
continuation peaked at the ages of 13 to 14 years, and
then decreased in all but those interviewed at the Catholic
school. In both the Protestant and Catholic children
the 7 year old was most likely (p < .01) to accept death
as total cessation; this corresponded with the decrease in
fantasy of imagery at the same age. By the age of 8, death
as a total cessation was less acceptable with responses of
increasing belief in spiritual immortality. (p. 530)

It was further added that frequency of religious instruction within

the various church groups did not seem to have any apparent effect on

the children's avowed concepts of death. There was also some investi-

gation of the children's imagery of what happens to the body after

death. McIntire et al. (1972) reported that "the concept of dis-

integration to ashes or dust was clearly a factor of religious

education," although no more specificity in this area was given.










The investigators also found differential effects of religion regard-

ing questions on the meaning of life and on suicide ideation. These

areas are discussed later in the chapter in the section on suicide.

Blum (1976) interviewed 155 children ages 7, 9, 13, and 18

years old. Half of the children were Catholic and half were Jewish.

Half attended religious Parochial schools and half attended public

schools. Blum (1976) also found that children's concepts of death

changed with age. He further found significance in the factor of

religion. For children in the formal operations stage, Blum reports

the following:

It was Catholicism (vs. Judaism) and a parochial-school
background (vs. a public-school background) that were,
in certain circumstances, related to more abstract levels
of thinking about an after-life. Finally, regarding
belief vs. non-belief in an after-life, Jews and
Catholics were very distinguishable at all ages, with
Catholics believing significantly more than Jews.
(p. 5248)

It was interesting to note that in adult populations, religious

activity and religious beliefs seemed to affect one's attitude toward

death. For example, Swenson (1965) found that "persons engaged in

frequent religious activity or demonstrating a fundamentalistic

type of religion evidenced a very positive or forward looking death

attitude whereas those with little religious activity or interest

either evaded reference to death or feared it" (p. 109). Similar

results were reported by Chasin (1971), although there appeared to

be differential effects related to sex, level of education, and

income levels.

As discussed earlier, Kane (1979) investigated the effects of

children's experience with death on their death concepts. In general,










experienced children 3 to 6 years of age seemed to manifest more of

the measured components of death concepts than those 3 to 6 year

olds who were not experienced with death in their life. No differ-

ential effects were found in children 7 to 12 years of age. Zweig

(1977) found that experiences with death influenced the attitudes

and concepts of death of 8 to 12 year olds. Bolduc (1972), in

studying the attitudes and concepts of death in 9 to 14 year olds,

found experience with death to be an influential factor. On the

other hand, Mclntire et al. (1972) who studied the death concepts of

children 5 to 18 years of age, found no apparent effect of experience

on children's avowed concepts of death. Thus, the results in this

area were rather contradictory, although the research tended to

suggest that experiences with death did affect children's death

attitudes and death concepts.


Children's Attitudes Toward Death


There appeared to be very limited research concerning children's

attitudes toward death. The only instruments which even approached

the early adolescent level were the Attitude Toward Death Scale

(Hardt, 1975) for 13 to 26 year olds and the Early Adolescent Death

Attitude Scale (Fauquet, 1980) for children in the sixth, seventh,

and eighth grades.

In older populations, mainly college students and adults, investi-

gations of death attitudes have been approached through a variety of

models and dimensions. However, there did appear to be four broad

divisions which emerge from the literature on this topic. The most










frequently investigated areas appeared to be those of fear of death

(Bailis & Kennedy, 1977; Bell, 1975; Boyar, 1964; Gold, 1974;

Leviton, 1974; Mueller, 1976; Nelson & Nelson, 1975), and death anxiety

(Alexander & Alderstein, 1959; Nelson & Nelson, 1975; Rowe & Loesch, 1978;

Templer, 1970). Attitudes concerning denial of death have been

investigated by Gold (1974) and Nelson (1975). Attitudes concerning

the acceptance of death have been studied by Kurlychek (1976).

A few studies (Ackerly, 1967; Alexander & Adlerstein, 1959;

Beauchamp, 1974; Blake, 1969; Levinson, 1967; Rochlin, 1965) have

alluded to children's fear of death. For example, Rochlin (1965)

presented the following thesis:

children very early, perhaps around three or four, become
aware that they will die but due to their overwhelming fear
of death, they erect elaborate defenses against this
concept. Thus the young child describes death as reversible
and temporary in order to master the realization of death.
(in Ackerly, 1967)

Beauchamp (1974), who studied the death perceptions of 3 and 5

year old children in the Midwest, reported that the older children

exhibited less fear than did the younger children.

Gartley and Bernasconi (1967), who interviewed 60 children 5

to 14 years of age, concluded that "children can accept death matter-

of-factly, but acquired a fear of death by observing the behavior of

adults" (p. 85). Cox (1979) and Zeligs (1967) findings also supported

the view that children's death attitudes are affected by the parents

and adults in their environment. On the other hand, Dugan (1977),

who administered the Taylor Manifest Anxiety Scale and the Lester

Fear of Death Scale to adolescents and their parents, reported that

"fear of death in parents did not significantly influence that










attitude in children, nor was children's general anxiety score

affected" (p. 230).

Blake (1969) investigated the death attitudes of adolescents

as compared to older people as they related to the psychosocial

developmental stages proposed by Erikson (1958, 1959, 1964).

Adolescents reported more fear of death than older people. However,

the older people tended to use denial more than the adolescents.

Religious versus non-religious did not appear to be a factor. It

should also be noted that these populations were white, Protestant,

and middle-class.

O'Brien (1979) studied The Effects of Inclusion and Exclusion in

Mourning Rituals on the Development of Children's Conceptual Under-

standing and Attitudes About Death. A questionnaire was administered

to 174 children in an inner-city public school, a parochial school,

and a Sunday school in the first, third, fifth, and seventh grades.

O'Brien (1979) found that middle-class children were more likely to

view death as painful and scary. Also, older children who had

participated in mourning rites evidenced increased anxiety in regard

to death.

Although little specificity is given, Melear (1973) placed some

focus on clarifying the death anxiety of 41 children 3 to 12 years

old among other issues related to their concepts of death. Melear

(1973) reported that some degree of death anxiety was evident in 12

percent of the 3 to 7 year old children, and in 75 percent of the 5

to 12 year old children. He commented, "all of the children, except

one, who exhibited anxiety also expressed a belief in an afterlife.










Perhaps this belief is an effort to overcome anxiety produced by

the realization that death is final and universal" (p. 360).

Only one study made some investigation of children's acceptance

of death. Rutzky (1979) examined the attitudes toward death of

children who grew up in concentration camps. Like other death

concepts, the children's responses varied according to their age.

Rutzky (1979) stated the following:

It is reported that the same mechanism and reactions
are observed in those who witnessed killing and mass
murders as in American children growing up in a peace-
ful environment. Children from concentration camps
were not found to accept death more readily, even though
their environment introduced them to loss repeatedly and
might have inured them to death."(p. 101)

Anthony (1940) and Plotz and Plotz (1979) made some attempts to

discern the meanings children attribute to death on both the cognitive

and emotional level. Anthony (1940) suggested that children associated

death with "inner fears and feelings about separation, loneliness,

aggressive impulses, and birth" (p. 46). Plotz and Plotz (1979)

suggested that children's attitudes toward death may have been

associated with cultural factors.

Thus, there were relatively few studies which yielded any signi-
ficant information concerning children's attitudes toward death.

Further, many of the comments appeared to be more speculative and

interpretive than descriptive. Other writings (Anthony, 1940;

Harnik, 1930; Kotsovsky, 1939; Menninger, 1938; Osipov, 1935)

theorized about children's feelings and reactions toward deathmainly

from a psychoanalytic basis. However, little substantive investiga-

tion was offered to support the theories.










There was a body of information in the medical literature
which addressed the many issues of caring for the terminally ill

child and the needs of the family. In many cases, there was

specificity as to the child's particular illness, such as cancer,

leukemia, or congenital heart disease. The topic of the sudden

traumatic death of infants and children was also addressed. However,

the medical and psychiatric literature did not yield research on the

attitudes of normal children concerning death and dying.

The specific topic of children's bereavement has received some
attention in the literature. Stein (1974) reported that during

childhood one out of every 20 children in the United States will lose

a parent to death and that by the age of 16, one out of every five

children will have lost at least one parent. Kastenbaum (1972) stated

that the death of a parent has the "single and longest lasting" effect

on children. He further suggested that "bereavement in early child-

hood has been implicated as the underlying cause of depression and

suicide attempts in later life" (Kastenbaum, 1975, p. 186). Moriarity

(1967) reported that his studies suggested that the case histories of

a large number of juvenile delinquents indicate unresolved childhood

grief. Fauquet's (1980) review of the literature revealed that

"during childhood and early adolescence bereavement reactions are
similar to those of adults: disbelief, physiological distress,

guilt, fear, anger, and panic" (p. 7).

Miya (1972) theorized that the children's perceptions of death
and dying were influenced by the three growth processes of (a)

individual developmental levels of abstract and concrete reasoning,

(b) parental attitudes, and (c) personal experiences.










Other studies (Cox, 1979; Escamilla, 1977; Gomez-Ossorio, 1978;

Pinette, 1977; Zeligs, 1967) generally agreed that children's

emotional reactions to death were largely determined by their age

and developmental stage, their personal experiences, and the

parents' responses to death. Pinette (1977) stated that "the

limited understanding of the child is in itself a built in protec-

tion for the child against being plunged into the depressed condi-

tion that the adult might enter" (p. 6). On the other hand, Dugan

(1977) presented data which supported the contrary point of view in

regard to adolescent populations. Dugan (1977) used instruments,

including the Taylor Manifest Anxiety Scale and the Lester Fear of

Death Scale, to determine the nature of the fear of death in adoles-

cents and their parents. This researcher stated the following:

Results indicated that fear of death in parents did not
significantly influence that attitude in children, nor
was children's general anxiety score affected. It was
concluded that the nature of the fear of death in
children is extremely complex and that: (1) adolescents
do not correlate viewpoints with parents even though
they are influenced by them; (2) unconscious death fear
plays a major role in the psyche; (3) people tend not to
think or are unable to think of the reality of their
personal death even though they have confronted it in
a specific life incident; and (3) this inability to think
of or grasp the reality of personal death is especially
true of persons who are in no immenent danger of death
(adolescents). (p. 239)


Research Concerning Suicide and Children

In 1946 in The Manual of Child Psychology, Carmichael spoke of

adolescent suicide as "a rarity." In 1979 the American Association

of Suicidology reported that suicide was ranked as the second leading










cause of death among this nation's youth. The incidence has nearly

tripled over the past 20 years. Green (1978) has associated self-

destructive behaviors in children 5 to 12 years of age to factors

of child abuse. Paulson, Stone, and Sposto (1978) conducted a

three year study of 662 children, 12 years of age and under, who

were identified as self-abusive or suicidal and in treatment at the

UCLA Neuropsychiatric Institute. Pfeffer (1978) reported that over

100 suicidal children 6 to 12 years of age were treated at the Child

Psychiatry Inpatient Service at Bronx Municipal Hospital in the

previous four years. The National Clearinghouse for Poison Control

Centers (1968) and several researchers (e.g., McIntire & Angle, 1973;

Sobel, 1970; Teicher, 1970; Springthorpe, Oates, & Hayes, 1977)

reported increasing admissions of children under 12 years of age to

poison centers and/or emergency hospitals for accidents and
"accidental overdoses." The National Center for Health Statistics

reported 170 confirmed child suicides in 1975. In the State of

Florida in 1977, five suicidal deaths were reported by children in

the 5 to 14 year old range. .Schnake (1972) estimated the ratio of

suicide attempts to actual suicides is 50 to 8, while Jacobs (1971)

estimated the ratio at 50 to 7. Jacobziner (1960) estimated the

proportions at 50 to 1, while still higher ratios are cited by

Tuckman (1962) at 120 to 1. Thus, there was considerable evidence

suggesting serious and significant increase in suicidal attempts and

suicidal behavior in children.

In the last few years Orbach and Glaubman (1978, 1979a, 1979b)

produced some very interesting studies investigating the concepts of










death of normal, suicidal, and aggressive children. Zeligs (1974)

and Orbach and Glaubman (1977) have postulated that suicidal

behavior in the young could be partly attributed to the child's

concept of death. It was suggested (Orbach & Glaubman, 1977) that

suicidal children would likely evidence a more idiosyncratically

distorted view of death than would normal children or children with

other disturbances, such as problems of impulse control and aggression.

In 1978 Orbach and Glaubman individually interviewed 21 children,

ages 10 to 12, who were either suicidal, aggressive, or normal accord-

ing to school records and school services. All of the children were

of low socioeconomic status; 20 were of Middle-Eastern origin, and

one was of European origin. They lived in Ramat-Gan, Israel. The

children were also matched for cognitive functioning by their per-

formance on the Similarities subtest of the WISC. The children were

then administered structured questionnaire based on a modified

version of questions used in Koocher's (1974b) study. They were as

follows:

One set consisted of questions about impersonal death,
namely: How do things die?; What happens to things
when they die?; Can dead things come back to life?
The other set contained the same questions about per-
sonal death, namely: How do you think you will die?;
What will happen to you when you die?; Can you come
back to life after you die? (p. 405)
The responses for the first questions in the two sets were categorized

as (a) natural death, (b) aggressive or brutal death, or (c) suicide

and self-destruction. The categories for the second question were

(a) burial process, (b) cessation of life activities or life process,

(c) deterioration of the body, (d) continuation of the life process or










life activities, (e) reference to other people's reaction, or

(f) other, such as don't know or the soul going to heaven. The

third question in the two sets was classified into one of the

following: (a) no return to life, (b) return to life in any form,

or (c) other. The following results were reported:

Aggressive children, compared to the other groups, gave
significantly more frequent responses of aggression and
brutality as causes of death, and suicidal children gave
more such responses than normal children. Suicidal
children named suicide and self-destruction significantly
more than any of the other groups. Responses of old age
and illness were given mostly by normal children. The
aggressive children gave the fewest responses of old age
and illness as causes of death. The frequency of responses
of old age and illness given by the suicidal children was
intermediate between these two groups. Normal children
attributed cessation of life to the state of death to a
significantly greater degree than the other two groups.
Suicidal children, on the other hand, attributed life
qualities to the state of death significantly more than
aggressive or normal children. This difference was
significant for responses about personal death and total
responses but not for responses about impersonal death.
The data also indicate that the distortion in con-
cepts that concern death is not related to differences
in IQ because all three groups were equal in level of
intelligence as measured in this study. (p. 853-856)

In a similar study a year later, Orbach and Glaubman (1979)r

presented measures and questions to 27 suicidal, aggressive, and

normal children, ages 10 to 12 years old. The children were indivi-

dually administered the Similarities subtest of the WISC, and inter-

viewed with a modified version of questions from Koocher (1974) and

Safier's (1964) questions regarding children's concepts of animism.

Orbach and Glaubman (1979),found the following:

Suicidal children showed distortion in the death concept
more frequently than the other group, but they showed
no inferiority in their ability for abstract thinking.









The results favor the assumption that distortions in
the death concept are specific and, therefore, can
be attributed to a defensive process. "(p. 671)

Orbach and Glaubman (1978, 1979) repeatedly emphasized that a

discussion of the concepts and meaning of death must be an essential

part in the treatment of suicidal children.

McIntire et al. (1972) reported one of the more striking statistics

from their interviews with the 598 Midwestern children 5 to 18 years of

age. When asked, "Are there times when you really wished you were

dead?" 238 (40 percent) of the children replied "occasionally" and

18 (3 percent) said "frequently." Those admitting frequent death

wishes held less naturalistic views of death, evidenced more fantasy

and imagery (such as reincarnation), and were more likely to believe

in reversibility and cognizance for themselves after death. Ten of

the 18 children reported that their death wishes were most often

percipitated by family arguments or fear of punishment, and most often

characterized by anger or sadness. Fourteen of the 18 children

were Protestant. All of them were over the age of 10 years.

Thus, there was considerable evidence which suggests that suicide

has become a matter of increasing frequency and concern among children

and adolescents. Further, since very few studies have focused on the

relationship between children's concepts of death and thoughts of

suicide, continued investigation of children's concepts, thoughts,

and attitudes toward death certainly seemed warranted.















CHAPTER III

METHODOLOGY


The assessment of death attitudes among elementary school age

children occurred through structured interviews in the school

setting. Self-reports in reference to discussions of self, a

"friend," and the environment of death were used in the explora-

tion of the death attitudes of denial, fear, anxiety, and acceptance.

Each of these attitudinal dimensions were assessed in terms of

the following frames of reference (as developed by Fauquet, 1980);

death of self, death of other, and the environment of death. In

the Early Adolescent Death Attitude Scale, Fauquet (1980) further

included the frame of reference of the death ritual. However, this

aspect was omitted in this study because it was believed that children

in this study were likely to have had only limited exposure or

experience with death rituals.


Sample Selection

For the purposes of this study, normal elementary school children

were those in regular classes in the fourth and fifth grades who were

determined to exhibit adequate adjustment in learning, behavioral,

and social areas in the professional judgment of the investigator.









The age range was 7 years 6 months to 10 years 11 months, as of

September 1, 1980. Children who had been retained and who were

performing at an average level academically were included in the

sample. Average was defined as "C" or better, or 2.0 or higher on

a 4.0 scale, in the combined subjects of reading and mathematics.

However, children who had been retained or who were performing

below average academically; that is, below "C" or 1.9 on a 4.0

scale were not included. Children who were identified by the school

Child Study Team as possibly educable, trainable, or profoundly

mentally handicapped were not included. However, those who were

receiving resource room delivery of special education services, e.g.,

speech, learning disabilities, and other categories of Exceptional

Student Education were included in the sample. Children who were

known to have experienced separation or loss of a parent or close

friend, or a trauma related to death in the last two years were also

ruled out. Thus, by the criteria, all of the children were function-

ing intellectually within the dull normal range or higher, and were

not so severe in their learning, behavior, or other maladjustment

problems so as to warrant full-time special education services in a

setting other than the regular classroom.

The children were attending the public schools of Marion County,

Florida. One school was selected from a suburban area in a community

of approximately 120,000, and one school was selected from a rural

area. Both schools had a pupil population between 450 to 800.

There was selection of alternative schools in each category in case

a local principal chose not to participate in the research project.









The principal was asked to select three fourth grade classes

and three fifth grade classes in which he/she judged the receptivity

and cooperation of the teacher to the research project to be optimal.

The principal was also asked to write a cover letter to the parent

consent form expressing support for the research study (see

Appendix A). In a teachers' meeting, the nature of the study and

the criteria for selecting the children was explained. Teachers

were asked to identify eight students in their classes who met

criteria. Parent consent forms were sent home with a request for

return the next day. There were five or more consent forms returned

for each class yielding a total N of 70.



Procedure

In November of 1980, cooperation on this study was solicited

from the Director of Student Services, School Board of Marion County,

as to how to proceed further in the school system. Subsequent

contacts were made with the Supervisor of School Psychology Services,

the Supervisor of School Counseling Services, and the appropriate

school principals. The logistics were discussed in detail with the

school principals and teachers in the identified schools. A copy of

the research proposal was provided to each school. The school

personnel and researcher developed a schedule as to the time and

setting of the interviews. The structured interviews were conducted

in a private room of the school guidance and administrative area.

Each interview required approximately 20 minutes. There was insured

freedom from distractibility, privacy, and additional optimal










conditions for the interview process. (The structured interview is

recorded in Appendix B.) The interviews were conducted by the

researcher who is certified by the Department of Education as a

school psychologist, a school counselor, and an elementary teacher.

She has had nine years experience as a school psychologist mainly in

the elementary school setting.

The nature of this topic made it especially important for the

structured interview to be conducted skillfully and sensitively. It

was important that the child felt comfortable in the situation and

trusting of the interviewer. Attention was given to the adequacy and

appropriateness of the environment. It was characterized by privacy,

comfort, safety, and familiarity. It was also important that the

child develop feelings of trust, openness, and spontaniety. Thus,

the initial part of the interview was designed to emphasize the

examiner's acceptance, positive regard, and interest in the child.

The child's responses and preferences were accepted readily thereby

facilitating the development of a warm rapport. Only after rapport

was adequately developed in the judgment of the interviewer were the

questions on death attitudes asked. In the atmosphere of acceptance,

warmth, and trust, it was anticipated that the child's responses

were, therefore, relatively honest and accurate.


Data Collection

As much as possible, the demographic data on each child included
the following: date of birth, sex, ethnic origin, grade, grade










point average, and number of retentions. Further, efforts were

made to secure the following data from the structured interview

and/or the report of school personnel: number of siblings, sibling

position of the child, status of the parents or caregivers (natural

or step), and parents' vocations. Data were collected concerning any

recent events which may have been traumatic to the child in the

areas of loss or separation. Specifically, this information focused

on indication of loss of parent or significant others through death,

divorce, or separation. Reported death of one or more pets was

noted also.


Nature of the Data

The scoring concerning the six questions on concept of death has

been developed by Koocher (1974-). The exact questions and scoring

were used with the exception of one addition of an "other" category

in the first set. The first two questions were the following:

1. How do things die?

2. How do you think you will die?

The above questions were scored according to the following categories:

A. Natural Causes (e.g., old age)

B. Aggressive Causes (e.g., murdered)

C. Suicidal or Self-destructive causes (e.g., killed himself)

D. Other (e.g., I don't know)

The next two questions were the following:

3. What happens to things when they die?

4. What will happen to you when you die?










The above questions were scored in one of these categories:

A. Burial (e.g., put 'em in the ground.)

B. End of Life (e.g., It's all over.)

C. Deterioration (e.g., It gets rotten.)

D. Continuation of Life Processes (e.g., You still know

what's going on.)

E. Other (e.g., I never thought about it.)

The next questions were as follows:

5. Can dead things come back to life?

6. Can you come back to life after you die?

The responses to these questions were scored as follows:

A. No return

B. Return in Any Form (e.g., I might be an angel.)

C. Other (e.g., I really couldn't say.)

The subsequent questions which focused on death attitudes yielded

responses in one of the following categories: Yes, No, Sometimes, or

Other.


Data Analysis

Since this was basically a descriptive study, frequency distribu-

tion of the various responses to each of the questions concerning con-

cepts of death (Koocher, 1974a) was calculated. In reference to each of

the attitudinal dimensions of denial, fear, anxiety, and acceptance, a

frequency distribution was calculated for grade level, GPA, retention in a

grade, sex, ethnic origin, urban-rural setting, pet ownership, acquaintance










with death of a pet, and for the total sample. Further, responses

were analyzed by percentages.


Validity

The first six items in the death attitudes interview were

developed by Koocher (1974) in exploring children's general concep-

tual understanding of death. The 12 questions concerning death

attitudes were modified to some extent from the Early Adolescent

Death Attitude Scale (Fauquet, 1980). In developing the EADAS,

Fauquet (1980) established face validity, content validity, and

construct factoriall) validity. A rather extensive three phase

process of developing and selecting the items was completed by four

reviewers who were counseling professionals of the following

description:

a university professor who teaches a course in counseling
research, a counselor education doctoral student who has
had varied experiences with death in his role as an
instructor and as a hospital chaplain, a doctoral student
who is working in the field of gerontology, and a practic-
ing school counselor with ten years' experience working
with early adolescents. (p. 19)

Among the criteria for the items was the establishment of a

fourth grade readability level as determined by a reading specialist

through readability analysis. The EADAS was administered as a pencil

and paper test.

The children in this study, however, were not asked to read the

statements, but to listen and respond to them in a structured inter-

view procedure. Oral responses were recorded by the interviewer.










Elementary school children vary widely in their reading skills.

Therefore, the limitation of reading was eliminated as a factor

through the structured interview format.

Reliability

In order to establish inter-rater reliability, two other certified

school psychologists were asked to evaluate and categorize the

responses of three children. Comparison was made with the judgment

of the researcher regarding the categorization of the responses.

Although no reliability procedure as such was used in this study,

these modified items are based on those developed in the EADAS

(Fauquet, 1980), in which reliability was established by test-retest

procedures using the Pearson Product Moment Correlation Coefficients

and by determining the internal consistency of the instrument by

comparing split half variances using Cronbach's Alpha reliability

coefficient. The total test-retest reliability was r = .77 (p < .01).

The reliability coefficient (split-half) was r = .89 (p < .01).

It is believed that children at the pre-adolescent level are

more responsive to the structured interview approach than to a

Likert-type scale using paper and pencil. In that adequate rapport

in the interview situation was clinically established and in that

the factor of readability level was essentially eliminated the

present format was determined to be adequate for data collection

with normal children at the fourth and fifth grade levels.

It was assumed that the data indicated the attitudes of normal

elementary children toward death through self-report. The children's

responses were spontaneous, honest, and accurate because of the










structured interview design. The structured interview design

provided for an adequate environmental setting, an age appropriate

manner of administration, and a child-centered format of inter-

action.


Methodological Limitations

To some extent, one may question whether self-report fully

reflects the child's concepts and attitudes concerning death and

suicide. Also, the sample of one or two questions in each area may

seem rather limited. However, one must consider the general tendency

of children to be rather direct and honest in an accepting environ-

ment, as well as their limited attention span in task-oriented

situations.















CHAPTER IV

RESULTS


The present data were derived from the purposes of this study:

specifically, an exploration of normal children's attitudes toward

death. Normal children's general concepts of death and of the

attitudes of fear, denial, anxiety, and acceptance in reference to

death of self, death of other, and the environment of death were

investigated. There was also an examination of various demographic

variables which have sometimes been shown to be related to normal

children's death concepts and death attitudes.


Sampling Procedure

The children sampled were randomly selected according to the

previously specified criteria from three fourth grade classrooms

and three fifth grade classrooms in each of two schools. In each

of the 12 classrooms, eight parent consent forms, with supporting

letters by the school principals, were sent home. No less than five

were returned in every class. All children who returned affirmative

consent forms were initially interviewed. However, two interviews

were eventually eliminated because more careful scrutiny revealed










that the children did not meet the selection criteria. Thirty-five

fourth grade children and 35 fifth grade children yielded valid

interviews that were used in the data analysis.

A total of five parent conferences were held following the

interviews with the children. Four conferences were by parent request

and one was by the request of the researcher. In one of these cases,

it was decided to eliminate the child's interview from the sample due

to situational adjustment difficulties in the child. It should be noted

that this child's parents were already in the process of pursuing

appropriate treatment.


Demographic Data

A total of 31 male (44 percent) and 39 female (56 percent) students

were interviewed. Thirty-seven children (53 percent) were from the

urban school and 33 children (47 percent) were from the rural school.

The grade point averages of the children were as follows: 21 percent

had an A average, 63 percent had a B average, and 16 percent had a C

average. Only 9 percent of the children had ever been retained in

grade level.

The age data revealed that 16 percent of the children were in the

range 8 years 9 months to 9 years 6 months old, 54 percent of the

children were in the range 9 years 7 months to 10 years 6 months old,

and 30 percent were in the range 10 years 7 months to 11 years 1 month

of age. In terms of ethnic characteristics, 93 percent of the children

were Anglo-American, 6 percent were Afro-American, and 1 percent were

Asian American.










Because attitudes toward death might be related to religious

beliefs, inquiries of religious preference were made. The

expressed religious preferences were as follows: 34 percent were

Baptist, 13 percent were Methodist, 4 percent were Presbyterian, 11

percent were Catholic, and 24 percent expressed other preferences.

The other 13 percent reported no preference or did not attend church.

In all cases, the children were living with their biological

mothers. Also, 80 percent were living with their biological fathers.

Of those children who were from homes where the parents were divorced,

almost 60 percent of the children were three years old or younger

at the time of the divorce. In regard to siblings in the home,

approximately 10 percent of the children had no siblings, almost

60 percent had one sibling, and approximately 30 percent had three

or more siblings. This included natural, step, and half siblings

by family structure.

When asked whether they presently owned or have ever owned a pet,

84 percent of the children reported yes and 16 percent reported no.

When asked whether they had ever had a pet die, 80 percent responded

positively. In 21 percent of the cases, the children had acquaintance

with death of pets in two or more instances. Twenty percent of the

children had no such incident in their lives with pets of their own.

The employment of the parents was noted. Approximately three-

fourths of the mothers were gainfully employed outside the home.

Ninety-three percent of the fathers were employed outside the home.

The parents' occupations were categorized by the same criteria of the

five condensed categories as recorded in the Weschler Intelligence










Scale for Children Revised. The incidence of the parents occupations

is recorded in Table 1.


Table 1

Occupational Status of Mothers and Fathers


Category Mothers Fathers

1. Not employed 34% 9%

2. Professional and technical workers 7% 19%

3. Managers, officials, proprietors, 40% 30%
clerical workers, and sales workers

4. Craftsmen and foremen 1% 24%

5. Operatives, service workers, farmers, 10% 13%
and farm managers

6. Laborers, farm laborers, and farm 7
foremen 7% 6%


Questions Related to Children's Concepts of Death


The purpose of this study was to explore children's concepts of

death. Using questions initially designed by Koocher (1974), there were

analyses of the children's responses concerning personal and impersonal

death. Table 2 summarizes the analyses of the data regarding what

children viewed as causes of death. Most of the children (70 percent)

reported that the cause of death of other things (i.e., animals) was

usually due to old age, illness, or both. More importantly, nearly

90 percent of the children stated that their own deaths were expected










to be from these causes. Approximately 10 percent believed that death

was likely to occur from aggressive causes, such as a car accident or

getting shot or kidnapped. A small percentage (6 percent) believed

that death comes when "God decides." No children reported suicide as

a cause of death.


Table 2

Children's Views of the Causes of Death


Impersonal Personal
(How do (How do you think
Causes things die?) you will die?)


1. Old age 24% 61%

2. Illness, heart attack, cancer, etc. 34% 24%

3. Old age and illness 13% 3%

4. Aggressive causes (car accident, etc.) 10% 9%

5. Old age and aggressive causes 9% 1%

6. Suicidal causes 0 0

7. God decides 6% 1%

8. Other 4% 0


Table 3 summarizes the data analyses regarding children's views as

to what happens after death in reference to other things (impersonal

death) and themselves (personal death). Thirty percent of the

children stated that things and themselves would be buried after

death. Approximately 50 percent expressed a belief in some kind of










continuation of life. Most of these responses were "Go to heaven."

Twenty percent of the children reported that things deteriorate when

they die. However, only 10 percent reported that they would deteriorate

when they died. One percent or less expressed the belief that

death was the total end of life.


Table 3

Children's Views of Conditions After Death


Impersonal Personal
(What happens to (What will happen
Conditions After Death things when to you
they die?) when you die?)

1. Burial 30% 31%

2. Burial and continuation 7% 3%

3. Burial and deterioration 6% 3%

4. Continuation 41% 48%

5. Deterioration 14% 7%

6. End of life 1% 0

7. Other 0 7%


Table 4 summarizes the data analyses regarding children's views

as to whether dead things can come back to life and as to whether they

can come back to life after they die. Seventy percent of the children

reported that they believed dead things could come back to life.










Fifty-four percent stated that they could come back to life after they

died. Most of the remaining children held opinions to the contrary.


Table 4

Children's Views Concerning


Life After Death


Yes No Other

Impersonal
Can dead things come back 70% 26% 4%
to life?

Personal
Can you come back to life 54% 43% 3%
after you die?


Questions Related to Children's Attitudes Toward Death


A second purpose of this study was to investigate children's

attitudes toward death. Questions adopted from Fauquet (1980) were

modified to examine the presence of the attitudes of denial, fear,

anxiety, and acceptance in regard to death of self, death of other,

and the environment of death. Refer to Table 5 for a summary of

the data.

Denial

In examining the attitude of denial toward death in children,

most 77 percent of the children report some denial in regard to their

own death. There was considerably less denial in reference to the

death of another. Forty percent of the children reportedly experienced










Table 5
Responses Concerning Attitudes Toward Death


Yes No Sometime

Denial

1. Do you sometimes feel this way: I
don't like to think about how I will 77% 10% 13%
die? (self)

2. If a friend died, do you feel you
would ever want to talk about it 46% 40% 14%
with anybody? (other)

3. Would you ever want to go where a
friend is dead? (environment of 81% 14% 4%
death)

Fear

1. Are you afraid of dying? (self) 50% 37% 13%

2. Would the death of a friend scare % 2%
you? (other) 67% 21% 1 1
3. Are you scared to go to a cemetery?
(environment of death) 24% 60% 16%
Anxiety

1. Do you worry about dying? (self) 31% 39% (30%

2. Does the thought of a friend dying 7 9
upset you? (other) 79% 9% 12%

3. Does a cemetery make you upset?3% 4%
(environment of death) 33% 9% 18%
Acceptance

1. Does it bother you to think about 6 1
how you may die? (self) 29% 61% 10% / ,
2. Would you want to visit a dying \ 6
friend in the hospital? (other) 71% 23% 6%

3. Would you be willing to go where 7 2
a friend is dead? (environment) 71% 23% 6%










denial in regard to talking about the death of a friend. Fourteen

percent of the children expressed a willingness to discuss the

death of a friend sometimes. Forty-six percent reported a clear

willingness to do so. There appears to be even less tendency for

the children to deny the environment of death, since only 14 percent

reported denial in this area. On the other hand, 81 percent of the

children did not express denial in this area.


Fear

In reference to the attitude of fear toward death, more (67

percent) children reported a sense of fear over death of a friend

than over their own death (50 percent). Thirty-seven percent of the

children stated that they were not afraid of dying. In regard to the

environment of death, only 24 percent reported that they were afraid

to go to a cemetery. Many of these qualified their responses by

expressing the fear of doing so alone or at night. Sixty percent of

the children stated that they were not afraid to go to a cemetery.

Sixteen percent apparently experienced the fear sometimes.

Anxiety

In examining the attitude of anxiety toward death, 31 percent of

the children stated that they did worry about their own death.

Approximately one-third (30 percent) worried about dying sometimes.

Thirty-nine percent of the children reported that they do not worry

about dying. Many children (79 percent) indicated that they experienced

anxiety over the thought of a friend dying. Twelve percent reportedly

experienced such anxiety sometimes. Only 9 percent reported no anxiety










over the death of another. One third (33 percent) of the children

indicated anxiety in the environment of death. Almost half (49 per-

cent) reported experiencing no anxiety in the environment of death

(specifically a cemetery). Eighteen percent reported the experience

of such anxiety sometimes.

Acceptance

In regard to the attitude of acceptance toward death, 61 percent

of the children reported some sense of acceptance in regard to their

own deaths. Twenty-nine percent did not indicate such acceptance.

Ten percent reported acceptance sometimes. Many of the children (71

percent) reported acceptance of the death of another. Twenty-three

percent did not. Six percent expressed acceptance of the death of

another sometimes. Thirty-seven percent expressed acceptance toward

the environment of death. Twenty-eight percent did not. Five per-

cent of the children reported such acceptance of the environment of

death sometimes.


Comparison of Attitudes Within Personal Death, Impersonal
Death, and the Environment of Death

There was a range of attitudes expressed by the children concern-

ing their own death. The majority of the children (77 percent)

expressed occasional denial of personal and half expressed fear.

One-third of the children expressed anxiety and one-third expressed

acceptance of their own deaths.

In general, there was less variability of attitudes concerning

impersonal death (death of another). Approximately half of the

children expressed denial and 67 percent expressed fear concerning










the death of a friend. Four out of five children indicated anxiety

over the death of a friend. Very importantly, 71 percent of the

children also expressed acceptance of another's death.

There was some variability of attitudes concerning the environ-

ment of death. Approximately one in five children expressed denial

or fear. Only one-third of the children expressed anxiety. Almost

40 percent of the children indicated acceptance of the environment of

death.


Differential Trends Relative to Sex, Grade,
School, GPA, and Retention

Although there may be some question concerning the validity of

the chi square analyses due to the sparse number of responses in

several cells of the tables, certain trends and characteristics are

suggested. Analysis of the data indicated that the children's views

of death and death attitudes may tend to be different in some respects

relative to the demographic characteristics of sex, grade, school,

grade point average, and retention.

In regard to responses relative to sex, minor differences were

noted (refer to Table 6). For instance, more females (28 percent)

than males (19 percent) attributed the cause of their personal death

as being due to illness, heart attacks, and similar reasons. Signifi-

cantly more males (26 percent) than females (5 percent) stated that

things deteriorate after death. On the other hand, more females (46

percent) reported that things continue to exist in some manner after

death than did males (35 percent). In regard to attitudes, 77 percent










of the females and 55 percent of the males reported some fear in

regard to the death of another. Also, more females (46 percent)

than males (32 percent) expressed denial in regard to the environment

of death. Considerably more females (56 percent) than males (42

percent) also expressed fear in regard to their own death. More

females (79 percent) than males (70 percent) also tended to deny

death in regard to themselves. Table 6 summarizes the data in this

area.


Table 6

Differences in Responses Relative to Sex


Males Females

Concepts

Attribute major cause of personal death
to illness, heart attack, and similar 19% 28%
reasons ,

Report a belief that things deteriorate 2
after death .2%

Report a belief that things continue to
exist after death /'c 1 I 35% 46%

Attitudes

Express denial regarding personal death -" 70% 79%

Express denial regarding environment of( i- 32%
death 32% 46%

Express fear regarding personal death : 42% 56%

Express fear regarding impersonal death : 55% 77%









In regard to differences relative to grade, concepts and

attitudes were explored. (Refer to Table 7.) Little or very

little difference was noted between the two grades. More fourth

graders (16 percent) than fifth graders (9 percent) attributed old

age as being the major cause of death for other things. Also,

more fifth graders (20 percent) attributed aggressive causes to the

death to other things while no fourth graders named such a category.

More fourth graders (31 percent) than fifth graders (17 percent)

viewed illness and related causes to their own deaths. More fifth

graders (14 percent) than fourth graders (3 percent) also attributed

their own deaths to aggressive causes, such as car accidents. More

fourth graders (49 percent) than fifth graders (34 percent) expressed

the view of some nature of continuation of life after death. Several

fifth graders (14 percent) expressed a view of the end of life at

death while no fourth graders expressed such a view. In regard to

death attitudes, 20 percent of the fifth graders expressed denial

in regard to their own deaths while no fourth graders did so except

on the basis of "sometimes." Almost 20 percent more fifth graders

than fourth graders also expressed fear and anxiety in regard to

their own deaths. On the other hand, more fourth graders (14 percent)

expressed anxiety in regard to the death of another than did fifth

graders (3 percent). More fourth graders (80 percent) than fifth
graders (63 percent) also expressed acceptance of the environment of

death.










Table 7

Differences in Responses Relative to Grade


Fourth Fifth

Concepts

Attribute major cause of personal death to 31% 17%
illness

Attribute major cause of personal death to 3% 14%
aggressive causes

Attribute major cause of impersonal death 16% 9%
to old age

Attribute major cause of impersonal death 20%
to aggressive causes

Report a belief in continuation of life 4%
after death 49% 34%

Report a belief in end of life after death 0 14%

Attitudes

Express denial regarding personal death 0 20%

Express fear and anxiety regarding personal death

Express anxiety regarding impersonal death 14% 3%

Express acceptance regarding environment of 8%
death 80% 63%





In comparing the attitudes expressed between urban and rural

children, some differences were noted. Table 8 summarizes the data

in this area. More urban children (76 percent) believed that they

will die of old age than did rural children (45 percent) who suggested










Table 8

Differences in Responses Relative to Rural-Urban Setting


Rural


Concepts

Attribute major cause of death to old age

Attribute major cause of personal death to
illness, heart attack, and similar reasons

Report a belief that things are buried
after death

Report a belief in continuation of life
after death

Attitudes

Express denial regarding personal death

Express denial regarding impersonal death

Express denial regarding environment of death

Express anxiety regarding personal death

Express acceptance regarding personal death

Express acceptance regarding environment of
death


45%

33%


42%


30%



85%

76%

58%

39%

27%

67%


Urban


76%

16%


19%

51%



24%

49%

24%

24%

51%

76%










that cause. About twice as many more rural children than urban

children (33 percent to 16 percent) attributed the causes of their

own deaths to illness, heart attack, or other similar reasons.

Considerably more rural children (42 percent) viewed things as being

buried after death than did urban children (19 percent). On the

other hand, more urban children (51 percent) viewed a continuation

of life after death than did rural children (30 percent) who expressed

such a view. More rural children (76 percent) than urban children

(49 percent) expressed the attitude of denial in regard to another's

death. Almost twice as many rural children (58 percent) than urban

children (24 percent) expressed denial in regard to the environment

of death. Also, more rural children (39 percent) than urban children

(24 percent) reported anxiety over their own deaths. Eighty-five

percent of the rural children compared to 68 percent of the urban

children expressed the attitude of denial in regard to their own deaths.

On the other hand, 51 percent of the urban children expressed more

acceptance of their own deaths as compared to 27 percent of the rural

children. Also, more urban children (76 percent) expressed more

acceptance of the environment of death as compared to 67 percent of

the rural children.

There was some differentiation of children's attitudes relative

to their grade point averages (refer to Table 9). Children with

lower GPA's increasingly viewed illness as the cause of death of

other things. The percentages who attributed death due to illness

were 13 percent of those children with A averages, 39 percent of those

children with B averages, and 45 percent of those children with C










averages. Children with lower GPA's also increasingly viewed

themselves as able to come back to life after they die. The

percentage of children who responded positively to that concept

were as follows: 33 percent of those with A averages, 55 percent

of those with B averages, and 82 percent of those with C averages.

There was also a slight trend for children with lower GPA's to

express the attitude of denial in reference to their own deaths.

Sixty-seven percent of the A students expressed such denial; 77 per-

cent of the B students did; and 82 percent of the C students did so.

A similar trend, but less obvious, was also suggested in regard to

denial of the death of another.

A stronger trend of increasing denial toward the environment of

death was noted as children's GPA's become lower. Specifically, 27

percent of the A students reported such denial; 39 percent of the B

students did; and 64 percent of the C students stated denial of the

environment of death. More students (55 percent) with GPA's of C

seemed to experience anxiety of their own deaths more than did

students with GPA's of A (27 percent) or B (27 percent). Also, more

C students (100 percent) reported anxiety over the death of another

than did A students or B students.

There were some differences in responses among children who were

retained as compared to those who were not retained (refer to Table

10). Half of the children who were retained viewed illness as the

cause of their deaths as compared to 22 percent of those who were not

retained. Sixty-seven percent of those who were retained reported a

view of continuation of life after death as compared to approximately










Table 9

Differences in Responses Relative to Grade Point Average


A B C


Concepts

Attribute major cause of death to illness 13% 39% 45%

Report a belief in coming back to life after 33% 55% 82%
personal death

Attitudes

Express denial regarding personal death 67% 77% 82%

Express denial regarding environment of death 27% 39% 64%

Express anxiety regarding personal death 27% 27% 55%

Express anxiety regarding impersonal death 80% 77% 100%


Table 10

Differences in Responses Relative to Retention


Retention No Retention


Concepts

Attribute major cause of death to illness 50% 22%

Report a belief in continuation of life 6%
after death

Attitudes

Express fear regarding environment of death 0 27%

Express anxiety regarding personal death 17% 33%

Express acceptance regarding personal death 67% 44%

Express acceptance regarding impersonal death 100% 80%










40 percent of those who were not retained. Commensurate attitudes and

percentages were also evident in regard to the view that one could

come back to life after death. No children who were retained reported

fear of the environment of death, while 27 percent of those who had

never been retained reported such fear. Twice as many students who

were never retained (33 percent) express anxiety over their own

deaths as did students who had been retained (17 percent). All

students who had been retained reported acceptance of death in regard

to another while 80 percent of the non-retained students expressed

acceptance. Approximately two-thirds of the retained students

reported acceptance of their own death while only 44 percent of

the students who had never been retained expressed acceptance.


Influences of Ethnic, Social and Familial Characteristics


In that 93 percent of the children were Anglo-American, an

interpretation of the differential responses by ethnic group did not

seem warranted.

There were no differential trends relative to the children's

religious preference.

There appeared to be no differential trends in the children's

responses relative to the married or divorced status of the parents,

employment status of the parents, or the number of siblings in the

family. The homogeniety of the population in some characteristics

and the considerable scatter in other characteristics were perhaps

factors in the limited distribution of the data relative to these

characteristics.










Differential Trends Relative to Ownership and
Acquaintance with the Death of a Pet

There were several instances in which children who owned pets

tended to respond differently from those children who did not own

pets. Table 11 summarizes the data in this area. More children who

owned pets reported illness as a cause of death, including their own

death, as compared to such reports from only 9 percent of the children

who had never owned a pet. Forty-three percent of the children who

owned pets reported a continuation of life after things die as

compared to 27 percent of those children who had not owned pets

making such reports. Also, 17 percent of those children who had

owned pets described some kind of deterioration after death, while

none of the children in the other category did. Twice as many children

who had never owned pets (55 percent) reported that burial is what

happens to things after they die. Similar frequencies of responses

were noted between the two groups of children in regard to what

happens after personal death in the areas of burial and continuation

of life in some manner after death. In regard to attitudes, children

who owned pets tended to have less denial concerning the death of

another and in regard to the environment of death as compared to

children who did not own pets. Also children who owned pets expressed

fear of the environment of death less frequently (18 percent less) than

children who did not own pets.

There was an examination of the responses regarding children who

never had a pet die, experienced the death of one pet, or experienced

two or more deaths of pets. When asked, "What happens to things when










Table 11

Differences in Responses Relative to Pet Ownership


Own Pet No Pet


Concepts

Attribute major cause of personal and 38% 9%
impersonal death to illness

Report a belief in continuation of life 43% 27%
after impersonal death

Report a belief in deterioration after 17% 0
death

Report a belief in burial after impersonal 27% 55%
death

Attitudes

Express denial regarding impersonal 59% 73%
death

Express fear regarding environment of 22% 36%
death









they die?" 60 percent of the children who experienced multiple deaths

of pets reported continuation of life as compared to approximately 35

percent in both of the other categories. Further, only 6 percent of

the children who had experienced multiple deaths of pets reported

burial as compared to approximately 36 percent of the children in both

of the other categories. When asked, "What will happen to you when

you die?" no children who had experienced multiple deaths of pets

reported burial, while approximately 40 percent of the children in the

other two categories reported burial for themselves. In response to

the same question, 27 percent of the children who experienced

multiple deaths of pets reported deterioration, while no children

who had one pet die made such a report. Seven percent of the children

who had never experienced the death of a pet made such a report.

Attitudes of children toward death of a pet are reported in

Table 12. Children who had never experienced the death of a pet

expressed denial of the environment of death only half as often as

those children who had experienced deaths of pets (22 percent to approxi-

mately 45 percent). Children who had experienced deaths of pet(s)

fear of the death of another more frequently (17 percent to 23 percent

more) than did children who had not experienced any deaths of pets,

about half of whom expressed fear. On the other hand, children who

had experienced deaths of pets expressed fear less frequently in regard

to their own death (10 to 18 percent less frequently) than did children

who had never known the death of a pet. Children who had experienced

deaths of pets generally expressed anxiety over the death of another

more often than those who had not experienced death of a pet.

Specifically, when asked, "Does the thought of a friend dying upset










Table 12

Differences in Responses Relative to None, One,
or Multiple Deaths of Pets


None One Multiple

Concepts

Report a belief in continuation of life 3 3
after impersonal death

Report a belief in continuation of life 2% 4
after personal death 49%

Report a belief in burial after impersonal 3 3
death36% 37% 6%

Report a belief in burial after personal 36% 41% 0
death 36% 41%

Report a belief in deterioration after 0
death 7 27%

Report a belief that things do not return 4% 7
to life after death 43% 78% 73%

Attitudes

Express denial regarding environment of 2% 4
death 22% 44% 47%

Express fear regarding impersonal death 50% 73% 67%

Express anxiety regarding environment 6% 4
of death 64% 44% 47%

Express anxiety regarding impersonal 5% 8
death 57% 88% 73%










you?" 57 percent of the children who had never known the death of a

pet responded yes; 57 percent of the children who had known the

death of one pet responded yes; and 73 percent of the children who

had known multiple deaths of pets responded positively. Sixty-four

percent of the children who experienced no deaths of pets reported no

anxiety in regard to the environment of death. On the other hand,

approximately 45 percent of the children who had experienced deaths

of pets expressed no anxiety. There were no clear differentiations in

regard to the attitude of acceptance toward death.


Interview Closure Activities

At the conclusion of the specific questions investigating death

concepts and attitudes, a few open-ended questions for closure and

a drawing activity were provided. The children were asked, "Is

there anything else you would like to tell me about this?" Seventy-

three percent of the children responded negatively. The children

were also asked, "Is there anything you would like to ask me?"

Fourteen percent of the children did have questions, 86 percent of

the children did not. Table 13 summarizes the questions. When asked,

"Is there anyone else you would like to talk with more about living

and dying?", 13 of the children responded positively, mainly naming

a parent. Table 14 specifies the persons the children identified for

further discussion. Finally, the children were asked to draw a

picture of anything they would like to draw before leaving. Ninety-six

percent of the children drew pictures of themes typical of their












Table 13

Questions Children Asked the Researcher


Question


"Is it true when you die they'll burn you?"

"If a person smokes, how long 'til they die?"

"How do diseases get started?"

(Later, child expressed worry over mother
smoking.)

"Do ghosts come back to families?"

"How old do people get?"

"Can you die of a heart attack?"

"Could God bring you back to life?"

"Can you read other people's minds?"

"How can you read people's minds?"

"How do you feel about dying?"

"Why do you ask children these things?"

"Do you work here?"

"How do you feel about it?"


Child


Child

Child

Child


Child #18

Child #22






Child #24

Child #25

Child #35


Child #38












Table 14

Persons Identified by Children to Ask Further Questions


Child Identified Person


Child #2 Parents

Child #8 Neighbor (who had a recent death in
family)
Child #13 Doctor or Mother or Nurse

Child #26 Mother

Child #47 Parents

Child #49 Anyone

Child #52 Parents

Child #56 Mother

Child #58 Anyone

Child #68 Doctor










special interests, such as people, cars, scenes with trees and flowers

and other content. However, 4 percent drew pictures of a death

related scene.


Clinical Impressions


In most cases, the children were informally met at the classroom

door by the researcher and escorted to the private conference room.

On the way, the researcher identified herself as the one who had

sent the note home for the child's parents to sign the preceding day.

The children were asked if their parents had made any comments con-

cerning the consent form. The children often shrugged as though it

was a rather insignificant event. They usually stated that the

parents had asked the child whether he/she had a willingness to

participate in the interview. The researcher often asked what the

child decided and the response was commonly, "Sure" or "It's OK with

me." The mood of the children seemed to be one of willing cooperation,

relaxation, and interest, except in one case in which the data could

not be obtained.

During the structured interviews all children readily responded

to the initial activity of drawing a picture of a person. This

activity seemed to give the children opportunities to become

accustomed to the setting and to focus on a self-directed task which

did not require much interpersonal interaction. In most cases, rapport

was established with ease. The format of the structured interview

typically proceededwith a continued sense of interest and cooperation

on the part of the child. Very few asked for clarification on the










questions concerning their concepts and attitudes toward death. Most

children responded rather quickly and spontaneously. Some children

responded slowly, with apparent thoughtful deliberation. In

general, there was more hesitation and reflection on questions

concerning the death of a friend than on the questions concerning

the environment of death or personal death.

The closure activities were particularly useful. The few children

who had additional comments seemed to find the opportunity to do so

an important one. The closing remarks usually focused on more

detailing of the events surrounding the death of a relative or pet.

When given the opportunity to ask the researcher questions,

approximately 13 percent (n = 10) of the children chose to do so.

Examples of these questions are listed in Table 13. It is interesting

to note that over half the questions reflected a need for information.

Two of the nine children expressed related concerns over the possible

dangers of their parents' smoking. Several questions reflected a

healthy curiosity over the researcher's interest and activities in

this area. The two questions relating to the researcher's ability

"to read other people's minds" were apparently prompted by a classroom

teacher's remarks which stated such. These questions are viewed as

extraneous artifacts of the investigation.

It is interesting to note the persons whom the children identified

for further discussion. More than half the normal children identified

their parents. This likely reflected very healthy positive relation-

ships in the family constellation. The two identifications of

medical personnel seemed to again reflect the children's need for










accurate information relating to their concerns over health, life,

and death.

The final activity of drawing a "picture of anything you would

like" provided an opportunity for spontaneous self-expression. It

is important to note that 96 percent of the pictures were not death

related drawings. The majority of the drawings were judged to be

clinically healthy drawings with content such as trees, houses,

nature scenes, cars and other vehicles, and so forth. In those cases

of death related scenes, the researcher further examined the child's

adjustment to determine whether there was need for concern. In the

two cases in which concern was warranted, conferences with the

children's parents were scheduled. Further responsible action was

pursued.

The parent conferences were cordial. All the parents expressed

genuine interest in the healthy adjustment of their children. A few

inquired whether their child evidenced apparent difficulties in the

area of death and dying which may need special attention. In two

cases, parent awareness of their child's attitudes seemed advisable.

In one instance, a discussion regarding provision for the child's

safety in the event of the parents' deaths seemed advisable. Appro-

priate professional services were advised and scheduled in a second

case. Most parents stated that they believed the interview with their

children had been a very positive, constructive event. They expressed

strong interest regarding their children's healthy adjustment in all

areas of life, including the matters of death and dying.















CHAPTER V

DISCUSSION


Limitations Regarding Generalizability

It is important to determine appropriate limits for generalization

of the results of this study. The present results can appropriately

be generalized to normal Anglo-American children in the fourth and

fifth grade classes who reside in urban or rural settings. However,

the differential trends of these characteristics as well as the child's

sex, grade point average, retention history, ownership of a pet, and

acquaintance with death of a pet should be kept in mind.

In that 93 percent of the children were Anglo-American it is

prudent to draw conclusions from the data only as they relate to

Anglo-American children in the United States. Even though there

were minor distinctions between the responses of the children in

urban and rural settings, between fourth grade and fifth grade

children, between males and females, and among grade point averages,

there should certainly be a recognition of these factors in the

population. In that there appeared to be no clear distinctions in

the responses from children of varying social-familial descriptions,

guarded acceptance of any implications of the data as they relate

to those areas is appropriate. Further study of the possible










relevance of these factors with a large N would also be appropriate.

These many characteristics are, of course, applicable to normal

children in basically regular classroom settings.



Conclusions

Children's Concepts Concerning Causes of Death

Analyses of the data concerning children's concepts of the

causes of personal and impersonal death, conditions after personal

and impersonal death, and the finality of personal and impersonal

death reveal a significant range of responses in most of the areas

of exploration.

In regard to children's views of how other things die compared

to the causes of their own death, the view of one's own personal

death being due to old age was expressed nearly three times more

frequently than old age being the cause of death of animals. Perhaps

old age is believed to be a more acceptable and less threatening way

to die than the other possible causes such as illnesses, heart

attacks, or aggressive causes. This concept is further supported

in comparing the differences in responses concerning personal and

impersonal deaths as being due to illness, heart attacks, cancer,

and related causes. Specifically, illness was reported as the cause

of death for other things more (34 percent) than it was reported as

the cause of one's own death (24 percent).

It is important to note that approximately 10 percent of normal

children apparently attribute aggressive causes, such as car accidents,

being kidnapped or killed, to a possible actual cause of either









personal (death or self) or impersonal (death of other things) death.

In evaluating the emotional adjustment of children particularly con-

cerning death, this finding should be viewed with care.

Although not a common response, the view of aggression as a

cause of death also may not necessarily be a deviant response.

Such a view would likely need to be evaluated in the context of

additional evaluative data relative to the child's emotional adjust-

ment. It is important to compare this finding to Orbach and Glaubman

(1978) who reported that "aggressive children gave significantly

more frequent responses of aggression and brutality as a cause of

death, and suicidal children gave more such responses than normal

children" (p. 852).

It is also interesting to note that none of the children attributed

suicidal causes to either their personal deaths or to the deaths of

other things. This finding also corraborates the work of Orbach

and Glaubman (1978) who found that (normal) children seldom identified

suicide as a cause of death. However, suicidal children named

suicide and self-destruction significantly more as a cause of death.

Thus, there is the strong indication that children who suggest

suicide as a possible cause of death may indeed by pre-suicidal.

Some attention must be given to the 6 percent (four children)

who stated that other things die because "God decides." Although

the data are too sparse to draw any conclusions, perhaps there is the

implication that children accept God's decisions for the fate of

other living things more readily than for the conditions of their own

lives. Further, investigation of the conditions of the role or









relationship of religious or spiritual views in regard to children's
concepts of death seems to warrant some consideration. Blum (1976),
Chasin (1971), Gartley and Bernasconi (1967), Mclntire et al. (1972),

O'Brien (1979), and Zweig (1977) have alluded to or investigated
children's views or concepts concerning death relative to religious
training. However, mixed results are reported in the studies

yielding no clear conclusions at this time.

Children's Views Concerning Conditions After Death

Perhaps the most striking feature of these data was the rela-
tively little variability of children's responses in comparing
personal and impersonal deaths. There was no more than a 7 percent

(5 out of 70) difference in any of the seven categories describing
conditions after death. Approximately one-half of the children
reported that burial or burial with continuation or deterioration

will happen after death. A significant percentage of children
(almost half) reported the view of a continuation of life in some
manner after death. Most commonly, this was described as "go to
heaven" or "go to heaven or go down there." These views corroborate

the work of Orbach and Glaubman (1978, 1979) and Zeligs (1974) as it
relates to normal children compared to aggressive children and pre-
suicidal children.

On the other hand, do 50 percent or so children who did not
describe some type of continuation after death believe that death
is indeed final? This issue becomes more complex in viewing the

children's responses to the questions, "Can dead things come back to










life?" and "Can you come back to life after you die?" Nearly three-

fourths of the children stated that dead things come back to life

and approximately half of the children expressed such a view in regard

to themselves. Analysis by sex suggests that almost half of the

females expressed a belief in continuation of life after death as

compared to one-third of the males. Also, fourth graders tend to

express the view of continuation more often than fifth graders (49

percent to 34 percent). Further, approximately 50 percent of the

urban children expressed a view of continuation of life compared to

one-third of the rural children. Children with lower GPA's also view

continuation of life more frequently.

In contrast, Nagy (1948) found that nine to ten year olds tended

to view death as a permanent and irreversible process. Melear's (1973)

results support this finding. Kane (1979) reported that death was

viewed as irrevocable and dysfunctional by children when they are

six years of age. On the other hand, Mclntire et al. (1972) presents

data which support this study. McIntire et al. (1972) stated, "the

belief in spiritual continuation peaked at the ages of 13 to 14

years" (p. 530). The perception of continuation was as high as 93

percent in 11 to 12 year olds. Blum (1975) also found that Christian

(Catholic) children tended to believe more in after life significantly

more than Jewish children. Thus, there does not appear to be a clear

definition of children's concepts in this area. Certain demographic

variables such as age, sex, environment (urban or rural), GPA, and

religion seem to have some relationship to children's views concerning

some nature of continuation of life after death.










Children's Attitudes Toward Death

In focusing on children's attitudes concerning their own deaths,

there seems to be considerably more denial than fear in that

approximately three-fourths of the children expressed the former

and only half expressed the latter. Further, only about 30 percent

of the children reported anxiety. Perhaps the defense mechanism of

denial enables the child to control anxiety about personal death.

There seems to be the attitude of acceptance of death among the

majority of children. Six out of ten children responded negatively

when asked, "Does it bother you to think how you may die?"

There seems to be generally more intensity in all the attitudes

concerning the death of a friend. Approximately 55 percent of the

children would even want to talk about the event or want to talk about

it sometimes. A considerable number of children expressed fear (67

percent) and anxiety (79 percent) concerning the death of a friend.
Further, 71 percent of the children also expressed acceptance to the

point of visiting a dying friend in the hospital. Thus, the attitudes

toward the death of another seem to be more intense, more mixed, and

perhaps more conflicting. Overall, there seems to be more interest

in the death of another than in one's own death for fourth and fifth

graders.

A rather consistent acceptance of the environment of death was

expressed. Sixty percent of the children reported no fear or anxiety

about going to a cemetery. Forty to eighty percent of the children

indicated a willingness to go where a friend is dead. Perhaps there

is a basic acceptance of the reality of death that is tolerated more









readily by children in the context of the environment of death.

Perhaps visiting the environment, namely a cemetery or "where a

friend is dead," enables the child to process or integrate the death

event into a greater sense of reality or acceptance.


Implications

The exploration of children's concepts and attitudes toward death

has several important implications for theory, training, practice,

and research. The present study basically coraborates the develop-

mental aspect of children's concepts of death. The children's

concepts of death seem generally consistent with much of the previous

research (e.g., Anthony, 1940; Kalmbach, 1979; Koocher, 1973, 1974a,

1974b; Melear, 1973; White, 1978) that has been done using the

Piagetian model. Some aspects of the data concerning children's

attitudes toward death may be interpreted rather readily in the

framework of Psychoanalytic Theory, particularly in the context of

defense mechanisms and the dynamics of personality adjustment.

However, many questions concerning normal children's attitudes toward

death still remain for research to answer.

There needs to be further investigation regarding the development

of the concepts of death and the intensities of attitudes. This

should include a clarification of possible relationships among the

demographic variables such as ethnic and cultural background, age and

grade level, grade point average, sex, urban-rural environment,

religious training or orientation, or other aspects of the children's

lives. Because the interview process seems to be very effective with










this sensitive area, it is recommended for the control of many of

the variables of data collection.

In regard to the training of professionals in counseling,

education, and mental health, there should be significant emphasis

on understanding children's concepts and attitudes toward death.

In addition to the usual professional skills in mental health

services, there should be allocation of at least part of a course to

focus on the salient issues and related research regarding death

concepts and death attitudes. Current curricula could be evaluated

carefully to provide for the inclusion of valid information concerning

children's concepts of death and death attitudes. There needs to be

awareness of the available research and information concerning the

differential concepts and attitudes among normal aggressive, and

suicidal children in regard to their own deaths and the deaths of

others.

Self-clarification of students' perceptions and attitudes con-

cerning death should be encouraged. Appropriately structured and

supervised opportunities for such exploration should be provided.

For instance, students may be encouraged to recall their own

experiences concerning death, dialogue with their colleagues concern-

ing the emotional effects and intellectual conclusions, increase their

own awareness of sensitive or problem areas, and clarify lingering

issues concerning death of self or others.

It is important to realize that the information and voluminous

recent writings on death and dying for adult populations may have

very limited applicability to children's concepts and attitudes










concerning death and dying. The literature for adults is important

to the extent that it enables clarification of thinking and feelings

concerning death. However, such perspectives and conclusions must

be very guarded in application to children.

There is not enough research and expertise related to the

professional practice concerning many aspects of normal and abnormal

children's concepts and attitudes toward death to make very extensive

recommendations. The practitioner must, of course, be cognizant of

all the available information concerning children's concepts of

death. The practitioner must have a great deal of self-awareness in

regard to the multiplicity of death issues. Further, the practitioner

must be very selective in using commercial materials. Any structured

experiences must be conducted with considerable caution and with

detailed knowledge of children's social, emotional, and academic

adjustment. It is important for the practitioner to be especially

aware of the verbalizations, fantasies, and behaviors of disturbed

children toward death, should any significant death concerns manifest

themselves.

Children want to have their questions answered concerning death.

They need to explore their own feelings and attitudes, and to

experience support from family or other significant adults who

have a healthy clarity of their own feelings concerning death issues.

Then, the child may be provided with support and appropriate

responsiveness should a death occur. If a child seems to be

experiencing significant difficulties in areas related to death

concerns, including their own deaths, it would be prudent to refer










these children for services to a qualified counselor, therapist, or

psychologist.

This study of children's concepts and attitudes toward death

has yielded insights, questions for research, implications for

theory, and directions for training and practice. With increased

knowledge and sensitivity to the needs of children, the competent

professional will more readily and more skillfully respond to

children regarding the important matter of the universal experience

of death and dying.















APPENDIX A

PARENT CONSENT


Dear Parent:

In order to better understand and help children, it is important

to learn their thoughts and attitudes on many subjects. As you

know, there recently is more discussion about attitudes toward life

and death by adults.

I would like to ask permission for your child to participate in

a research project to explore children's attitudes concerning death.

This will be through a 20 minute individual discussion. If you agree

to let your child participate, you may withdraw your permission at any

time. Your child's identity will be known only to me and to school

persons who help arrange for your child to talk to me. I would also

like to ask permission to review your child's cumulative folder and

to check the information, such as status of the family members, with

your child.

A copy of this study is available at the school. If you have any

questions or would like to know the results, a conference can be

arranged with me through the school secretary. My phone number is

listed below, and you can feel free to call me at any time to discuss

this research. There is no monetary compensation for participation

in this project.




Full Text
7
number of juvenile delinquents indicated unresolved childhood grief.
Fauquet's (1980) review of the literature revealed that "during
childhood and early adolescence bereavement reactions are similar
to those of adults: disbelief, physiological distress, guilt, fear,
anger, and panic" (p. 7).
Thus, there has been very limited research specifically investigat
ing normal children's attitudes toward death and factors related to
them. Since there was such a scarcity of information in this area and
since children's concepts of death appeared to be relatively defined
from a developmental point of view, it seemed important to explore the
attitudes of normal children toward death. Therefore, the problem
was:. What are normal children's attitudes toward death? A related
question was: What factors relate to children's death attitudes?
Need for the Study
The increased attention to the factors, needs, and attitudes of
adults concerning death has yielded a proliferation of material,
resources, and programs in a variety of professional fields and
institutions. With increased knowledge as to the attitudes of normal
children concerning death, a number of related possibilities in the
theory, research, training, and practice of counselors and school
psychologists could result.
Increased knowledge of children's attitudes toward death and
related factors could yield further development and possible modifica
tion in theory, particularly as it may relate to the developmental
point of view. While it appeared that children's concepts of death


42
life activities, (e) reference to other people's reaction, or
(f) other, such as don't know or the soul going to heaven. The
third question in the two sets was classified into one of the
following: (a) no return to life, (b) return to life in any form,
or (c) other. The following results were reported:
Aggressive children, compared to the other groups, gave
significantly more frequent responses of aggression and
brutality as causes of death, and suicidal children gave
more such responses than normal children. Suicidal
children named suicide and self-destruction significantly
more than any of the other groups. Responses of old age
and illness were given mostly by normal children. The
aggressive children gave the fewest responses of old age
and illness as causes of death. The frequency of responses
of old age and illness given by the suicidal children was
intermediate between these two groups. . Normal children
attributed cessation of life to the state of death to a
significantly greater degree than the other two groups.
Suicidal children, on the other hand, attributed life
qualities to the state of death significantly more than
aggressive or normal children. This difference was
significant for responses about personal death and total
responses but not for responses about impersonal death.
. . The data also indicate that the distortion in con
cepts that concern death is not related to differences
in IQ because all three groups were equal in level of
intelligence as measured in this study, (p. 853-856)
In a similar study a year later, Orbach and Glaubman (1979)
presented measures and questions to 27 suicidal, aggressive, and
normal children, ages 10 to 12 years old. The children were indivi
dually administered the Similarities subtest of the WISC, and inter
viewed with a modified version of questions from Koocher (1974) and
Safier's (1964) questions regarding children's concepts of animism.
Orbach and Glaubman (1979) found the following:
Suicidal children showed distortion in the death concept
more frequently than the other group, but they showed
no inferiority in their ability for abstract thinking.


16
Several other studies (Hansen, 1973; Kalmbach, 1979; Kane,
1979; Koocher, 1973; Nass, 1956; White, Elsom, & Prawat, 1973)
have specifically investigated children's concepts of death in the
context of Piagetian theory of intellectual development. Children's
concepts of death seem to evolve in sequential stages generally
consistent with Piaget's stages of preoperational thought, concrete
operations, and formal operations. Hansen (1973) asserts that "the
notions of classification, conservation, time and age acquired in
the concrete operational stages seem to be necessary elements for
grasping death as a definitive and universal event" (p. 110).
Although Hansen's data was generally consistent with Piaget's
stages, other evidence suggested that 7 to 8 year olds tend to view
death as an internal process. This concept seemed to be grasped at
an age earlier than Hansen (1973) predicted and earlier than what
is stated in the literature. Formanek (1974) reported findings
similar to Hansen (1973) in his study of the responses of 300
children. On the other hand, Melear (1973) found evidence which
suggested that children do not develop a realistic view of death
until they are more nearly 10 years old.
Kalmbach (1979), Koocher (1972, 1974), and White (1977) presented
the children with conservation tasks to determine their stage of
intellectual development. The children were then presented with
various questions concerning various concepts of death in an indivi
dual interview format. He asked 75 children ages 6 to 15 years a
group of four questions about the meaning of death and their expecta
tions about their own death. The sample was of middle SES status,


99
Is there anything else you would like to tell me about this?
Is there anything you would like to ask me?
Is there anyone you would like to talk with more about living or dying?
Before you go, why don't you draw me a picture of anything you would
like? (If child draws a scene related to death, I would talk with
him/her further and determine the nature of the effects of this
interview, and take appropriate measures, i.e., further discussion,
conference with parents and/or school personnel, etc.)-


60
if
Table 5
Responses Concerning Attitudes Toward Death
A /
rf \y
ay
KT
Yes
No
Sometime
Denial
1.
Do you sometimes feel this way: I
don't like to think about how I will
die? (self)
77%
10%
13%
jo>Yi
2.
If a friend died, do you feel you
would ever want to talk about it
with anybody? (other)
46%
40%
14%
7oo7a
3.
Would you ever want to go where a
friend is dead? (environment of
death)
81%
14%
4%
997a
Fear
1.
Are you afraid of dying? (self)
50%
37%
13%
/oo%
2.
Would the death of a friend scare
you? (other)
67%
21%
11%
l9%
3.
Are you scared to go to a cemetary?
(environment of death)
24%
60%
16%
700%
Anxiety
1.
Do you worry about dying? (self)
31%
39%
30%
2.
Does the thought of a friend dying
upset you? (other)
79%
9%
12%
700%
3.
Does a cemetary make you upset?
(environment of death)
33%
49%
18%
!Od%
Acceptance
1.
Does it bother you to think about
how you may die? (self)
29%
61%
10%
¡00%
2.
Would you want to visit a dying
friend in the hospital? (other)
71%
23*
6%
700%
3.
Would you be willing to go where
a friend is dead? (environment)
71%
23%
6%
700%


REFERENCES
XAckerly, W. C. Latency-age children who threaten or attempt to kill
themselves. Journal of The American Academy of Child Psychiatry,
1967, 6(2), 242-61.
Alexander, I. E., & Alderstein, A. M. Affective responses to the
concept of death in a population of children and early adolescents.
Journal of Genetic Psychology, 1959, 93, 167-177.
Anthony, S. The child's discovery of death. New York: Harcourt,
Brace, & World, 1940.
} Bail is, L. A. & Kennedy, W. R. Effects of a death education program
upon secondary school students. Journal of Educational Research,
1977, 71(2), 63-67.
XBeauchamp, N. F. The young child's perception of death (Doctoral
dissertation, Purdue University, 1974). Dissertation Abstracts
International, 1974, 35j6-A), 3288-3289. (University Microfilms
No. 74-26, 684)
y Bell, B. D. The experimental manipulation of death attitudes: A
preliminary investigation. Omega, 1975, 6^(3), 199-205.
Bender, L., & Schilder, P. Suicidal pre-occupations and attempts in
childhood. American Journal of Orthopsychiatry, 1937, _7, 225-234.
XBlake, R. R. Attitudes toward death as a function of developmental
stages (Doctoral dissertation, Northwestern University, 1969).
Dissertation Abstracts International, 1969, 29(5-B), 3380.
(University Microfilms No. 69-54, 291)
>kBlum, A. H. Children's conceptions of death and an after-life (Doctoral
dissertation, State University of New York, 1976). Dissertation
Abstracts International, 1976, 36(10-B). (University Microfilms
No. 76-090,32)
Bolduc, J. A developmental study of the relationship between experiences
of death and age and development of the concept of death (Doctoral
dissertation, Columbia University 1972). Dissertation Abstracts
International, 1972, 33(6-A), 2758.
% Boyar, J. I. The construction and partial validation of a scale for the
measurement of fear of death (Doctoral dissertation, University of
Rochester, 1964). Dissertation Abstracts International, 1964, 25_,
2041B. (University Microfilms No. 64-9228)
100


CHILDREN'S ATTITUDES TOWARD DEATH
BY
BONNIE ANDERSEN ENGEL
A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL
OF THE UNIVERSITY OF FLORIDA IN
PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR
THE DEGREE OF DOCTOR OF PHILOSOPHY
UNIVERSITY OF FLORIDA
1981

Copyright 1981
by
Bonnie Andersen Engel

The energy and form of this
dissertation are dedicated to Ram

ACKNOWLEDGMENTS
Warm appreciation is expressed
to Dr. Janet Larsen, committee chairperson,
Dr. Larry Loesch,
Dr. Michael Resnick, and
Dr. William Brievogel
for their unending support and guidance;
to Cathy, Carl, Jo Dolley, Bob A., Jim E., Henry, Geraldine, Lee,
Linda, Don, and Frank.
for their abundance of encouragement;
to my parents and professors
for providing the firm foundation of both vision and
determination;
to Mickey Singer and Amrit
for reminding me of love, perfection, and clarity of
perspective;
to the fourth and fifth grade students, their parents and teachers,
Mr. Glanzer and Mrs Marcos, assistant principals, and especially
Dr. Lee Rowell of Marion County Public Schools
for so willingly participating in this research endeavor;
to Leila Cantara
for excellence in typing services and warm sensitivity in
the fragile finalities.

TABLE OF CONTENTS
ACKNOWLEDGMENTS iv
ABSTRACT vi i
CHAPTER I
INTRODUCTION 1
Background 1
Need for the Study 7
Purpose 9
Rationale 10
Definition of Terms 11
CHAPTER II
REVIEW OF RELATED LITERATURE 13
Children's Concepts of Death From a Developmental View . . . 13
The Influence of Various Factors Concerning Children's
Concepts of Death 29
Children's Attitudes Toward Death 34
Research Concernii.g Suicide and Children 39
CHAPTER III
METHODOLOGY 44
Sample Selection 44
Procedure 46
Data Collection 47
Nature of the Data 48
Data Analysis 49
Validity 50
Reliability 51
Methodological Limitations 52
CHAPTER IV
RESULTS 53
Sampling Procedure 53
v

Demographic Data * . . . . 54
Questions Related to Children's Concepts of Death .... 56
Questions Related to Children's Attitudes Toward Death . . 59
Denial 59
Fear 61
Anxiety 61
Acceptance 62
Comparison of Attitudes Within Personal Death,
Impersonal Death, and the Environment of Death .... 62
Differential Trends Relative to Sex, Grade, School, GPA,
and Retention 63
Influences of Ethnic, Social, and Familial Characteris¬
tics 71
Differential Trends Relative to Ownership and
Acquaintance with the Death of a Pet 72
Interview Closure Activities 76
Clinical Impressions 79
CHAPTER V
DISCUSSION 82
Limitations Regarding Generalizability 82
Conclusions 83
Children's Concepts Concerning Causes of Death .... 83
Children's Views Concerning Conditions After Death . . 85
Children's Attitudes Toward Death 87
Implications 88
APPENDIX A PARENT CONSENT 92
B STRUCTURED INTERVIEW 95
REFERENCES 100
BIOGRAPHICAL SKETCH 108
vi

Abstract of Dissertation Presented to the Graduate
Council of the University of Florida in Partial Fulfillment of
the Requirements for the Degree of Doctor of Philosophy
CHILDREN’S ATTITUDES TOWARD DEATH
By
Bonnie Andersen Engel
June, 1981
Chairperson: Janet J. Larsen
Major Department: Counselor Education
The purpose of this dissertation was to assess and evaluate
normal children's concepts and attitudes toward death. The sample
for the study was composed of 35 fourth grade and 35 fifth grade
students attending one urban and one rural school. Each child
participated in individual structured interviews. Children's views
concerning the causes and events related to personal death (death
of self) and impersonal death (death of another) were explored.
There was also investigation of their attitudes of death denial,
fear, and anxiety, their acceptances regarding personal and impersonal
death; and their attitudes toward the environments of death.
The results indicated that these children viewed old age and
illness as the primary causes of death. Almost 80 percent of the
children expressed denial (i.e., aversion) regarding the environment
vii

of death and personal death. They also expressed anxiety concernina
impersonal death (e.g., death of a friend). Approximately half the
children expressed some fears relating to personal and impersonal
death. Psychological "acceptance" of personal and impersonal death
was expressed by approximately 65 percent of the children. A pre¬
ponderance of children expressed a mixture of all the measured
attitudes of denial, fear, anxiety, and acceptance in regard to the
death of a friend. These attitudes were consistently expressed
significantly more concerning impersonal death as compared to
personal death. Forty percent expressed "acceptance" of the environ¬
ment of death.
The results were also analyzed relative to sex, grade level,
urban-rural setting, grade point average, retention in grade, pet
ownership, and acquaintance with death of a pet. Approximately 15
percent more females than males consistently expressed fear and denial
of death. More rural children expressed denial of death than did
urban children. Also, significantly more urban children than rural
children expressed psychological acceptance of death. Children with
decreasing grade point averages expressed denial and anxiety of death
increasingly more often.
The results of this study indicate that normal children expressed
a.wide variety of attitudes toward death. These were primarily
characterized as denial or acceptance. It was also noted that there
was relatively little fear and anxiety of death expressed by these
children.
vm

CHAPTER I
INTRODUCTION
Background
The view of children's attitudes toward death as a developmental
concept has received relatively little attention in the professional
literature. Only in the last ten years or so has the topic of
"death and dying" emerged as a significant area of research in the
scientific community and as a "visible" topic of interest in popular
literature. While there has been a rather sudden proliferation of
books and articles on death in response to the needs and interests
of adults, there has been very limited generation of material
addressing this area as it relates to children. A close scrutiny
of both professional and popular literature yields rather limited
information or guidance for parents or professionals concerning
children's concepts, views, or attitudes concerning death. Further,
little of the information has been based on scientific investigation,
as compared to the singular or collective opinions of professionals
in the varied fields of education, psychology, medicine, sociology,
anthropology, religion, and philosophy. Some authors (Fauquet, 1980;
Kubler-Ross, 1975; Moody, 1975; Wass, 1976) have asserted that the
topic of death has been characteristically ignored, denied, or evaded
1

2
in our society for a rather long period of time. However, interest in
this topic through bona fide scientific investigation has clearly
emerged. Moreover, serious researchers have become increasingly
aware of the opportunity to examine children's concepts and attitudes
toward death as a fundamental and significant area of inquiry and
clarification.
The first investigations concerning children's concepts of death
occurred approximately four decades ago. Although Schilder and
Wechsler (1934), Bender and Schilder (1937), and Anthony (1940)
presented articles mainly of case report and theoretical nature,
Maria Nagy (1948) pioneered the first comprehensive study of children's
views concerning the nature of death through individual interviews
with a large number of subjects (n = 378). Using adjusted formats
of written composition, drawing, and/or structured interviews, Nagy
assembled 484 protocols from Hungarian children 3 to 10 years of age
in Budapest, Hungary, and its environs. Nagy found evidence for
differential stages in children's understanding of death. Children
3 to 5 years of age generally denied death as a regular and final
process. They viewed it as a temporary state, with varying "degrees"
of death. The children were aware that they were alive, but they
also imagined that dead people were alive. Children 5 to 9 years of
age tended to personify death. Death was viewed as a person walking
around trying to catch people and carry them off. Children 9 to 10
years of age tended to view death as a permanent, inevitable,
irreversible, and internal process.

3
Rochlin (1959, 1965) later corraborated these findings with
American children 3 to 5 years of age. Rochlin (1965) theorized
that in response to their overwhelming fear of death, children
construct elaborate defenses such as the ideas of reversibility,
temporariness, and continuing existence in places like heaven or
hell.
Kastenbaum (1965) similarly interpreted the personification of
death by 5 to 9 year olds as a necessary emotional compromise. He
stated that the person or image of death is created by the children and
modified by culture in order to make death more remote or more con¬
trollable. Weininger (1979) also speculated that the data obtained
from the older children in Nagy's (1948) research was strongly
affected by the cultural conditions of World War II Hungary.
On the other hand, Gartley and Bernasconi (1967), who studied
60 American Catholic children 51/2 to 14 years of age, did not observe
the concepts of reversibility or personification of death. These
researchers speculated that "early religious teaching and television
may acquaint the child with the facts of death earlier than was
usual in times past" (Gartley & Bernasconi, 1967, p. 85). Like the
other studies, the children's concepts of death did seem to solidify
and standardize with increasing age. Mclntire, Angle, and Struempler
(1972) found no differences in children's avowed concepts of death
as related to total hours a week of television watching or type of
favorite program (aggression, fantasy, or reality). Rochlin (1965)
also commented that children's concepts of life after death or places
people go after death seem to arise spontaneously and without
necessarily any formal religious education.

4
Consistent with the research concerning concepts of death since
Nagy (1948), much of the recent research in the field further yielded
evidence for stages of development in children's concepts of death.
Mclntire, Angle, and Struempler (1972) attempted to measure the views
of causes, images, and finality of death in children 5 to 18 years of
age of three different religious affiliations: Catholic, Protestant,
and Jewish. Children up to the age of approximately 6 years viewed
death as reversible, and viewed dead pets or persons as having
cognizance. Seven to 9 year olds viewed death as irreversible and
considerably fewer children believed in cognizance after death. A
second drop in the percentage of children who accepted cognizance was
evident in 13 year olds. It was also noted that death was not viewed
as a total cessation of life activities until the children were 7
years old.
Weininger (1979) used the techniques of structured interview
and structured play with 4 to 9 year olds to examine the relationship
of children's concepts of death as expressed verbally and as expressed
in play. In this study, the children evidenced increasing accuracy
in their understanding of death and dying with increasing age.
However, the data indicated that corresponding continuity between
play expression and verbal expression regarding these concepts was
not evident until the children were 8 to 9 years of age.
Thus, several studies (Gartley & Bernasconi, 1967; Kastenbaum,
1965; Mclntire et al., 1972; Nagy, 1948; Weininger, 1979) consistently
concluded that children's concepts of death develop in relatively
distinctive, identifiable stages. Children up to the age of 6 years

5
viewed death as reversible, temporary, and characterized by life
activities such as feeling, talking, and motion. Children 7 to 10
years of age generally accepted the concept of irreversibility,
although death was not viewed in a personal way. Some studies
(Kastenbaum, 1965; Nagy, 1948; Rochlin, 1959, 1965) suggested that
children 7 to 10 years of age viewed death as like a person who
caught people, while such personification was not evident in other
studies (Gartley & Bernasconi, 1967; Mclntire et al., 1972). At
the age of 10 or 11 years, most children tended to view death as
permanent, irreversible, and inevitable. Commensurate with the
evidence supporting developmental stages in children's views of
death, some studies (Formanek, 1974; Hansen, 1973; Koocher, 1974)
have related Piaget's theory of intellectual development to children's
emerging concepts of death. Thus, there has been general consistency
in the conclusions of researchers concerning children's concepts of
death.
However, there has been minimal research concerning children's
attitudes toward death. Most death attitudes studies have focused
on adult populations, particularly college students. Only two
assessment instruments have been developed to measure death attitudes
at the early adolescent level: the Attitude Toward Death Scale
(Hardt, 1975) and the Early Adolescent Death Attitude Scale (Fauquet,
1980).
In reviewing the literature concerning death attitudes, four
broad divisions seemed to emerge. The most frequently investigated
areas were the fear of death (Bailis & Kennedy, 1977; Bell, 1975;

6
Boyar, 1964; Gold, 1974; Levitón, 1974; Mueller, 1976; Nelson & Nelson, 1975)
and death anxiety (Alexander & Alderstein, 1959; Nelson & Nelson, 1975)
Rowe & Loesch, 1978; Templer, 1970). Attitudes concerning denial
of death have been investigated by Gold (1974) and Nelson and Nelson (1975).
Attitudes concerning acceptance have been studied by Kurlychek (1976).
Thus, the areas of fear, anxiety, denial, and acceptance which have
received investigation in older populations do not appear to have
been investigated in reference to young children.
There was significant information in the medical literature which
addressed the many issues of caring for the terminally ill child and
the needs of the family. In many cases, there was specificity as to
the child's particular illness, such as cancer, leukemia, or congenital
heart disease. The topic of the sudden traumatic death of children
was also addressed. However, the medical and psychiatric literature
has not yielded research on the attitudes of normal children concern¬
ing death and dying.
The topic of bereavement in children has received some attention
in the literature. Stein (1974) reported that "during childhood one
out of every 20 children in the United States will lose a parent to
death and that by the age of 16, one of every five children will
have lost at least one parent." Kastenbaum (1972) stated that the
death of a parent has the "single and longest lasting" effect on
children. He further suggested that "bereavement in early childhood
has been implicated as the underlying cause of depression and suicide
attempts in later life" (Kastenbaum, 1975, p. 186). Moriarity (1967)
reported that his studies suggested that the case histories of a large

7
number of juvenile delinquents indicated unresolved childhood grief.
Fauquet's (1980) review of the literature revealed that "during
childhood and early adolescence bereavement reactions are similar
to those of adults: disbelief, physiological distress, guilt, fear,
anger, and panic" (p. 7).
Thus, there has been very limited research specifically investigat¬
ing normal children's attitudes toward death and factors related to
them. Since there was such a scarcity of information in this area and
since children's concepts of death appeared to be relatively defined
from a developmental point of view, it seemed important to explore the
attitudes of normal children toward death. Therefore, the problem
was:. What are normal children's attitudes toward death? A related
question was: What factors relate to children's death attitudes?
Need for the Study
The increased attention to the factors, needs, and attitudes of
adults concerning death has yielded a proliferation of material,
resources, and programs in a variety of professional fields and
institutions. With increased knowledge as to the attitudes of normal
children concerning death, a number of related possibilities in the
theory, research, training, and practice of counselors and school
psychologists could result.
Increased knowledge of children's attitudes toward death and
related factors could yield further development and possible modifica¬
tion in theory, particularly as it may relate to the developmental
point of view. While it appeared that children's concepts of death

8
emerge in stages over rather identifiable age levels, it was also
important to determine whether children's attitudes toward death
develop and mature over time. While there appeared to be various
attitudes toward death evident in the adult population, it was
important to determine whether a similar variety was manifested in
the population of normal children, or whether the attitudes were
relatively invariant. Furthermore, it seemed useful to ascertain
possible factors related to the emergence, modification, or change of
death attitudes in children. Increased information concerning
children's death attitudes would also better enable one to explore
the implications as they relate to such models as Psychoanalysis,
Piagetian theory, Behaviorism, and others. Thus, several ramifica¬
tions would emerge as increased information concerning children's death
attitudes is discovered.
Increased knowledge concerning children's attitudes toward death
would also yield further implications in subsequent research. It
would be important to determine the intensity, stability, or
flexibility of children's death attitudes, and the factors related
to such dimensions. The influence of socioeconomic level, cultural,
ethnic, and religious background also merited investigation. Further
research concerning the influence of traumas on children's attitudes
toward death would need to be pursued. There also would need to be
considerable investigation of the premise that death attitudes may be
related to children's and adolescents' behaviors in such areas as
delinquency, depression, drug usage, and suicide, as suggested by some
researchers (Fauquet, 1980; Kastenbaum, 1975; Klagsbrun, 1976;

9
Moriarity, 1967; Orbach & Glaubman, 1978; Smith, 1976). Thus, there
are numerous implications for further research related to children's
attitudes toward death.
Increased knowledge of children's attitudes toward death also
would have significant impact on the training and practice of
counseling, school psychology, and other areas of mental health.
If such attitudes were known, it would be possible to "sensitize"
professionals to the characteristics and needs of children concerning
their attitudes toward death. Intervention and facilitation of more
healthy attitudes might also be developed by skillfully trained profes¬
sionals. It might also be possible to identify some children who
may be pre-suicidal based in part on their expressed attitudes toward
death. The implementation of formal classes in death education may
also be prudently and appropriately pursued. It would be possible
to provide guidance to parents, teachers, and other caregivers con¬
cerning children's attitudes toward death. On occasions when death
of a classmate or a classmate's parent or sibling is experienced, it
would be possible to facilitate an appropriate response based on valid
information regarding children's death attitudes. Thus, there are
multiple practical implications which may occur in the areas of train¬
ing and practice based on further knowledge of children's death
attitudes.
Purpose
The purpose of this study was to explore normal children's
attitudes toward death. Specifically, there was investigation of

10
normal children's general concepts of death as initially structured
by Koocher (1974). Further, there was investigation of death
attitudes of denial, fear, anxiety, and acceptance in reference
to death of self, death of other, and the environment of death.
There was examination of the demographic factors which may relate
to children's death attitudes.
Rationale
The structured interview technique has been used with young
children consistently more than any other type of assessment. From
the early work of Nagy (1948), to the pivotal studies conducted by
Koocher (1973, 1974) and Orbach and Glaubamn (1978, 1979), the
format of self-report concerning questions about death with young
children has been most commonly used. There has been some pairing
with other tasks, such as Piaget's conservation problems, the WISC
Similarities Subtest, or structured play activities, but the indivi¬
dual interview procedure seemed to be a key part of sound methodology
with young children in evaluating their concepts and attitudes about
death. Therefore, it was the method of choice for this study.
Recognition had to be given to the special sensitivity of this
topic. In that some authorities (Kubler-Ross, 1975; Moody, 1975;
Wass, 1976) asserted that there has been a tendency for people in this
society to ignore, evade, or deny the topic of death, it seemed
prudent to use a methodology which enabled maximum sensitivity, support,
and response to the child. In that many of today's elementary children
experience periods of leaving the regular classroom for various

11
activities such as media center instruction, group guidance, music,
speech therapy, etc., the format of individually interviewing
children away from the classroom setting seemed to permit a sense
of routine procedure to the child. Further, the individual interview
situation better enabled the establishment of rapport, privacy, and
personal attention.
Definition of Terms
To clarify the terms and concepts of this study, the following
definitions were used:
Acceptance - "A willingness or openness to understand a topic;
to have particular ideas about or to consent to think about a topic"
(Fauquet, 1980, p. 5).
Anxiety - A generalized "feeling of apprehension which tends to
be elicited by situations in which the individual feels threatened
. . . the nature of the threat may or may not be clearly perceived"
(Coleman & Hammen, 1974, p. 124).
Attitude - "A relatively enduring system of affective, evaluative
reactions based upon and reflecting the evaluative concepts or beliefs
which have been learned about the characteristics of a social object
or class or social objects" (Shaw & Wright, 1967, p. 10).
Cemetery - A place where people are buried.
Children - Persons 8 years 6 months to 11 years 0 months of age
as of September 1 , 1980..

12
Concept - "A general meaning, an idea, or a property, that can
be predicted of two or more individual items" (English & English,
1966, p. 104).
Denial - "Denial is a mental mechanism. ... Its function is
to dispense with a perceived danger. ... It is a process requiring
constant revision of facts and constant correction of perceptions.
It nullifies part of a reality and restores a state of previous
harmony" (Weisman, 1972, p. 25).
Environment of Death - The setting in which the dying or dead
person is known to be present, such as a cemetary or a hospital in
which a friend or acquaintance is dying.
Fear - A specific feeling that is experienced "in the face of a
present, anticipated, or imagined danger or pain. There is a real or
imaginary threat to one's well being or survival" (Wood, 1976, p. 22).
Normal - Those children in regular class who are achieving
academically at an A, B, or C level, who have been retained only once
or not at all, and who are determined to exhibit adequate adjustment
in learning, behavioral, and social areas in the professional judgment
of the classroom teacher.
Suicide - "The deliberate act of self-injury with the intention
that the injury should kill" (Garfinkel & Golombek, 1974, p. 1278).

CHAPTER II
REVIEW OF RELATED LITERATURE
The review of the literature pertaining to this study concerning
children's attitudes toward death provided a theoretical basis for
the study. Attention was given to research which has investigated
children's concepts of death from a developmental view, particularly
from a Piagetian and a psychoanalytic theoretical basis; research
which has investigated the effects of various factors such as
socio-economic level, race, television viewing, and experience with
death on children's concepts of death; research which has investigated
children's attitudes toward death; and relevant research which has
investigated children's perceptions of death as may be related to
suicide.
Children's Concepts of Death From a Developmental View
Since the first comprehensive study (Nagy, 1948) of children's
concepts of death, developmental stages have been evident consistently
in the literature in this area. Through individual interviews with
378 Hungarian children ages 3 to 10 years, Nagy (1948) found evidence
for differential stages in children's understanding of death.
Children 3 to 5 years of age generally denied death as a regular
13

14
and final process, death was viewed as another kind of existence
in changed circumstances. Death was also seen as temporary and in
varying "degrees." The children were aware that they were alive,
and they imagined that dead people were alive also. "Living" and
"lifeless" were not yet distinguished. Thus, a sense of animism
was attributed to the dead.
Other studies (described later) have investigated the child's
concept of animism in detail. Nagy (1948) found that children 5 to
9 years of age tended to personify death. Death was viewed as a
person walking around trying to catch people and carry them off.
Death was also viewed as an eventuality, but the children endeavored
to keep it distant from themselves. Children 9 to 10 years of age
tended to view death as a permanent, inevitable, irreversible, and
internal process. The perceptible result of death was the dissolu¬
tion of bodily life. Animism and egocentrism were not characteristic
of this age group.
Rochlin (1959, 1965) corraborated Nagy's findings concerning
young children's concepts of death at the 3 to 5 year age range.
Rochlin (1965) theorized that in response to their overwhelming fear
of death, children constructed elaborate defenses such as the ideas
of reversibility, temporariness, and continuing existence in places
like heaven or hell.
Beauchamp (1974) studied the death perceptions of 3 and 5 year
olds. She found that the two groups differed significantly on the
concepts of universality, irreversibility, causality, and fear of
death. Three year old children did not view death as irreversible

15
or universal. They exhibited more fear of death than the five year
olds, and attributed death to such causes as anger, naughtiness,
and wishful thinking. On the other hand, the five year olds viewed
death as universal, irreversible, and due to more realistic causes.
Swain (1976) studied the concepts of death of children 2 years
to 16 years of age through a semi-structured individual interview
format. The 2 to 4 year olds viewed death as reversible rather than
final, improbably or escapable rather than inevitable, and not
personally applicable to them. Children 5 to 7 years old expressed
the belief that death was inevitable and applicable to them personally,
but at a time remote from today. Like the younger children the 5 to
7 year olds tended to emphasize the accidental and punishing nature
of death. In general, the 5 to 7 year old children also demonstrated
less magical thinking and a greater reliance on biological and social
reality.
Anthony (1940) summarized a series of investigations of children
3 to 13 years of age in England over a two year period. Anthony
found that thoughts of death were frequent in children's fantasies.
For example, approximately 50 percent of the children in a story
completion task made reference to death in completing the story even
though the concept did not appear in the story stem. Anthony (1940)
distinguished five stages in children's concepts of death from
ignorance of the meaning of the word to a clear definition in logical
or biologically essential terms. Anthony (1940) observed differen¬
tial stages in children's concepts of death which generally parallelled
Piaget's theory on the development of children's understanding of
causality.

16
Several other studies (Hansen, 1973; Kalmbach, 1979; Kane,
1979; Koocher, 1973; Nass, 1956; White, Elsom, & Prawat, 1973)
have specifically investigated children's concepts of death in the
context of Piagetian theory of intellectual development. Children's
concepts of death seem to evolve in sequential stages generally
consistent with Piaget's stages of preoperational thought, concrete
operations, and formal operations. Hansen (1973) asserts that "the
notions of classification, conservation, time and age acquired in
the concrete operational stages seem to be necessary elements for
grasping death as a definitive and universal event" (p. 110).
Although Hansen's data was generally consistent with Piaget's
stages, other evidence suggested that 7 to 8 year olds tend to view
death as an internal process. This concept seemed to be grasped at
an age earlier than Hansen (1973) predicted and earlier than what
is stated in the literature. Formanek (1974) reported findings
similar to Hansen (1973) in his study of the responses of 300
children. On the other hand, Melear (1973) found evidence which
suggested that children do not develop a realistic view of death
until they are more nearly 10 years old.
Kalmbach (1979), Koocher (1972, 1974), and White (1977) presented
the children with conservation tasks to determine their stage of
intellectual development. The children were then presented with
various questions concerning various concepts of death in an indivi¬
dual interview format. He asked 75 children ages 6 to 15 years a
group of four questions about the meaning of death and their expecta¬
tions about their own death. The sample was of middle SES status,

17
of equal representation in sexes, and composed of 20 percent non-
\erf
white children. Koocher also sought to obtain an estimate of the
children's intellectual level by administering the Similarities
Subtest of the Wechsler Intelligence Scale for Children. In order
to classify the children according to their level of cognitive
functioning by a Piagetian model, each child was tested with three
conservation tasks (i.e., mass, number, and volume) and one task in
hypothesis formation. Koocher's criteria were the following:
If the child failed one or more of the conservation tasks,
he was placed in the "preoperational" group. If he
passed all three of those, but failed the hypothesis
formation task the child was classified as "concrete-
operational." If the child dealt with all four tasks
successfully, he was classified as "formal operational."
(p. 405)
In an individual interview format, each child was administered the
Similarities subtest, the conservation tasks, and asked the following
questions: "What makes things die?" "How do you make dead things
come back to life?" "When will you die?" "What will happen then?"
Koocher found no statistical differences attributable to race or sex.
The results did, however, reflect developmental differences across
children's ages. Koocher reported that children 7 years of age and
under generally evidenced fantasy reasoning, magical thinking, and
realistic causes of death marked by egocentric reasoning. Death was
viewed as reversible and impermanent by this age group. Children 7
to 12 years of age described the infliction of death with or without
intention, such as through weapons, poison, or assault. Children 12
years of age and older cited relatively abstract clusters of specific
possibilities of death. These included physical deterioration, often

IS
with a recognition of death as a natural process. In response to the
/ question of what will happen when one dies, Koocher grouped the
responses into the following non-exclusive categories:
references to being buried alive were given by 52% of
the children; references to being judged, going to
heaven or hell, or other hints at any sort of after¬
life by 21%; references to having a funeral by 19%;
specific predictions of how death would occur by 10%;
references to some aspect of sleep by 7%; references
to being remembered by others by 5%; references to
reincarnation by 4%; and references to cremation by
3%. (p. 409)
In contrast to the findings of Nagy (1948), Koocher (1974)
found no personification type responses given in reference to what
might happen at the time of death. Weininger (1979) speculated
that Nagy's (1948) findings concerning children's personification of
death perhaps had its source "in specific cultural situations--the
armies, bombs, and threat of imminent death of World War II Hungary"
(p. 397). On the other hand, Kastenbaum (1965) theorized that the
personification of death by 5 to 9 year olds was a necessary emotional
compromise. The children created a person or image of death in order
to make death more controllable.
Kane (1979) investigated the death concepts of 122 mid-America,
middle class white children, ages 3 to 12 years, through 10
components of the death concept which she described as the following:
1. Realization is the awareness of death, of the state of being
deceased, or an event which happens. Death can happen to someone,
or it can be something which makes the living die.
2. Separation deals with the location of the dead and is con¬
cerned with the child's idea of where the dead are: i.e., "In the
trees," "Under the ground."

19
3. Immobility has to do with the child's notions concerning
the movement of the dead. The dead may be seen as totally inactive
or partially or completely active.
4. Irrevocability has to do with the child's idea of death as
permanent and irreversible, or temporary and reversible.
5. Causality is a belief of what brought about the state of
death, whether from internal causes, such as heart attacks or external
causes such as guns or a combination of the two.
6. Dysfunctionality deals with the ideas about bodily functions
other than the senses. A child could believe that the dead are totally
dysfunctional, or that they are partially or completely functional.
7. Universality deals with the child's ideas of mortality. A
child could have notions that everybody dies, or that nobody dies, or
that there are exceptions.
8. Insensivity is a consideration of mental and sensory functions
such as dreaming, feeling, thinking, and hearing. Ideas may be held
that the dead are totally insensate or partially or completely sensate.
9. Appearance is the notion of the way the dead look. Ideas
could be held that a dead person cannot or does not look as though he
were alive or, to the contrary, that he looks the same.
10.Personification is a notion of death as concretized and
reified as a person or thing.
During the course of the study it became apparent that a
child could be aware, recognize, or realize death as
having a substance. The Realization component was seen,
therefore, to include Personification, and Personifica¬
tion was dropped as a separate component, (p. 144)

20
Kane (1979) discerned three stages in the children's concept
development. Stage One was characterized by the presence of the
components of Realization, Separation, and Immobility. Death was
mainly a description: lying down with immobility. Egocentricity
and magical thinking was evident. The children believed they could
make someone dead by their behavior, wish, or label. At Stage Two,
death was viewed as specific, concrete, and dysfunctional. The
beginnings of logical thought were evident. Besides further develop¬
ment of the aforenamed components, there was inclusion and development
of the remaining components of Irrevocability, Causality, Dysfunc-
tionality, Universality, Insensitivity, and Appearance. However, the
components were not interrelated. Early in Stage Two, the children
tended to believe that death was externally caused, although internal
causes of death were recognized later. Except for violence, death
was viewed as a part of old age and very far away. At Stage Three,
the children began to interrelate the components. The children's
conceptualizations were more abstract, logical, and reality-based.
Some children considered the existential issues of life and death.
Death was a definition, an internally caused state characterized by
dysfunctionality, inactivity, and insensitivity. The stages were
shown to develop year by year. Kane (1979) further stated that the
stages were related to Piagetian preoperational, concrete operations,
and formal operations stages. The youngest children in Stage One
organized their thinking in terms of structure; those in Stage Two
thought in terms of function; those in Stage Three evidenced abstrac¬
tion.

21
Factor analysis of children's death concepts as defined by
Kane (1979) evidenced an increasing multiplicity in the components
during the early childhood years. In general, children acquired
Realization by age 3; Separation and Immobility be age 5; Irrevoc¬
ability, Causality, and Dysfunctionality, and Universality by age
6; Insensivity by age 8; and Appearance was added by age 12. Kane
(1979) emphasized that the addition of components in each cluster
was not in any particular order. Thus, a one-to-one sequence of
component acquisition could not be established.
Kane (1979) also differentiated as to whether the children
were experienced or inexperienced with death. This was established
through postinterview contacts with the parents. The following
criteria were used:
A child was considered to be experienced if, after the
age of 18 months, he had known at least one intimate such
as a parent, sibling, or close friend, or four non¬
intimates who had died, or if he had seen at least one
dead person, or had gone to at least one funeral or
funeral home, or had been greatly affected by the death
of a nonintimate. A child was considered to be in¬
experienced if he had encountered death before he was
18 months old or had never encountered it. (p. 145)
Kane (1979) found that the experienced 3 to 6 year olds evidenced
the presence of the death components at a significantly greater degree
than the inexperienced peers. Children 7 through 12 years of age
manifested the same concepts whether they were experienced or not.
However, the older children generally evidenced the presence of most
of the concepts anyway, and a differentiation would be more difficult
to establish, if indeed it existed. Bolduc (1972) also found that
children who have had experiences with death evidenced significant

22
differences in their death concepts as compared to those who had no
experiences with death.
Contrary to Nagy's (1948) results, in which the inevitability
of death occurred to children at age 9, Kane (1979) found this
belief occurring frequently in children by age 6, and consistently
in children 8 years of age and older. Also contrary to Nagy's
(1948) investigations in which personification of death was expressed,
Kane (1979) found no such form of reification. Thus, there appeared
to be some significant differences in the concepts of death as
expressed by American middle class white children in the 1970's as
compared to the concepts of death of Hungarian children of post World
War II.
In studying children in kindergarten through the fourth grade,
White, Elsom, and Prawat (1978) also found that children's concepts
of irrevocability, universality, and cessation of bodily processes
in regard to death were related to the children's age and intellectual
development. White et al. (1978), however, isolated a rather inter¬
esting differentiation in their study. After determining the child's
intellectual conceptual level by presenting three conservation tasks
taken from the Concept Assessment Kit by Goldschmid and Bentler
(1968), a story was read to the children. Half of the children
heard a version in which the main character, an elderly woman who
dies, is a kind, likeable, and friendly person who always says "hello"
to children. Half of the children heard a version in which the
elderly woman is unkind, mean to her pets, and yells at children.
The researchers found that the children's understanding of death was

23
not affected by the story. However, the children's views concerning
the cause of death were influenced. It is reported:
Twenty two percent of the children who heard the story
about the unkind woman attributed her death to some
unkind act she committed. Some children, for example,
claimed she died because she yelled at the school
children and some because she would never laugh.
Of the children who heard the story about the nice
woman, only one subject out of 85 attributed the
woman's death to her own behavior, claiming, perhaps
whimsically, that she died because she laughed too
much. There was, then a significant relationship
between a child's perception of the attractiveness of
the story character and a child's understanding of
the cause of that character's death, x2(l) = 18.36,
p < .001. (p. 309)
Mel ear (1973) who interviewed 41 children 3 to 12 years of age
in Greeley, Colorado, found children's death concepts to be generally
consistent with those reported in other studies which suggested a
developmental view. Mel ear (1973) categorized the responses into
four stages. The first stage was characterized by relative ignorance
of the meaning of the word death as evidenced by children 3 and 4
years of age. (However, one may question the limited sample of six
children at this age range from which such a conclusion is drawn.)
In the second stage, 4 to 7 year olds viewed death as a temporary
state in which the dead can be revived, experience feelings, and
engage in biological functioning. Five to 10 year olds, in the third
stage, viewed death as final, but the dead were able to see, hear,
feel, and in other ways function biologically. (Again, Melear (1973)
reported only four children in this category, and one may question
the size of the sample.) The fourth stage was characterized by the
view that death was final with the cessation of all biological func¬
tioning. In other words, a more realistic concept of death was

24
expressed. It was interesting to review the ages of the children
in this stage as reported by Melear (1973). Of the 21 children,
two were between 4 and 5 years of age, one was between 5 and 6
years, and the remainder viere 6 years and older.
Other studies which found children's views of death to be a
developmental phenomenon were those by Anthony (1940), Blum (1976),
Childers and Wimmer (1971), Gartley and Bernasconi (1967), Hornblum
(1978), Mclntire, Angle, and Struempler (1972), Nass (1956), O'Brien
(1979), Swain (1976), and Weininger (1979).
Some portion of the literature (Buhrmann, 1970; Maurer, 1966;
Plank & Plank, 1978; Schilder & Wechsler, 1934; Schnieder & Schneider,
1977) interpreted children's developmental concepts of death based
on Psychoanalytic Theory. For example, Plank and Plank (1978) .
examined children's art and autobiographies to discern the process
of building up defenses, the rejection and denial of death, and
children's reactions to catastrophies. In Maturation of Concepts of
Death, Maurer (1966) outlined 12 developmental steps illustrated by
quotations from various essays. Briefly, the maturational steps
were the following:
1. Awareness. The primal terror was there, less among the
brighter and so great among the dull that they feared direct mention
of it. . . . "When I think of death, right away I am horrified.
Sometimes when I see a dead person, they seem so unreal."
2. Denial. This may take many forms: childlike whistling in
the dark ("My grandfather ain't never going to die"); reversals
("Death is a triumph"); clinging to attributes of life ("All I want

25
to know is what it feels like"); or refusing to think ("I think it
is a word that should be thought only when it occurs").
3. Projection. The death of an "other" leaves one grateful
for one's own life, indeed more fully alive.
4. Curiosity. Questions do not cease and some remain silly
even in adolescence. Wrote one: "I think it is the fear of the
unknown. What's going to happen? Will I just be there with no
thoughts, then all of a sudden someone blows a horn and up I come
or will I be conscious every minute? I would like for someone to
tell me what it's like and what happens afterward? Maybe if I trust
God and be a good little girl I will not fear the answers and not ask
so many questions."
5. Personification. "Will death call your name to go?"
6. Propitation. The death of the self being too traumatic to
express, they could approach it only one step removed. "If I lost
one of my parents, death would probably be hard to accept because I
am close to both of them."
7. Dare-devi1ry. No mention was made of this, possibly because
it is an action language.
8. Substitution. A remnant of this appeared as: "A new life
is born each day just as an old life dies each day."
9. Contempt with laughter. "I went on a dare one time with this
friend who knows a guy who works at the, you know, morgue. He puts
his lunch right on the body in the cold room to keep it like in an ice
box. He laughed and said: 'It's all right. He won't eat much.' But
I didn't care for that too much."

26
10. Acceptance of inevitability. "Some people think that it
is best not to know, but I feel you can appreciate life more and get
more out of it."
11. Despair. "When I think of death I think of living. I
think about the things I should have done but didn't, the places I
wanted to see but never did. Ordinary things like I should have
treated my sister and brother better or I should have gotten better
grades in school and the little bad things I did that upset my
mother."
12. Transmutation to idealism. "Death is something most people
hate to think about, but it is also something we have to accept. What
we should do is to make the best of our lives before it is too late."
Other psychoanalytic studies and writings (Ackerly, 1967; Menninger,
1938; Pfeffer, 1978; Pfeffer, Hope, Conte, Plutchik, & Jerrett, 1979;
Ringel, 1976) interpreted concepts of death in reference to suicide.
This topic will be discussed in more detail later in this chapter.
A few studies (Bruce, 1941; Huang & Lee, 1945; Klingberg, 1957;
Klingensmith, 1953; Russell, 1939, 1940a; Safier, 1964) have examined
children's concepts of animism as it relates to their concepts of
death. Piaget (1929) described animism as the mental phenomenon.in
children in which life and consciousness is attributed to certain
inanimate objects. According to Piaget, this was partially due to
the child's view of objects as extensions of himself or herself.
Piaget identified four stages in the development of the concept of
animism. In Stage One, children up to 6 or 7 years of age attributed
life to anything that demonstrated activity in any way. For example,

27
a stove was alive because "it cooked." In the second stage,
children 6 to 8 years of age attributed life to anything that
moved at the time it was moving. For example, a ball was alive
while it was rolling. Clouds, cars, and bicycles were alive while
they were moving. At Stage Three, children 8 to 11 years of age
attributed life to anything that moved on its own accord, such as
the sun and moon. Mechanical devices were not considered alive
because an operator was required to move them. At Stage Four,
children 11 years of age and older attributed life and consciousness
to animals alone or to plants and animals. The age limits were some¬
what indefinite, but Piaget asserted that there was definite model
development in these stages.
Safier (1964) examined the responses of three groups of boys in
San Francisco who were ages 4 to 5, 7 to 8, and 10 to 11. She
administered the following ten stimulus words: dog, ball, tree,
bike, boy, moon, mother, ocean, car, cloud. For each word presented
at random, the following questions were asked:
1.
Does
a
live? Is it a
2.
Does
a
hurt when hit?
3.
Does
a
grow up?
4.
Does
a
die?
In the second part of the interview, the children were asked their
rationale for their responses. Two independent judges evaluated the
tape-recorded conversations in reference to the following questions:

28
1. Is life or death seen as a recurrent process?
2. Does life or death come from the outside to a person
or thing (external process)? Or does it come from
the inside, and is it seen as an internal process?
3. Is there neither basis for considering life or death
either as a recurrent or irrevocable or as an
internal event. (Safier, 1964, p. 288)
Basically, Safier (1964) found a decrease in "animism" and "death"
scores with increase in age. As children's concepts of death improved,
so also did their concepts of life. Safier stated, "The judges'
conclusions seemed to support a common rationale underlying Piaget's
stages of animism and Nagy's stages of death conception" (1964, p.
294).
Another approach to clarifying children's concepts of death was
implemented by Weininger (1979) who compared children's verbalizations
about death and dying with their behavior and comments in structured
play situations. Weininger (1979) combined the four questions used by
Koocher (1973, 1974a, 1974b) with two differently structured play
situations to determine the children's perception of death. Weininger
(1979) examined the verbal and play responses of 30 boys and 30 girls
ages 4 to 9 years old living in a middle class urban area. In a
small empty classroom, there was a tape recorder, a small table and
two chairs, and the following play materials: a mother and a father
doll, a child doll, a pretend stethoscope, a pretend hypodermic
needle, candy pills, a pretend thermometer, a blanket, a pillow,
a double bed, a box with a lid, 2 inch glass of water. The play
procedure was described as follows:
the interviewer presented all the materials, saying that
"the doll is very sick and the doll is going to die."
The interviewer gave the child time, and, if necessary,
helped the child to play out the situation, encouraging

29
the child in a free fashion to play with the materials
and to say what was happening. Following this play,
the interviewer said, "the doll is very sick and is now
dead" and encouraged the child to play out the situation
as the child perceived it. ... All children were
encouraged to respond both in terms of vocalization and
in terms of play and gesture, (p. 400)
As a preface to asking Koocher's (1974) questions, the interviewer
generally stated, "I would like to find out what children think about
dying, and I wonder if you have ever thought about this." The play
procedure or the interview procedure were done in random fashion.
Weininger (1979) summarized the results as follows:
The children's play indicated increasing accuracy in their
understanding of the concepts of dying and dead. Their
answers to the questions also indicated accuracy increased
with age. There were, however, differences between their
play understanding, and their verbal expressiveness.
Children's play frequently contradicts what they say about
dying and death, sometimes indicating a more complex
understanding than verbal expression would suggest, some¬
times reflecting a failure to grasp freely the concepts
they speak about. Concepts of dying and death are hard
for children to understand and accept; the data indicate
that it is not until 8 or 9 years that play and verbal
expressions come to terms with each other, (p. 395)
Thus, there were a number of studies which examined children's
concepts of death in the context of Piaget's stages of logical thinking
through the use of individual interview and structured play format. In
general, the results appeared to be relatively consistent in supporting
a developmental evolution in children's concepts of death throughout the
childhood years.
The Influence of Various Factors Concerning
""Children's Concepts of Death
Some studies (Beauchamp, 1974; Bolduc, 1972; Gartley & Bernasconi,
1967; Hornblum, 1978; Mclntire, Angle, & Struempler, 1972; Plotz &

30
Plotz, 1979) gave attention as to whether factors such as sex, socio¬
economic level, religion, and television viewing affected children's
concepts of death. The results tended to be consistent in most of
the measured factors.
Beauchamp (1974) found no differences in children's concepts of
death as a function of sex. On the other hand, Zweig (1977) found
significant sex differences in the death attitudes of children 8 to
12 years old. It was interesting to note that Chasin (1971) who
studied the death attitudes of adults did find sex differences.
Further, this factor was differentially influenced by level of educa¬
tion and religious orthodoxy.
Plotz and Plotz (1979) reported that children have many miscon¬
ceptions about death which are culturally induced. For example,
there may have been an overemphasis on violence. However, the
researchers suggested that this factor needs further study. Zweig
(1977) also reported some effect from cultural differences as well
as racial differences. On the other hand, Beauchamp (1974) found
no significant differences in children's concepts of death as a
function of social class. Chasin (1971), however, found that higher
income (over $10,000) populations were differentially affected in
their death attitudes as a function of religious orthodoxy. However,
the death attitudes of lower income ($10,000) populations were not
differentially influenced.
Some attention has been given to examining the effects of
children's television viewing on their concepts of death. Although
Gartley and Bernasconi (1967) speculated that television may acquaint

31
children with the facts of death earlier than was usual in past
times, they did not investigate this variable in their study.
Hornblum (1978) and Mclntire et al. (1972) reported no differential
effects of television viewing on children's conceptions of death.
Mclntire et al. (1972) found no significant differences even when
there was factor analysis of the total number of hours of television
viewing and type of favorite program: aggression, fantasy, or
reality. On the other hand, Zweig (1977) reported that her results
indicated that children learn more about death from the media and
reading than from religious training or school.
The matter of the effects of religion on children's concepts of
death has received very little attention in the literature. Gartley
and Bernasconi (1967) speculated on possible effects due to early
religious training, although they did not investigate this factor.
Mclntire et al. (1972) investigated the death concepts of 598
children, ages 5 to 18 years, who attended youth classes at either
a Roman Catholic elementary school, a Protestant Sunday school, or
a Jewish Temple. The children's religious affiliation was found to
be a significant variable in several measured aspects of their
acquaintance and concepts of the cause, imagery, and finality of
death. When asked "Why do people die?" there were significant
differences evident in the responses of the Catholic children at
the 6 year through 11 year range. At the age of 6 years, 33 percent
of the Catholic children gave the cause as "because they are bad."
However, no children in this or any other group attributed a known
death to moral guilt. At the age of 11 years, 22 percent of the

32
Catholic children stated that selection by God as the reason people
die, although only 2 percent of the Protestant and Jewish children
gave this as a reason. Mclntire et al. (1972) also attempted to
determine children's views of what happens after death. The children
who had lost a pet were asked, "Do you think the pet knows you miss
it?" For all children, there was a drop in this belief at 7 years
and at 13 years of age. However, some differences were noted at the
ages of 15 to 16 years. Twenty-eight percent of the Protestant
children and 12 percent of the entire group attributed cognizance
to the pet. Further, at all ages, the belief in cognizance or
awareness after death for self was much less than that attributed
to the pet. Mclntire et al. reported the following:
Catholic school children, ages 11 to 12 years, for example,
93% gave the response of spiritual continuation without
cognizance to the pet. Coexistence of these two responses
wás interpreted as a belief in personal spiritual continua¬
tion. ... In all four groups, the belief in spiritual
continuation peaked at the ages of 13 to 14 years, and
then decreased in all but those interviewed at the Catholic
school. ... In both the Protestant and Catholic children
the 7 year old was most likely (p < .01) to accept death
as total cessation; this corresponded with the decrease in
fantasy of imagery at the same age. By the age of 8, death
as a total cessation was less acceptable with responses of
increasing belief in spiritual immortality, (p. 530)
It was further added that frequency of religious instruction within
the various church groups did not seem to have any apparent effect on
the children's avowed concepts of death. There was also some investi¬
gation of the children's imagery of what happens to the body after
death. Mclntire et al. (1972) reported that "the concept of dis¬
integration to ashes or dust was clearly a factor of religious
education," although no more specificity in this area was given.

33
The investigators also found differential effects of religion regard¬
ing questions on the meaning of life and on suicide ideation. These
areas are discussed later in the chapter in the section on suicide.
Blum (1976) interviewed 155 children ages 7, 9, 13, and 18
years old. Half of the children were Catholic and half were Jewish.
Half attended religious Parochial schools and half attended public
schools. Blum (1976) also found that children's concepts of death
changed with age. He further found significance in the factor of
religion. For children in the formal operations stage, Blum reports
the following:
It was Catholicism (vs. Judaism) and a parochial-school
background (vs. a public-school background) that were,
in certain circumstances, related to more abstract levels
of thinking about an after-life. Finally, regarding
belief vs. non-belief in an after-life, Jews and
Catholics were very distinguishable at all ages, with
Catholics believing significantly more than Jews.
(p. 5248)
It was interesting to note that in adult populations, religious
activity and religious beliefs seemed to affect one's attitude toward
death. For example, Swenson (1965) found that "persons engaged in
frequent religious activity or demonstrating a fundamentaliStic
type of religion evidenced a very positive or forward looking death
attitude whereas those with little religious activity or interest
either evaded reference to death or feared it" (p. 109). Similar
results were reported by Chasin (1971), although there appeared to
be differential effects related to sex, level of education, and
income levels.
As discussed earlier, Kane (1979) investigated the effects of
children's experience with death on their death concepts. In general,

34
experienced children 3 to 6 years of age seemed to manifest more of
the measured components of death concepts than those 3 to 6 year
olds who were not experienced with death in their life. No differ¬
ential effects were found in children 7 to 12 years of age. Zweig
(1977) found that experiences with death influenced the attitudes
and concepts of death of 8 to 12 year olds. Bolduc (1972), in
studying the attitudes and concepts of death in 9 to 14 year olds,
found experience with death to be an influential factor. On the
other hand, Mclntire et al. (1972) who studied the death concepts of
children 5 to 18 years of age, found no apparent effect of experience
on children's avowed concepts of death. Thus, the results in this
area were rather contradictory, although the research tended to
suggest that experiences with death did affect children's death
attitudes and death concepts.
Children's Attitudes Toward Death
There appeared to be very limited research concerning children's
attitudes toward death. The only instruments which even approached
the early adolescent level were the Attitude Toward Death Scale
(Hardt, 1975) for 13 to 26 year olds and the Early Adolescent Death
Attitude Scale (Fauquet, 1980) for children in the sixth, seventh,
and eighth grades.
In older populations, mainly college students and adults, investi¬
gations of death attitudes have been approached through a variety of
models and dimensions. However, there did appear to be four broad
divisions which emerge from the literature on this topic. The most

35
frequently investigated areas appeared to be those of fear of death
(Bailis & Kennedy, 1977; Bell, 1975; Boyar, 1964; Gold, 1974;
Levitón, 1974; Mueller, 1976; Nelson & Nelson, 1975), and death anxiety
(Alexander & Alderstein, 1959; Nelson & Nelson, 1975; Rowe & Loesch, 1978;
Tempier, 1970). Attitudes concerning denial of death have been
investigated by Gold (1974) and Nelson (1975). Attitudes concerning
the acceptance of death have been studied by Kurlychek (1976).
A few studies (Ackerly, 1967; Alexander & Adlerstein, 1959;
Beauchamp, 1974; Blake, 1969; Levinson, 1967; Rochlin, 1965) have
alluded to children's fear of death. For example, Rochlin (1965)
presented the following thesis:
children very early, perhaps around three or four, become
aware that they will die but due to their overwhelming fear
of death, they erect elaborate defenses against this
concept. Thus the young child describes death as reversible
and temporary in order to master the realization of death.
(in Ackerly, 1967)
Beauchamp (1974), who studied the death perceptions of 3 and 5
year old children in the Midwest, reported that the older children
exhibited less fear than did the younger children.
Gartley and Bernasconi (1967), who interviewed 60 children 5h
to 14 years of age, concluded that "children can accept death matter-
of-factly, but acquired a fear of death by observing the behavior of
adults" (p. 85). Cox (1979) and Zeligs (1967) findings also supported
the view that children's death attitudes are affected by the parents
and adults in their environment. On the other hand, Dugan (1977),
who administered the Taylor Manifest Anxiety Scale and the Lester
Fear of Death Scale to adolescents and their parents, reported that
"fear of death in parents did not significantly influence that

36
attitude in children, nor was children's general anxiety score
affected" (p. 230).
Blake (1969) investigated the death attitudes of adolescents
as compared to older people as they related to the psychosocial
developmental stages proposed by Erikson (1958, 1959, 1964).
Adolescents reported more fear of death than older people. However,
the older people tended to use denial more than the adolescents.
Religious versus non-religious did not appear to be a factor. It
should also be noted that these populations were white, Protestant,
and middle-class.
O'Brien (1979) studied The Effects of Inclusion and Exclusion in
Mourning Rituals on the Development of Children's Conceptual Under¬
standing and Attitudes About Death. A questionnaire was administered
to 174 children in an inner-city public school, a parochial school,
and a Sunday school in the first, third, fifth, and seventh grades.
O'Brien (1979) found that middle-class children were more likely to
view death as painful and scary. Also, older children who had
participated in mourning rites evidenced increased anxiety in regard
to death.
Although little specificity is given, Melear (1973) placed some
focus on clarifying the death anxiety of 41 children 3 to 12 years
old among other issues related to their concepts of death. Melear
(1973) reported that some degree of death anxiety was evident in 12
percent of the 3 to 7 year old children, and in 75 percent of the 5
to 12 year old children. He commented, "all of the children, except
one, who exhibited anxiety also expressed a belief in an afterlife.

37
Perhaps this belief is an effort to overcome anxiety produced by
the realization that death is final and universal" (p. 360).
Only one study made some investigation of children's acceptance
of death. Rutzky (1979) examined the attitudes toward death of
children who grew up in concentration camps. Like other death
concepts, the children's responses varied according to their age.
Rutzky (1979) stated the following:
It is reported that the same mechanism and reactions
are observed in those who witnessed killing and mass
murders as in American children growing up in a peace¬
ful environment. Children from concentration camps
were not found to accept death more readily, even though
their environment introduced them to loss repeatedly and
might have inured them to death."(p. 101)
Anthony (1940) and Plotz and Plotz (1979) made some attempts to
discern the meanings children attribute to death on both the cognitive
and emotional level. Anthony (1940) suggested that children associated
death with "inner fears and feelings about separation, loneliness,
agressive impulses, and birth" (p. 46). Plotz and Plotz (1979)
suggested that children's attitudes toward death may have been
associated with cultural factors.
Thus, there were relatively few studies which yielded any signi¬
ficant information concerning children's attitudes toward death.
Further, many of the comments appeared to be more speculative and
interpretive than descriptive. Other writings (Anthony, 1940;
Harnik, 1930; Kotsovsky, 1939; Menninger, 1938; Osipov, 1935)
theorized about children's feelings and reactions toward deaths mainly
from a psychoanalytic basis. However, little substanitive investiga¬
tion was offered to support the theories.

38
There was a body of information in the medical literature
which addressed the many issues of caring for the terminally ill
child and the needs of the family. In many cases, there was
specificity as to the child's particular illness, such as cancer,
leukemia, or congenital heart disease. The topic of the sudden
traumatic death of infants and children was also addressed. However,
the medical and psychiatric literature did not yield research on the
attitudes of normal children concerning death and dying.
The specific topic of children's bereavement has received some
attention in the literature. Stein (1974) reported that during
childhood one out of every 20 children in the United States will lose
a parent to death and that by the age of 16, one out of every five
children will have lost at least one parent. Kastenbaum (1972) stated
that the death of a parent has the "single and longest lasting" effect
on children. He further suggested that "bereavement in early child¬
hood has been implicated as the underlying cause of depression and
suicide attempts in later life" (Kastenbaum, 1975, p. 186). Moriarity
(1967) reported that his studies suggested that the case histories of
a large number of juvenile delinquents indicate unresolved childhood
grief. Fauquet's (1980) review of the literature revealed that
"during childhood and early adolescence bereavement reactions are
similar to those of adults: disbelief, physiological distress,
guilt, fear, anger, and panic" (p. 7).
Miya (1972) theorized that the children's perceptions of death
and dying were influenced by the three growth processes of (a)
individual developmental levels of abstract and concrete reasoning,
(b) parental attitudes, and (c) personal experiences.

39
Other studies (Cox, 1979; Escamilla, 1977; Gomez-Ossorio, 1978;
Pinette, 1977; Zeligs, 1967) generally agreed that children's
emotional reactions to death were largely determined by their age
and developmental stage, their personal experiences, and the
parents' responses to death. Pinette (1977) stated that "the
limited understanding of the child is in itself a built in protec¬
tion for the child against being plunged into the depressed condi¬
tion that the adult might enter" (p. 6). On the other hand, Dugan
(1977) presented data which supported the contrary point of view in
regard to adolescent populations. Dugan (1977) used instruments,
including the Taylor Manifest Anxiety Scale and the Lester Fear of
Death Scale, to determine the nature of the fear of death in adoles¬
cents and their parents. This researcher stated the following:
Results indicated that fear of death in parents did not
significantly influence that attitude in children, nor
was children's general anxiety score affected. It was
concluded that the nature of the fear of death in
children is extremely complex and that: (1) adolescents
do not correlate viewpoints with parents even though
they are influenced by them; (2) unconscious death fear
plays a major role in the psyche; (3) people tend not to
think or are unable to think of the reality of their
personal death even though they have confronted it in
a specific life incident; and (3) this inability to think
of or grasp the reality of personal death is especially
true of persons who are in no immenent danger of death
(adolescents), (p. 239)
Research Concerning Suicide and Children
In 1946 in The Manual of Child Psychology, Carmichael spoke of
adolescent suicide as "a rarity." In 1979 the American Association
of Suicidology reported that suicide was ranked as the second leading

40
cause of death among this nation's youth. The incidence has nearly
tripled over the past 20 years. Green (1978) has associated self¬
destructive behaviors in children 5 to 12 years of age to factors
of child abuse. Paulson, Stone, and Sposto (1978) conducted a
three year study of 662 children, 12 years of age and under, who
were identified as self-abusive or suicidal and in treatment at the
UCLA Neuropsychiatric Institute. Pfeffer (1978) reported that over
100 suicidal children 6 to 12 years of age were treated at the Child
Psychiatry Inpatient Service at Bronx Municipal Hospital in the
previous four years. The National Clearinghouse for Poison Control
Centers (1968) and several researchers (e.g., Mclntire & Angle, 1973;
Sobel, 1970; Teicher, 1970; Springthorpe, Oates, & Hayes, 1977)
reported increasing admissions of children under 12 years of age to
poison centers and/or emergency hospitals for accidents and
"accidental overdoses." The National Center for Health Statistics
reported 170 confirmed child suicides in 1975. In the State of
Florida in 1977, five suicidal deaths were reported by children in
the 5 to 14 year old range. Schnake (1972) estimated the ratio of
suicide attempts to actual suicides is 50 to 8, while Jacobs (1971)
estimated the ratio at 50 to 7. Jacobziner (1960) estimated the
proportions at 50 to 1, while still higher ratios are cited by
Tuckman (1962) at 120 to 1. Thus, there was considerable evidence
suggesting serious and significant increase in suicidal attempts and
suicidal behavior in children.
In the last few years Orbach and Glaubman (1978, 1979a, 1979b)
produced some very interesting studies investigating the concepts of

41
death of normal, suicidal, and aggressive children. Zeligs (1974)
and Orbach and Glaubman (1977) have postulated that suicidal
behavior in the young could be partly attributed to the child's
concept of death. It was suggested (Orbach & Glaubman, 1977) that
suicidal children would likely evidence a more idiosyncratically
distorted view of death than would normal children or children with
other disturbances, such as problems of impulse control and aggression.
In 1978 Orbach and Glaubman individually interviewed 21 children,
ages 10 to 12, who were either suicidal, aggressive, or normal accord¬
ing to school records and school services. All of the children were
of low socioeconomic status; 20 were of Middle-Eastern origin, and
one was of European origin. They lived in Ramat-Gan, Israel. The
children were also matched for cognitive functioning by their per¬
formance on the Similarities subtest of the WISC. The children were
then administered structured questionnaire based on a modified
version of questions used in Koocher's (1974b) study. They were as
follows:
One set consisted of questions about impersonal death,
namely: How do things die?; What happens to things
when they die?; Can dead things come back to life?
The other set contained the same questions about per¬
sonal death, namely: How do you think you will die?;
What will happen to you when you die?; Can you come
back to life after you die? (p. 405)
The responses for the first questions in the two sets were categorized
as (a) natural death, (b) aggressive or brutal death, or (c) suicide
and self-destruction. The categories for the second question were
(a) burial process, (b) cessation of life activities or life process,
(c) deterioration of the body, (d) continuation of the life process or

42
life activities, (e) reference to other people's reaction, or
(f) other, such as don't know or the soul going to heaven. The
third question in the two sets was classified into one of the
following: (a) no return to life, (b) return to life in any form,
or (c) other. The following results were reported:
Aggressive children, compared to the other groups, gave
significantly more frequent responses of aggression and
brutality as causes of death, and suicidal children gave
more such responses than normal children. Suicidal
children named suicide and self-destruction significantly
more than any of the other groups. Responses of old age
and illness were given mostly by normal children. The
aggressive children gave the fewest responses of old age
and illness as causes of death. The frequency of responses
of old age and illness given by the suicidal children was
intermediate between these two groups. . . . Normal children
attributed cessation of life to the state of death to a
significantly greater degree than the other two groups.
Suicidal children, on the other hand, attributed life
qualities to the state of death significantly more than
aggressive or normal children. This difference was
significant for responses about personal death and total
responses but not for responses about impersonal death.
. . . The data also indicate that the distortion in con¬
cepts that concern death is not related to differences
in IQ because all three groups were equal in level of
intelligence as measured in this study, (p. 853-856)
In a similar study a year later, Orbach and Glaubman (1979)
presented measures and questions to 27 suicidal, aggressive, and
normal children, ages 10 to 12 years old. The children were indivi¬
dually administered the Similarities subtest of the WISC, and inter¬
viewed with a modified version of questions from Koocher (1974) and
Safier's (1964) questions regarding children's concepts of animism.
tv ^ •
Orbach and Glaubman (1979) found the following:
Suicidal children showed distortion in the death concept
more frequently than the other group, but they showed
no inferiority in their ability for abstract thinking.

43
The results favor the assumption that distortions in
the death concept are specific and, therefore, can
be attributed to a defensive process, "(p. 671)
Orbach and Glaubman (1978, 1979) repeatedly emphasized that a
discussion of the concepts and meaning of death must be an essential
part in the treatment of suicidal children.
Mclntire et al. (1972) reported one of the more striking statistics
from their interviews with the 598 Midwestern children 5 to 18 years of
age. When asked, "Are there times when you really wished you were
dead?" 238 (40 percent) of the children replied "occasionally" and
18 (3 percent) said "frequently." Those admitting frequent death
wishes held less naturalistic views of death, evidenced more fantasy
and imagery (such as reincarnation), and were more likely to believe
in reversibility and cognizance for themselves after death. Ten of
the 18 children reported that their death wishes were most often
percipitated by family arguments or fear of punishment, and most often
characterized by anger or sadness. Fourteen of the 18 children
were Protestant. All of them were over the age of 10 years.
Thus, there was considerable evidence which suggests that suicide
has become a matter of increasing frequency and concern among children
and adolescents. Further, since very few studies have focused on the
relationship between children's concepts of death and thoughts of
suicide, continued investigation of children's concepts, thoughts,
and attitudes toward death certainly seemed warranted.

CHAPTER III
METHODOLOGY
The assessment of death attitudes among elementary school age
children occurred through structured interviews in the school
setting. Self-reports in reference to discussions of self, a
"friend," and the environment of death were used in the explora¬
tion of the death attitudes of denial, fear, anxiety, and acceptance.
Each of these attitudinal dimensions were assessed in terms of
the following frames of reference (as developed by Fauquet, 1980);
death of self, death of other, and the environment of death. In
the Early Adolescent Death Attitude Scale, Fauquet (1980) further
included the frame of reference of the death ritual. However, this
aspect was omitted in this study because it was believed that children
in this study were likely to have had only limited exposure or
experience with death rituals.
Sample Selection
For the purposes of this study, normal elementary school children
were those in regular classes in the fourth and fifth grades who were
determined to exhibit adequate adjustment in learning, behavioral,
and social areas in the professional judgment of the investigator.
44

45
The age range was 7 years 6 months to 10 years 11 months, as of
September 1, 1980. Children who had been retained and who were
performing at an average level academically were included in the
sample. Average was defined as "C" or better, or 2.0 or higher on
a 4.0 scale, in the combined subjects of reading and mathematics.
However, children who had been retained or who were performing
below average academically; that is, below "C" or 1.9 on a 4.0
scale were not included. Children who were identified by the school
Child Study Team as possibly educable, trainable, or profoundly
mentally handicapped were not included. However, those who were
receiving resource room delivery of special education services, e.g.,
speech, learning disabilities, and other categories of Exceptional
Student Education were included in the sample. Children who were
known to have experienced separation or loss of a parent or close
friend, or a trauma related to death in the last two years were also
ruled out. Thus, by the criteria, all of the children were function¬
ing intellectually within the dull normal range or higher, and were
not so severe in their learning, behavior, or other maladjustment
problems so as to warrant full-time special education services in a
setting other than the regular classroom.
The children were attending the public schools of Marion County,
Florida. One school was selected from a suburban area in a community
of approximately 120,000, and one school was selected from a rural
area. Both schools had a pupil population between 450 to 800.
There was selection of alternative schools in each category in case
a local principal chose not to participate in the research project.

46
The principal was asked to select three fourth grade classes
and three fifth grade classes in which he/she judged the receptivity
and cooperation of the teacher to the research project to be optimal.
The principal was also asked to write a cover letter to the parent
consent form expressing support for the research study (see
Appendix A). In a teachers' meeting, the nature of the study and
the criteria for selecting the children was explained. Teachers
were asked to identify eight students in their classes who met
criteria. Parent consent forms were sent home with a request for
return the next day. There were five or more consent forms returned
for each class yielding a total N of 70.
Procedure
In November of 1980, cooperation on this study was solicited
from the Director of Student Services, School Board of Marion County,
as to how to proceed further in the school system. Subsequent
contacts were made with the Supervisor of School Psychology Services,
the Supervisor of School Counseling Services, and the appropriate
school principals. The logistics were discussed in detail with the
school principals and teachers in the identified schools. A copy of
the research proposal was provided to each school. The school
personnel and researcher developed a schedule as to the time and
setting of the interviews. The structured interviews were conducted
in a private room of the school guidance and administrative area.
Each interview required approximately 20 minutes. There was insured
freedom from distractibility, privacy, and additional optimal

47
conditions for the interview process. (The structured interview is
recorded in Appendix B.) The interviews were conducted by the
researcher who is certified by the Department of Education as a
school psychologist, a school counselor, and an elementary teacher.
She has had nine years experience as a school psychologist mainly in
the elementary school setting.
The nature of this topic made it especially important for the
structured interview to be conducted skillfully and sensitively. It
was important that the child felt comfortable in the situation and
trusting of the interviewer. Attention was given to the adequacy and
appropriateness of the environment. It was characterized by privacy,
comfort, safety, and familiarity. It was also important that the
child develop feelings of trust, openness, and spontaniety. Thus,
the initial part of the interview was designed to emphasize the
examiner's acceptance, positive regard, and interest in the child.
The child's responses and preferences were accepted readily thereby
facilitating the development of a warm rapport. Only after rapport
was adequately developed in the judgment of the interviewer were the
questions on death attitudes asked. In the atmosphere of acceptance,
warmth, and trust, it was anticipated that the child's responses
were, therefore, relatively honest and accurate.
Data Collection
As much as possible, the demographic data on each child included
the following: date of birth, sex, ethnic origin, grade, grade

48
point average, and number of retentions. Further, efforts were
made to secure the following data from the structured interview
and/or the report of school personnel: number of siblings, sibling
position of the child, status of the parents or caregivers (natural
or step), and parents' vocations. Data were collected concerning any
recent events which may have been traumatic to the child in the
areas of loss or separation. Specifically, this information focused
on indication of loss of parent or significant others through death,
divorce, or separation. Reported death of one or more pets was
noted also.
Nature of the Data
The scoring concerning the six questions on concept of death has
been developed by Koocher (1974b). The exact questions and scoring
were used with the exception of one addition of an "other" category
in the first set. The first two questions were the following:
1. How do things die?
2. How do you think you will die?
The above questions were scored according to the following categories
A. Natural Causes (e.g., old age)
B. Aggressive Causes (e.g., murdered)
C. Suicidal or Self-destructive causes (e.g., killed himself)
D. Other (e.g., I don't know)
The next two questions were the following:
3. What happens to things when they die?
4. What will happen to you when you die?

49
The above questions viere scored in one of these categories:
A. Burial (e.g., put 'em in the ground.)
B. End of Life (e.g., It's all over.)
C. Deterioration (e.g., It gets rotten.)
D. Continuation of Life Processes (e.g., You still know
what's going on.)
E. Other (e.g., I never thought about it.)
The next questions were as follows:
5. Can dead things come back to life?
6. Can you come back to life after you die?
The responses to these questions were scored as follows:
A. Mo return
B. Return in Any Form (e.g., I might be an angel.)
C. Other (e.g., I really couldn't say.)
The subsequent questions which focused on death attitudes yielded
responses in one of the following categories: Yes, No, Sometimes, or
Other.
Data Analysis
Since this was basically a descriptive study, frequency distribu¬
tion of the various responses to each of the auestions concerning con¬
cepts of death (Koocher, 1974a) was calculated. In reference to each of
the attitudinal dimensions of denial, fear, anxiety, and acceptance, a
frequency distribution was calculated for grade level, GPA, retention in a
grade, sex, ethnic origin, urban-rural setting, pet ownership, acquaintance

50
with death of a pet, and for the total sample. Further, responses
were analyzed by percentages.
Validity
V*
The first six items in the death attitudes interview were
developed by Koocher (1974) in exploring children's general concep¬
tual understanding of death. The 12 questions concerning death
attitudes were modified to some extent from the Early Adolescent
Death Attitude Scale (Fauquet, 1980). In developing the EADAS,
Fauquet (1980) established face validity, content validity, and
construct (factorial) validity. A rather extensive three phase
process of developing and selecting the items was completed by four
reviewers who were counseling professionals of the following
description:
a university professor who teaches a course in counseling
research, a counselor education doctoral student who has
had varied experiences with death in his role as an
instructor and as a hospital chaplain, a doctoral student
who is working in the field of gerontology, and a practic¬
ing school counselor with ten years' experience working
with early adolescents, (p. 19)
Among the criteria for the items was the establishment of a
fourth grade readability level as determined by a reading specialist
through readability analysis. The EADAS was administered as a pencil
and paper test.
The children in this study, however, were not asked to read the
statements, but to listen and respond to them in a structured inter¬
view procedure. Oral responses were recorded by the interviewer.

51
Elementary school children vary widely in their reading skills.
Therefore, the limitation of reading was eliminated as a factor
through the structured interview format.
Reliability
In order to establish inter-rater reliability, two other certified
school psychologists were asked to evaluate and categorize the
responses of three children. Comparison was made with the judgment
of the researcher regarding the categorization of the responses.
Although no reliability procedure as such was used in this study,
these modified items are based on those developed in the EADAS
(Fauquet, 1980), in which reliability was established by test-retest
procedures using the Pearson Product Moment Correlation Coefficients
and by determining the internal consistency of the instrument by
comparing split half variances using Cronbach's Alpha reliability
coefficient. The total test-retest reliability was r = .77 (p < .01).
The reliability coefficient (split-half) was r = .89 (p < .01).
It is believed that children at the pre-adolescent level are
more responsive to the structured interview approach than to a
Likert-type scale using paper and pencil. In that adequate rapport
in the interview situation was clinically established and in that
the factor of readability level was essentially eliminated the
present format was determined to be adequate for data collection
with normal children at the fourth and fifth grade levels.
It was assumed that the data indicated the attitudes of normal
elementary children toward death through self-report. The children's
responses were spontaneous, honest, and accurate because of the

52
structured interview design. The structured interview design
provided for an adequate environmental setting, an age appropriate
manner of administration, and a child-centered format of inter¬
action.
Methodological Limitations
To some extent, one may question whether self-report fully
reflects the child's concepts and attitudes concerning death and
suicide. Also, the sample of one or two questions in each area may
seem rather limited. However, one must consider the general tendency
of children to be rather direct and honest in an accepting environ¬
ment, as well as their limited attention span in task-oriented
situations.

CHAPTER IV
RESULTS
The present data were derived from the purposes of this study:
specifically, an exploration of normal children's attitudes toward
death. Normal children's general concepts of death and of the
attitudes of fear, denial, anxiety, and acceptance in reference to
death of self, death of other, and the environment of death were
investigated. There was also an examination of various demographic
variables which have sometimes been shown to be related to normal
children's death concepts and death attitudes.
Sampling Procedure
The children sampled were randomly selected according to the
previously specified criteria from three fourth grade classrooms
and three fifth grade classrooms in each of two schools. In each
of the 12 classrooms, eight parent consent forms, with supporting
letters by the school principals, were sent home. No less than five
were returned in every class. All children who returned affirmative
consent forms were initially interviewed. However, two interviews
were eventually eliminated because more careful scrutiny revealed
53

54
that the children did not meet the selection criteria. Thirty-five
fourth grade children and 35 fifth grade children yielded valid
interviews that were used in the data analysis.
A total of five parent conferences were held following the
interviews with the children. Four conferences were by parent request
and one was by the request of the researcher. In one of these cases,
it was decided to eliminate the child's interview from the sample due
to situational adjustment difficulties in the child. It should be noted
that this child's parents were already in the process of pursuing
appropriate treatment.
Demographic Data
A total of 31 male (44 percent) and 39 female (56 percent) students
were interviewed. Thirty-seven children (53 percent) were from the
urban school and 33 children (47 percent) were from the rural school.
The grade point averages of the children were as follows: 21 percent
had an A average, 63 percent had a B average, and 16 percent had a C
average. Only 9 percent of the children had ever been retained in
grade level.
The age data revealed that 16 percent of the children were in the
range 8 years 9 months to 9 years 6 months old, 54 percent of the
children were in the range 9 years 7 months to 10 years 6 months old,
and 30 percent were in the range 10 years 7 months to 11 years 1 month
of age. In terms of ethnic characteristics, 93 percent of the children
were Anglo-American, 6 percent were Afro-American, and 1 percent were
Asian American.

55
Because attitudes toward death might be related to religious
beliefs, inquiries of religious preference were made. The
expressed religious preferences were as follows: 34 percent were
Baptist, 13 percent were Methodist, 4 percent were Presbyterian, 11
percent were Catholic, and 24 percent expressed other preferences.
The other 13 percent reported no preference or did not attend church.
In all cases, the children were living with their biological
mothers. Also, 80 percent were living with their biological fathers.
Of those children who were from homes where the parents were divorced,
almost 60 percent of the children were three years old or younger
at the time of the divorce. In regard to siblings in the home,
approximately 10 percent of the children had no siblings, almost
60 percent had one sibling, and approximately 30 percent had three
or more siblings. This included natural, step, and half siblings
by family structure.
When asked whether they presently owned or have ever owned a pet,
84 percent of the children reported yes and 16 percent reported no.
When asked whether they had ever had a pet die. 80 percent responded
positively. In 21 percent of the cases, the children had acquaintance
with death of pets in two or more instances. Twenty percent of the
children had no such incident in their lives with pets of their own.
The employment of the parents was noted. Approximately three-
fourths of the mothers were gainfully employed outside the home.
Ninety-three percent of the fathers were employed outside the home.
The parents' occupations were categorized by the same criteria of the
five condensed categories as recorded in the Weschler Intelligence

56
Scale for Children - Revised. The incidence of the parents occupations
is recorded in Table 1.
Table 1
Occupational Status of Mothers
and Fathers
Category
Mothers
Fathers
1.
Not employed
34%
9%
2.
Professional and technical workers
7%
19%
3.
Managers, officials, proprietors,
clerical workers, and sales workers
40%
30%
4.
Craftsmen and foremen
1%
24%
5.
Operatives, service workers, farmers,
and farm managers
10%
13%
6.
Laborers, farm laborers, and farm
foremen
7%
6%
Questions Related to Children's Concepts of Death
The purpose of this study was to explore children's concepts of
death. Using questions initially designed by Koocher (1974), there were
analyses of the children's responses concerning personal and impersonal
death. Table 2 summarizes the analyses of the data regarding what
children viewed as causes of death. Most of the children (70 percent)
reported that the cause of death of other things (i.e., animals) was
usually due to old age, illness, or both. More importantly, nearly
90 percent of the children stated that their own deaths were expected

57
to be from these causes. Approximately 10 percent believed that death
was likely to occur from aggressive causes, such as a car accident or
getting shot or kidnapped. A small percentage (6 percent) believed
that death comes when "God decides." No children reported suicide as
a cause of death.
Table 2
Children's Views of the Causes of Death
Causes
Impersonal Personal
(How do (How do you think
things die?) you will die?)
1.
Old age
24%
61%
2.
Illness, heart attack,
cancer, etc.
34%
24%
3.
Old age and illness
13%
3%
4.
Aggressive causes (car
accident, etc.)
10%
9%
5.
Old age and aggressive
causes
9%
1%
6.
Suicidal causes
0
0
7.
God decides
6%
1%
8.
Other
4%
0
Table 3 summarizes the data analyses regarding children's views as
to what happens after death in reference to other things (impersonal
death) and themselves (personal death). Thirty percent of the
children stated that things and themselves would be buried after
death. Approximately 50 percent expressed a belief in some kind of

58
continuation of life. Most of these responses were "Go to heaven."
Twenty percent of the children reported that things deteriorate when
they die. However, only 10 percent reported that they would deteriorate
when they died. One percent or less expressed the belief that
death was the total end of life.
Table 3
Children's Views of Conditions After Death
Impersonal Personal
(What happens to (What will happen
Conditions After Death things when to you
they die?) when you die?)
1.
Burial
30%
31%
2.
Burial and continuation
7%
3%
3.
Burial and deterioration
6%
3%
4.
Continuation
41%
48%
5.
Deterioration
14%
7%
6.
End of life
1%
0
7.
Other
0
7%
Table 4 summarizes the data analyses regarding children's views
as to whether dead things can come back to life and as to whether they
can come back to life after they die. Seventy percent of the children
reported that they believed dead things could come back to life.

Fifty-four percent stated that they could come back to life after they
died. Most of the remaining children held opinions to the contrary.
Table 4
Children's Views Concerning
Life After
Death
Yes
No
Other
Impersonal
Can dead things come back
to life?
70%
26%
4%
Personal
Can you come back to life
after you die?
54%
43%
3%
Questions Related to Children'
s Attitudes
Toward Death
A second purpose of this study was to investigate children's
attitudes toward death. Questions adopted from Fauquet (1980) were
modified to examine the presence of the attitudes of denial, fear,
anxiety, and acceptance in regard to death of self, death of other,
and the environment of death. Refer to Table 5 for a summary of
the data.
Denial
In examining the attitude of denial toward death in children,
most 77 percent of the children report some denial in regard to their
own death. There was considerably less denial in reference to the
death of another. Forty percent of the children reportedly experienced

Responses Concerning Attitudes Toward Death
Yes
No
Sometime
Denial
1.
Do you sometimes feel this way: I
don't like to think about how I will
die? (self)
77%
10%
13%
106%
2.
If a friend died, do you feel you
would ever want to talk about it
with anybody? (other)
46%
40%
14%
7óo7a
3.
Would you ever want to go where a
friend is dead? (environment of
death)
81%
14%
4%
997a
Fear
1.
Are you afraid of dying? (self)
50%
37%
13%
/oo%
2.
Would the death of a friend scare
you? (other)
67%
21%
11%
m
3.
Are you scared to go to a cemetary?
(environment of death)
24%
60%
16%
700%
Anxiety
1.
Do you worry about dying? (self)
31%
39%
30%
/OO^O
2.
Does the thought of a friend dying
upset you? (other)
79%
9%
12%
700%
3.
Does a cemetary make you upset?
(environment of death)
33%
49%
18%
700%
Acceptance
1.
Does it bother you to think about
how you may die? (self)
29%
61%
10%
too%
2.
Would you want to visit a dying
friend in the hospital? (other)
71%
23*
6%
700%
3.
Would you be willing to go where
a friend is dead? (environment)
71%
23%
6%
700%

61
denial in regard to talking about the death of a friend. Fourteen
percent of the children expressed a willingness to discuss the
death of a friend sometimes. Forty-six percent reported a clear
willingness to do so. There appears to be even less tendency for
the children to deny the environment of death, since only 14 percent
reported denial in this area. On the other hand, 81 percent of the
children did not express denial in this area.
Fear
In reference to the attitude of fear toward death, more (67
percent) children reported a sense of fear over death of a friend
than over their own death (50 percent). Thirty-seven percent of the
children stated that they were not afraid of dying. In regard to the
environment of death, only 24 percent reported that they were afraid
to go to a cemetary. Many of these qualified their responses by
expressing the fear of doing so alone or at night. Sixty percent of
the children stated that they were not afraid to go to a cemetary.
Sixteen percent apparently experienced the fear sometimes.
Anxiety
In examining the attitude of anxiety toward death, 31 percent of
the children stated that they did worry about their own death.
Approximately one-third (30 percent) worried about dying sometimes.
Thirty-nine percent of the children reported that they do not worry
about dying. Many children (79 percent) indicated that they experienced
anxiety over the thought of a friend dying. Twelve percent reportedly
experienced such anxiety sometimes. Only 9 percent reported no anxiety

62
over the death of another. One third (33 percent) of the children
indicated anxiety in the environment of death. Almost half (49 per¬
cent) reported experiencing no anxiety in the environment of death
(specifically a cemetary). Eighteen percent reported the experience
of such anxiety sometimes.
Acceptance
In regard to the attitude of acceptance toward death, 61 percent
of the children reported some sense of acceptance in regard to their
own deaths. Twenty-nine percent did not indicate such acceptance.
Ten percent reported acceptance sometimes. Many of the children (71
percent) reported acceptance of the death of another. Twenty-three
percent did not. Six percent expressed acceptance of the death of
another sometimes. Thirty-seven percent expressed acceptance toward
the environment of death. Twenty-eight percent did not. Five per¬
cent of the children reported such acceptance of the environment of
death sometimes.
Comparison of Attitudes Within Personal Death, Impersonal
Death, and the Environment of DeatF
There was a range of attitudes expressed by the children concern¬
ing their own death. The majority of the children (77 percent)
expressed occasional denial of personal and half expressed fear.
One-third of the children expressed anxiety and one-third expressed
acceptance of their own deaths.
In general, there was less variability of attitudes concerning
impersonal death (death of another). Approximately half of the
children expressed denial and 67 percent expressed fear concerning

63
the death of a friend. Four out of five children indicated anxiety
over the death of a friend. Very importantly, 71 percent of the
children also expressed acceptance of another's death.
There was some variability of attitudes concerning the environ¬
ment of death. Approximately one in five children expressed denial
or fear. Only one-third of the children expressed anxiety. Almost
40 percent of the children indicated acceptance of the environment of
death.
Differential Trends Relative to Sex, Grade,
School, GPA, and Retention
Although there may be some question concerning the validity of
the chi square analyses due to the sparse number of responses in
several cells of the tables, certain trends and characteristics are
suggested. Analysis of the data indicated that the children's views
of death and death attitudes may tend to be different in some respects
relative to the demographic characteristics of sex, grade, school,
grade point average, and retention.
In regard to responses relative to sex, minor differences were
noted (refer to Table 6). For instance, more females (28 percent)
than males (19 percent) attributed the cause of their personal death
as being due to illness, heart attacks, and similar reasons. Signifi¬
cantly more males (26 percent) than females (5 percent) stated that
things deteriorate after death. On the other hand, more females (46
percent) reported that things continue to exist in some manner after
death than did males (35 percent). In regard to attitudes, 77 percent

64
of the females and 55 percent of the males reported some fear in
regard to the death of another. Also, more females (46 percent)
than males (32 percent) expressed denial in regard to the environment
of death. Considerably more females (56 percent) than males (42
percent) also expressed fear in regard to their own death. More
females (79 percent) than males (70 percent) also tended to deny
death in regard to themselves. Table 6 summarizes the data in this
area.
Table 6
Differences in Responses Relative to Sex
Males Females
Concepts
Attribute major cause of personal death
to illness, heart attack, and similar
reasons CCAjul^)
19%
28%
Report a belief that things deteriorate
26%
5%
after death
Report a belief that things continue to
35%
46%
exist after death
Attitudes
Express denial regarding personal death
70%
79%
Express denial regarding environment of u' -
death
32%
46%
Express fear regarding personal death
42%
56%
Express fear regarding impersonal death
55%
77%

65
In regard to differences relative to grade, concepts and
attitudes were explored. (Refer to Table 7.) Little or very
little difference was noted between the two grades. More fourth
graders (16 percent) than fifth graders (9 percent) attributed old
age as being the major cause of death for other things. Also,
more fifth graders (20 percent) attributed aggressive causes to the
death to other things while no fourth graders named such a category.
More fourth graders (31 percent) than fifth graders (17 percent)
viewed illness and related causes to their own deaths. More fifth
graders (14 percent) than fourth graders (3 percent) also attributed
their own deaths to aggressive causes, such as car accidents. More
fourth graders (49 percent) than fifth graders (34 percent) expressed
the view of some nature of continuation of life after death. Several
fifth graders (14 percent) expressed a view of the end of life at
death while no fourth graders expressed such a view. In regard to
death attitudes, 20 percent of the fifth graders expressed denial
in regard to their own deaths while no fourth graders did so except
on the basis of "sometimes." Almost 20 percent more fifth graders
than fourth graders also expressed fear and anxiety in regard to
their own deaths. On the other hand, more fourth graders (14 percent)
expressed anxiety in regard to the death of another than did fifth
graders (3 percent). More fourth graders (80 percent) than fifth
graders (63 percent) also expressed acceptance of the environment of
death.

66
Table 7
Differences in Responses Relative to Grade
Fourth
Fifth
Concepts
Attribute major cause of personal death to
illness
31%
17%
Attribute major cause of personal death to
aggressive causes
3%
14%
Attribute major cause of impersonal death
to old age
16%
9%
Attribute major cause of impersonal death
to aggressive causes
0
20%
Report a belief in continuation of life
after death
49%
34%
Report a belief in end of life after death
0
14%
Attitudes
Express denial regarding personal death
0
20%
Express fear and anxiety regarding personal death
Express anxiety regarding impersonal death
14%
3%
Express acceptance regarding environment of
death
80%
63%
In comparing the attitudes expressed between urban and rural
children, some differences were noted. Table 8 summarizes the data
in this area. More urban children (76 percent) believed that they
will die of old age than did rural children (45 percent) who suggested

67
Table 8
Differences in Responses Relative to Rural-Urban Setting
Rural Urban
Concepts
Attribute major cause of death to old age
45%
76%
Attribute major cause of personal death to
illness, heart attack, and similar reasons
33%
16%
Report a belief that things are buried
after death
42%
19%
Report a belief in continuation of life
after death
30%
51%
Attitudes
Express denial regarding personal death
85%
24%
Express denial regarding impersonal death
76%
49%
Express denial regarding environment of death
58%
24%
Express anxiety regarding personal death
39%
24%
Express acceptance regarding personal death
27%
51%
Express acceptance regarding environment of
death
67%
76%

68
that cause. About twice as many more rural children than urban
children (33 percent to 16 percent) attributed the causes of their
own deaths to illness, heart attack, or other similar reasons.
Considerably more rural children (42 percent) viewed things as being
buried after death than did urban children (19 percent). On the
other hand, more urban children (51 percent) viewed a continuation
of life after death than did rural children (30 percent) who expressed
such a view. More rural children (76 percent) than urban children
(49 percent) expressed the attitude of denial in regard to another's
death. Almost twice as many rural children (58 percent) than urban
children (24 percent) expressed denial in regard to the environment
of death. Also, more rural children (39 percent) than urban children
(24 percent) reported anxiety over their own deaths. Eighty-five
percent of the rural children compared to 68 percent of the urban
children expressed the attitude of denial in regard to their own deaths.
On the other hand, 51 percent of the urban children expressed more
acceptance of their own deaths as compared to 27 percent of the rural
children. Also, more urban children (76 percent) expressed more
acceptance of the environment of death as compared to 67 percent of
the rural children.
There was some differentiation of children's attitudes relative
to their grade point averages (.refer to Table 9). Children with
lower GPA's increasingly viewed illness as the cause of death of
other things. The percentages who attributed death due to illness
were 13 percent of those children with A averages, 39 percent of those
children with B averages, and 45 percent of those children with C

69
averages. Children with lower GPA's also increasingly viewed
themselves as able to come back to life after they die. The
percentage of children who responded positively to that concept
were as follows: 33 percent of those with A averages, 55 percent
of those with B averages, and 82 percent of those with C averages.
There was also a slight trend for children with lower GPA's to
express the attitude of denial in reference to their own deaths.
Sixty-seven percent of the A students expressed such denial; 77 per¬
cent of the B students did; and 82 percent of the C students did so.
A similar trend, but less obvious, was also suggested in regard to
denial of the death of another.
A stronger trend of increasing denial toward the environment of
death was noted as children's GPA's become lower. Specifically, 27
percent of the A students reported such denial; 39 percent of the B
students did; and 64 percent of the C students stated denial of the
environment of death. More students (55 percent) with GPA's of C
seemed to experience anxiety of their own deaths more than did
students with GPA's of A (27 percent) or B (27 percent). Also, more
C students (100 percent) reported anxiety over the death of another
than did A students or B students.
There were some differences in responses among children who were
retained as compared to those who were not retained (refer to Table
10). Half of the children who were retained viewed illness as the
cause of their deaths as compared to 22 percent of those who were not
retained. Sixty-seven percent of those who were retained reported a
view of continuation of life after death as compared to approximately

70
Table 9
Differences in Responses Relative to Grade Point Average
A
B C
Concepts
Attribute major cause of death to illness
13%
39% 45%
Report a belief in coming back to life after
personal death
33%
55% 82%
Attitudes
Express denial regarding personal death
67%
77% 82%
Express denial regarding environment of death
27%
39% 64%
Express anxiety regarding personal death
27%
27% 55%
Express anxiety regarding impersonal death
80%
77% 100%
Table 10
Differences in Responses Relative to
Retention
Retention
No Retention
Concepts
Attribute major cause of death to illness
50%
22%
Report a belief in continuation of life
after death
67%
40%
Attitudes
Express fear regarding environment of death
0
27%
Express anxiety regarding personal death
17%
33%
Express acceptance regarding personal death
67%
44%
Express acceptance regarding impersonal death
100%
80%

71
40 percent of those who were not retained. Commensurate attitudes and
percentages were also evident in regard to the view that one could
come back to life after death. No children who were retained reported
fear of the environment of death, while 27 percent of those who had
never been retained reported such fear. Twice as many students who
were never retained (33 percent) express anxiety over their own
deaths as did students who had been retained (17 percent). All
students who had been retained reported acceptance of death in regard
to another while 80 percent of the non-retained students expressed
acceptance. Approximately two-thirds of the retained students
reported acceptance of their own death while only 44 percent of
the students who had never been retained expressed acceptance.
Influences of Ethnic, Social and Familial Characteristics
In that 93 percent of the children were Anglo-American, an
interpretation of the differential responses by ethnic group did not
seem warranted.
There were no differential trends relative to the children's
religious preference.
There appeared to be no differential trends in the children's
responses relative to the married or divorced status of the parents,
employment status of the parents, or the number of siblings in the
family. The homogeniety of the population in some characteristics
and the considerable scatter in other characteristics were perhaps
factors in the limited distribution of the data relative to these
characteristics.

72
Differential Trends Relative to Ownership and
Acquaintance with the Death of a Pet
There were several instances in which children who owned pets
tended to respond differently from those children who did not own
pets. Table 11 summarizes the data in this area. More children who
owned pets reported illness as a cause of death, including their own
death, as compared to such reports from only 9 percent of the children
who had never owned a pet. Forty-three percent of the children who
owned pets reported a continuation of life after things die as
compared to 27 percent of those children who had not owned pets
making such reports. Also, 17 percent of those children who had
owned pets described some kind of deterioration after death, while
none of the children in the other category did. Twice as many children
who had never owned pets (55 percent) reported that burial is what
happens to things after they die. Similar frequencies of responses
were noted between the two groups of children in regard to what
happens after personal death in the areas of burial and continuation
of life in some manner after death. In regard to attitudes, children
who owned pets tended to have less denial concerning the death of
another and in regard to the environment of death as compared to
children who did not own pets. Also children who owned pets expressed
fear of the environment of death less frequently (18 percent less) than
children who did not own pets.
There was an examination of the responses regarding children who
never had a pet die, experienced the death of one pet, or experienced
two or more deaths of pets. When asked, "What happens to things when

73
Table 11
Differences in Responses Relative to Pet Ownership
Own Pet No Pet
Concepts
Attribute major cause of personal and
impersonal death to illness
Report a belief in continuation of life
after impersonal death
Report a belief in deterioration after
death
Report a belief in burial after impersonal
death
Attitudes
Express denial regarding impersonal
death
Express fear regarding environment of
death
38%
9%
43%
27%
17%
0
27%
55%
59% 73%
22% 36%

74
they die?" 60 percent of the children who experienced multiple deaths
of pets reported continuation of life as compared to approximately 35
percent in both of the other categories. Further, only 6 percent of
the children who had experienced multiple deaths of pets reported
burial as compared to approximately 36 percent of the children in both
of the other categories. When asked, "What will happen to you when
you die?" no children who had experienced multiple deaths of pets
reported burial, while approximately 40 percent of the children in the
other two categories reported burial for themselves. In response to
the same question, 27 percent of the children who experienced
multiple deaths of pets reported deterioration, while no children
who had one pet die made such a report. Seven percent of the children
who had never experienced the death of a pet made such a report.
Attitudes of children toward death of a pet are reported in
Table 12. Children who had never experienced the death of a pet
expressed denial of the environment of death only half as often as
those children who had experienced deaths of pets (22 percent to approxi¬
mately 45 percent). Children who had experienced deaths of pet(s)
fear of the death of another more frequently (17 percent to 23 percent
more) than did children who had not experienced any deaths of pets,
about half of whom expressed fear. On the other hand, children who
had experienced deaths of pets expressed fear less frequently in regard
to their own death (10 to 18 percent less frequently) than did children
who had never known the death of a pet. Children who had experienced
deaths of pets generally expressed anxiety over the death of another
more often than those who had not experienced death of a pet.
Specifically, when asked, "Does the thought of a friend dying upset

75
Table 12
Differences in Responses Relative to None, One,
or Multiple Deaths of Pets
None
One
Multiple
Concepts
Report a belief in continuation of life
after impersonal death
36%
37%
60%
Report a belief in continuation of life
after personal death
29%
49%
67%
Report a belief in burial after impersonal
death
36%
37%
6%
Report a belief in burial after personal
death
36%
41%
0
Report a belief in deterioration after
death
0
7%
27%
Report a belief that things do not return
to life after death
43%
78%
73%
Attitudes
Express denial regarding environment of
death
22%
44%
47%
Express fear regarding impersonal death
50%
73%
67%
Express anxiety regarding environment
of death
64%
44%
47%
Express anxiety regarding impersonal
rlpath
57%
88%
73%

76
you?" 57 percent of the children who had never known the death of a
pet responded yes; 57 percent of the children who had known the
death of one pet responded yes; and 73 percent of the children who
had known multiple deaths of pets responded positively. Sixty-four
percent of the children who experienced no deaths of pets reported no
anxiety in regard to the environment of death. On the other hand,
approximately 45 percent of the children who had experienced deaths
of pets expressed no anxiety. There were no clear differentiations in
regard to the attitude of acceptance toward death.
Interview Closure Activities
At the conclusion of the specific questions investigating death
concepts and attitudes, a few open-ended questions for closure and
a drawing activity were provided. The children were asked, "Is
there anything else you would like to tell me about this?" Seventy-
three percent of the children responded negatively. The children
were also asked, "Is there anything you would like to ask me?"
Fourteen percent of the children did have questions, 86 percent of
the children did not. Table 13 summarizes the questions. When asked,
"Is there anyone else you would like to talk with more about living
and dying?", 13 of the children responded positively, mainly naming
a parent. Table 14 specifies the persons the children identified for
further discussion. Finally, the children were asked to draw a
picture of anything they would like to draw before leaving. Ninety-six
percent of the children drew pictures of themes typical of their

77
Table 13
Questions Children Asked the Researcher
Child
Question
Child #1
"Is it true when you die they'll burn you?"
Child #13
"If a person smokes, how long 'til they die?"
Child #16
"How do diseases get started?"
(Later, child expressed worry over mother
smoking.)
Child #18
"Do ghosts come back to families?"
Child #22
"How old do people get?"
"Can you die of a heart attack?"
"Could God bring you back to life?"
"Can you read other people's minds?"
Child #24
"How can you read people's minds?"
Child #25
"How do you feel about dying?"
Child #35
"Why do you ask children these things?"
"Do you work here?"
Child #38
"How do you feel about it?"

78
Table 14
Persons
Identified by Children to Ask Further Questions
Child
Identified Person
Child #2
Parents
Child #8
Neighbor (who had a recent death in
family)
Child #13 Doctor or Mother or Nurse
Child #26 Mother
Child #47
Parents
Child #49
Anyone
Child #52
Parents
Child #56
Mother
Child #58
Anyone
Child #68
Doctor

79
special interests, such as people, cars, scenes with trees and flowers
and other content. However, 4 percent drew pictures of a death
related scene.
Clinical Impressions
In most cases, the children were informally met at the classroom
door by the researcher and escorted to the private conference room.
On the way, the researcher identified herself as the one who had
sent the note home for the child's parents to sign the preceding day.
The children were asked if their parents had made any comments con¬
cerning the consent form. The children often shrugged as though it
was a rather insignificant event. They usually stated that the
parents had asked the child whether he/she had a willingness to
participate in the interview. The researcher often asked what the
child decided and the response was commonly, "Sure" or "It's OK with
me." The mood of the children seemed to be one of willing cooperation,
relaxation, and interest, except in one case in which the data could
not be obtained.
During the structured interviews all children readily responded
to the initial activity of drawing a picture of a person. This
activity seemed to give the children opportunities to become
accustomed to the setting and to focus on a self-directed task which
did not require much interpersonal interaction. In most cases, rapport
was established with ease. The format of the structured interview
typically proceeded with a continued sense of interest and cooperation
on the part of the child. Very few asked for clarification on the

80
questions concerning their concepts and attitudes toward death. Most
children responded rather quickly and spontaneously. Some children
responded slowly, with apparent thoughtful deliberation. In
general, there was more hesitation and reflection on questions
concerning the death of a friend than on the questions concerning
the environment of death or personal death.
The closure activities were particularly useful. The few children
who had additional comments seemed to find the opportunity to do so
an important one. The closing remarks usually focused on more
detailing of the events surrounding the death of a relative or pet.
When given the opportunity to ask the researcher questions,
approximately 13 percent (n = 10) of the children chose to do so.
Examples of these questions are listed in Table 13. It is interesting
to note that over half the questions reflected a need for information.
Two of the nine children expressed related concerns over the possible
dangers of their parents' smoking. Several questions reflected a
healthy curiosity over the researcher's interest and activities in
this area. The two questions relating to the researcher's ability
"to read other people's minds" were apparently prompted by a classroom
teacher's remarks which stated such. These questions are viewed as
extraneous artifacts of the investigation.
It is interesting to note the persons whom the children identified
for further discussion. More than half the normal children identified
their parents. This likely reflected very healthy positive relation¬
ships in the family constellation. The two identifications of
medical personnel seemed to again reflect the children's need for

81
accurate information relating to their concerns over health, life,
and death.
The final activity of drawing a "picture of anything you would
like" provided an opportunity for spontaneous self-expression. It
is important to note that 96 percent of the pictures were not death
related drawings. The majority of the drawings were judged to be
clinically healthy drawings with content such as trees, houses,
nature scenes, cars and other vehicles, and so forth. In those cases
of death related scenes, the researcher further examined the child's
adjustment to determine whether there was need for concern. In the
two cases in which concern was warranted, conferences with the
children's parents were scheduled. Further responsible action was
pursued.
The parent conferences were cordial. All the parents expressed
genuine interest in the healthy adjustment of their children. A few
inquired whether their child evidenced apparent difficulties in the
area of death and dying which may need special attention. In two
cases, parent awareness of their child's attitudes seemed advisable.
In one instance, a discussion regarding provision for the child's
safety in the event of the parents' deaths seemed advisable. Appro¬
priate professional services were advised and scheduled in a second
case. Most parents stated that they believed the interview with their
children had been a very positive, constructive event. They expressed
strong interest regarding their children's healthy adjustment in all
areas of life, including the matters of death and dying.

CHAPTER V
DISCUSSION
Limitations Regarding Generalizability
It is important to determine appropriate limits for generalization
of the results of this study. The present results can appropriately
be generalized to normal Anglo-American children in the fourth and
fifth grade classes who reside in urban or rural settings. However,
the differential trends of these characteristics as well as the child's
sex, grade point average, retention history, ownership of a pet, and
acquaintance with death of a pet should be kept in mind.
In that 93 percent of the children were Anglo-American it is
prudent to draw conclusions from the data only as they relate to
Anglo-American children in the United States. Even though there
were minor distinctions between the responses of the children in
urban and rural settings, between fourth grade and fifth grade
children, between males and females, and among grade point averages,
there should certainly be a recognition of these factors in the
population. In that there appeared to be no clear distinctions in
the responses from children of varying social-familial descriptions,
guarded acceptance of any implications of the data as they relate
to those areas is appropriate. Further study of the possible
82

83
relevance of these factors with a large N would also be appropriate.
These many characteristics are, of course, applicable to normal
children in basically regular classroom settings.
Conclusions
Children's Concepts Concerning Causes of Death
Analyses of the data concerning children's concepts of the
causes of personal and impersonal death, conditions after personal
and impersonal death, and the finality of personal and impersonal
death reveal a significant range of responses in most of the areas
of exploration.
In regard to children's views of how other things die compared
to the causes of their own death, the view of one's own personal
death being due to old age was expressed nearly three times more
frequently than old age being the cause of death of animals. Perhaps
old age is believed to be a more acceptable and less threatening way
to die than the other possible causes such as illnesses, heart
attacks, or aggressive causes. This concept is further supported
in comparing the differences in responses concerning personal and
impersonal deaths as being due to illness, heart attacks, cancer,
and related causes. Specifically, illness was reported as the cause
of death for other things more (34 percent) than it was reported as
the cause of one's own death (24 percent).
It is important to note that approximately 10 percent of normal
children apparently attribute aggressive causes, such as car accidents,
being kidnapped or killed, to a possible actual cause of either

84
personal (death or self) or impersonal (death of other things) death.
In evaluating the emotional adjustment of children particularly con¬
cerning death, this finding should be viewed with care.
Although not a common response, the view of aggression as a
cause of death also may not necessarily be a deviant response.
Such a view would likely need to be evaluated in the context of
additional evaluative data relative to the child's emotional adjust¬
ment. It is important to compare this finding to Orbach and Glaubman
(1978) who reported that "aggressive children . . . gave significantly
more frequent responses of aggression and brutality as a cause of
death, and suicidal children gave more such responses than normal
children" (p. 852).
It is also interesting to note that none of the children attributed
suicidal causes to either their personal deaths or to the deaths of
other things. This finding also corraborates the work of Orbach
and Glaubman (1978) who found that (normal) children seldom identified
suicide as a cause of death. However, suicidal children named
suicide and self-destruction significantly more as a cause of death.
Thus, there is the strong indication that children who suggest
suicide as a possible cause of death may indeed by pre-suicidal.
Some attention must be given to the 6 percent (four children)
who stated that other things die because "God decides." Although
the data are too sparse to draw any conclusions, perhaps there is the
implication that children accept God's decisions for the fate of
other living things more readily than for the conditions of their own
lives. Further, investigation of the conditions of the role or

85
relationship of religious or spiritual views in regard to children's
concepts of death seems to warrant some consideration. Blum (1976),
Chasin (1971), Gartley and Bernasconi (1967), Mclntire et al. (1972),
O'Brien (1979), and Zweig (1977) have alluded to or investigated
children's views or concepts concerning death relative to religious
training. However, mixed results are reported in the studies
yielding no clear conclusions at this time.
Children's Views Concerning Conditions After Death
Perhaps the most striking feature of these data was the rela¬
tively little variability of children's responses in comparing
personal and impersonal deaths. There was no more than a 7 percent
(5 out of 70) difference in any of the seven categories describing
conditions after death. Approximately one-half of the children
reported that burial or burial with continuation or deterioration
will happen after death. A significant percentage of children
(almost half) reported the view of a continuation of life in some
manner after death. Most commonly, this was described as "go to
heaven" or "go to heaven or go down there." These views corroborate
the work of Orbach and Glaubman (1978, 1979) and Zeligs (1974) as it
relates to normal children compared to aggressive children and pre-
suicidal children.
On the other hand, do 50 percent or so children who did not
describe some type of continuation after death believe that death
is indeed final? This issue becomes more complex in viewing the
children's responses to the questions, "Can dead things come back to

86
life?" and "Can you come back to life after you die?" Nearly three-
fourths of the children stated that dead things come back to life
and approximately half of the children expressed such a view in regard
to themselves. Analysis by sex suggests that almost half of the
females expressed a belief in continuation of life after death as
compared to one-third of the males. Also, fourth graders tend to
express the view of continuation more often than fifth graders (49
percent to 34 percent). Further, approximately 50 percent of the
urban children expressed a view of continuation of life compared to
one-third of the rural children. Children with lower GPA's also view
continuation of life more frequently.
In contrast, Nagy (1948) found that nine to ten year olds tended
to view death as a permanent and irreversible process. Melear's (1973)
results support this finding. Kane (1979) reported that death was
viewed as irrevocable and dysfunctional by children when they are
six years of age. On the other hand, Mclntire et al. (1972) presents
data which support this study. Mclntire et al. (1972) stated, "the
belief in spiritual continuation peaked at the ages of 13 to 14
years" (p. 530). The perception of continuation was as high as 93
percent in 11 to 12 year olds. Blum (1975) also found that Christian
(Catholic) children tended to believe more in after life significantly
more than Jewish children. Thus, there does not appear to be a clear
definition of children's concepts in this area. Certain demographic
variables such as age, sex, environment (urban or rural), GPA, and
religion seem to have some relationship to children's views concerning
some nature of continuation of life after death.

87
Children's Attitudes Toward Death
In focusing on children's attitudes concerning their own deaths,
there seems to be considerably more denial than fear in that
approximately three-fourths of the children expressed the former
and only half expressed the latter. Further, only about 30 percent
of the children reported anxiety. Perhaps the defense mechanism of
denial enables the child to control anxiety about personal death.
There seems to be the attitude of acceptance of death among the
majority of children. Six out of ten children responded negatively
when asked, "Does it bother you to think how you may die?"
There seems to be generally more intensity in all the attitudes
concerning the death of a friend. Approximately 55 percent of the
children would even want to talk about the event or want to talk about
it sometimes. A considerable number of children expressed fear (67
percent) and anxiety (79 percent) concerning the death of a friend.
Further, 71 percent of the children also expressed acceptance to the
point of visiting a dying friend in the hospital. Thus, the attitudes
toward the death of another seem to be more intense, more mixed, and
perhaps more conflicting. Overall, there seems to be more interest
in the death of another than in one's own death for fourth and fifth
graders.
A rather consistent acceptance of the environment of death was
expressed. Sixty percent of the children reported no fear or anxiety
about going to a cemetary. Forty to eighty percent of the children
indicated a willingness to go where a friend is dead. Perhaps there
is a basic acceptance of the reality of death that is tolerated more

88
readily by children in the context of the environment of death.
Perhaps visiting the environment, namely a cemetary or "where a
friend is dead," enables the child to process or integrate the death
event into a greater sense of reality or acceptance.
Imp!ications
The exploration of children's concepts and attitudes toward death
has several important implications for theory, training, practice,
and research. The present study basically corraborates the develop¬
mental aspect of children's concepts of death. The children's
concepts of death seem generally consistent with much of the previous
research (e.g., Anthony, 1940; Kalmbach, 1979; Koocher, 1973, 1974a,
1974b; Melear, 1973; White, 1978) that has been done using the
Piagetian model. Some aspects of the data concerning children's
attitudes toward death may be interpreted rather readily in the
framework of Psychoanalytic Theory, particularly in the context of
defense mechanisms and the dynamics of personality adjustment.
However, many questions concerning normal children's attitudes toward
death still remain for research to answer.
There needs to be further investigation regarding the development
of the concepts of death and the intensities of attitudes. This
should include a clarification of possible relationships among the
demographic variables such as ethnic and cultural background, age and
grade level, grade point average, sex, urban-rural environment,
religious training or orientation, or other aspects of the children's
lives. Because the interview process seems to be very effective with

89
this sensitive area, it is recommended for the control of many of
the variables of data collection.
In regard to the training of professionals in counseling,
education, and mental health, there should be significant emphasis
on understanding children's concepts and attitudes toward death.
In addition to the usual professional skills in mental health
services, there should be allocation of at least part of a course to
focus on the salient issues and related research regarding death
concepts and death attitudes. Current curricula could be evaluated
carefully to provide for the inclusion of valid information concerning
children's concepts of death and death attitudes. There needs to be
awareness of the available research and information concerning the
differential concepts and attitudes among normal aggressive, and
suicidal children in regard to their own deaths and the deaths of
others.
Self-clarification of students' perceptions and attitudes con¬
cerning death should be encouraged. Appropriately structured and
supervised opportunities for such exploration should be provided.
For instance, students may be encouraged to recall their own
experiences concerning death, dialogue with their colleagues concern¬
ing the emotional effects and intellectual conclusions, increase their
own awareness of sensitive or problem areas, and clarify lingering
issues concerning death of self or others.
It is important to realize that the information and voluminous
recent writings on death and dying for adult populations may have
very limited applicability to children's concepts and attitudes

90
concerning death and dying. The literature for adults is important
to the extent that it enables clarification of thinking and feelings
concerning death. However, such perspectives and conclusions must
be very guarded in application to children.
There is not enough research and expertise related to the
professional practice concerning many aspects of normal and abnormal
children's concepts and attitudes toward death to make very extensive
recommendations. The practitioner must, of course, be cognizant of
all the available information concerning children's concepts of
death. The practitioner must have a great deal of self-awareness in
regard to the multiplicity of death issues. Further, the practitioner
must be very selective in using commercial materials. Any structured
experiences must be conducted with considerable caution and with
detailed knowledge of children's social, emotional, and academic
adjustment. It is important for the practitioner to be especially
aware of the verbalizations, fantasies, and behaviors of disturbed
children toward death, should any significant death concerns manifest
themselves.
Children want to have their questions answered concerning death.
They need to explore their own feelings and attitudes, and to
experience support from family or other significant adults who
have a healthy clarity of their own feelings concerning death issues.
Then, the child may be provided with support and appropriate
responsiveness should a death occur. If a child seems to be
experiencing significant difficulties in areas related to death
concerns, including their own deaths, it would be prudent to refer

91
these children for services to a qualified counselor, therapist, or
psychologist.
This study of children's concepts and attitudes toward death
has yielded insights, questions for research, implications for
theory, and directions for training and practice. With increased
knowledge and sensitivity to the needs of children, the competent
professional will more readily and more skillfully respond to
children regarding the important matter of the universal experience
of death and dying.

APPENDIX A
PARENT CONSENT
Dear Parent:
In order to better understand and help children, it is important
to learn their thoughts and attitudes on many subjects. As you
know, there recently is more discussion about attitudes toward life
and death by adults.
I would like to ask permission for your child to participate in
a research project to explore children's attitudes concerning death.
This will be through a 20 minute individual discussion. If you agree
to let your child participate, you may withdraw your permission at any
time. Your child's identity will be known only to me and to school
persons who help arrange for your child to talk to me. I would also
like to ask permission to review your child's cumulative folder and
to check the information, such as status of the family members, with
your child.
A copy of this study is available at the school. If you have any
questions or would like to know the results, a conference can be
arranged with me through the school secretary. My phone number is
listed below, and you can feel free to call me at any time to discuss
this research. There is no monetary compensation for participation
in this project.
92

93
Your cooperation and that of your child can be very helpful
in better understanding children's needs and attitudes in this area.
Please indicate your answer below, sign and witness this form,
and return it with your child tomorrow. A copy of this consent will
be returned to you.
Thank you very much for your assistance.
Sincerely,
I have read and understand the procedure described above. I
give permission for my child, , to
participate in the procedure.
Signatures: Child
Parent
Witness
Researcher
Bonnie Bell
271-6 Schucht Village
Gainesville, FL 32603
Home phone: 904-373-1549

Principal's Letter
Dear Parents,
R. L. Ward - Highlands Elementary is very fortunate to have
been selected as one of the few schools participating in a recent
educational research study. Ms. Bonnie Bell, a doctoral candidate
at the University of Florida who has ten years experience in public
education, will personally conduct the structured interviews of the
study.
As principal, I would like to express my support for this
project and encourage you to consent to your child's participation.
If you have any questions, please call me or Ms. Bell.
Sincerely,
C. M. Glanzer

APPENDIX B
STRUCTURED INTERVIEW
Name Date
School Grade
Date of Birth Age Ethnic 0.
Religion Retentions GPA
"Hello, . My name is Bonnie Bell. Today I
am visiting your school to learn more about children who are in your
grade. I'd love to see how you draw! Would you please draw a picture
of a person here? (Present plain sheet of paper and pencil. Allow
child to draw. Keep drawing on the table during the interview.)
"That's really a very fine drawing. Do you like to draw? Your mother
(or other caregiver) has said that it's O.K. for me to ask you questions
about your family and about how you feel about living and dying. Is
it O.K. with you if I ask you some of these kind of questions?
(If child refuses, then terminate the interview.) "If later you
decide that you want to stop talking, just tell me and we'll stop.
Do you understand? O.K., let's begin.
Do you have any brothers or sisters?
Tell me their names and how old they are:
95

96
Are you living with your real mother?
Are you living with your real father?
(If not) Who takes care of you at home?
Are you related to this person?
(If applicable) How old were you when your folks split up?
Are they divorced? Separated?
Does your mom work at a job outside your house?
What does she do?
Does your dad work at a job outside your house?
What does he do?
Do you have a pet?
Did you ever have a pet die?
How did that make you feel?
I'd like to talk with you a while about living and dying. Is that OK
with you? (If child refuses, terminate
session.)

Concept of Death (Koocher, 1974)
Natural Aggressive
Suicidal
Other
1.How do things die?
2.How do you think you will die?
3.What happens to things when they die?
Burial End of Life Deterioration Continuation Other
4.What will happen to you when you die.
No Return Return Other
5. Can dead things come back to life?
6. Can you come back to life after you die?
Attitudes Toward Death
Yes No Sometime Other
y£>
1. Would the death of a friend scare you?
2J Would you ever want to go where a friend is dead?

3.
Can you tell me what a cemetary is?
(A cemetary is a place where people
are buried.)
4. Does a cemetary make you upset?
5. Would you be willing to go where a
friend is dead?
6.Do you sometimes feel this way?
I don't like to think about how I
will die?
7.If a friend died, do you feel you would
ever want to talk about it with anybody?
8. Are you afraid of dying?
9. Do you feel it does not bother you to
think about how you may die?
10.Are you scared to go to a cemetary?
Do you worry about dying?
12. Would you want to visit a dying friend
in the hospital?
Does the thought of a friend dying upset
you?
Yes
No
Sometime
Other
00

99
Is there anything else you would like to tell me about this?
Is there anything you would like to ask me?
Is there anyone you would like to talk with more about living or dying?
Before you go, why don't you draw me a picture of anything you would
like? (If child draws a scene related to death, I would talk with
him/her further and determine the nature of the effects of this
interview, and take appropriate measures, i.e., further discussion,
conference with parents and/or school personnel, etc.).

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1

BIOGRAPHICAL SKETCH
Bonnie Andersen Engel, daughter of Earl Charles Engel and
Hazel Irene Andersen Engel, was born August 31, 1946, in Elgin,
Illinois. Her family subsequently lived in Cocoli and Curundu,
Panama Canal Zone, until 1957. Upon returning to Hampshire,
Illinois, Bonnie attended the public schools and graduated as
Salutatorian in 1964. She graduated cum laude from Carthage College,
Kenosha, Wisconsin, 1968, with a dual major in psychology and
elementary education. After completing a Master of Arts degree
in Psychology at Bradley University, Peoria, Illinois, Bonnie
served an internship in school psychology in Springfield. Two years
later, she was employed by the West Georgia Educational Services
Cooperative. Since 1974, Bonnie has been employed as a school
psychologist in Volusia County, Florida.
Additional professional activities have included presidential
positions of the Central Florida Association of School Psychologists
and the Florida Association of School Psychologists, presentations
at numerous conventions, faculty member for NOVA University, Mental
Health Consultant for Gainesville Job Corps, and contract services
with the Florida Department of Education.
In completing her doctoral studies, Bonnie has served as a
student assistant in school psychology and an evaluation specialist
108

109
with Children's Developmental Services, Pediatric Clinic, Shands
Teaching Hospital. Her subspecialization has been early childhood
education.

I certify that I have read this study and that in my opinion
it conforms to acceptable standards of scholarly presentation and
is fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
I certify that I have read this study and that in my opinion
it conforms to acceptable standards of scholarly presentation and
is fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
I certify that I have read this study and that in my opinion
it conforms to acceptable standards of scholarly presentation and
is fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
Assistant Professor of Pediatrics
This dissertation was submitted to the Graduate Faculty of the
Department of Counselor Education in the College of Education and
to the Graduate Council, and was accepted as partial fulfillment of
the requirements for the degree of Doctor of Philosophy.
June, 1981
Dean for Graduate Studies and
Research

UNIVERSITY OF FLORIDA
3 1262 08554 6629



I certify that I have read this study and that in my opinion
it conforms to acceptable standards of scholarly presentation and
is fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
I certify that I have read this study and that in my opinion
it conforms to acceptable standards of scholarly presentation and
is fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
I certify that I have read this study and that in my opinion
it conforms to acceptable standards of scholarly presentation and
is fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
Assistant Professor of Pediatrics
This dissertation was submitted to the Graduate Faculty of the
Department of Counselor Education in the College of Education and
to the Graduate Council, and was accepted as partial fulfillment of
the requirements for the degree of Doctor of Philosophy.
June, 1981
Dean for Graduate Studies and
Research


38
There was a body of information in the medical literature
which addressed the many issues of caring for the terminally ill
child and the needs of the family. In many cases, there was
specificity as to the child's particular illness, such as cancer,
leukemia, or congenital heart disease. The topic of the sudden
traumatic death of infants and children was also addressed. However,
the medical and psychiatric literature did not yield research on the
attitudes of normal children concerning death and dying.
The specific topic of children's bereavement has received some
attention in the literature. Stein (1974) reported that during
childhood one out of every 20 children in the United States will lose
a parent to death and that by the age of 16, one out of every five
children will have lost at least one parent. Kastenbaum (1972) stated
that the death of a parent has the "single and longest lasting" effect
on children. He further suggested that "bereavement in early child
hood has been implicated as the underlying cause of depression and
suicide attempts in later life" (Kastenbaum, 1975, p. 186). Moriarity
(1967) reported that his studies suggested that the case histories of
a large number of juvenile delinquents indicate unresolved childhood
grief. Fauquet's (1980) review of the literature revealed that
"during childhood and early adolescence bereavement reactions are
similar to those of adults: disbelief, physiological distress,
guilt, fear, anger, and panic" (p. 7).
Miya (1972) theorized that the children's perceptions of death
and dying were influenced by the three growth processes of (a)
individual developmental levels of abstract and concrete reasoning,
(b) parental attitudes, and (c) personal experiences.


50
with death of a pet, and for the total sample. Further, responses
were analyzed by percentages.
Validity
CP
The first six items in the death attitudes interview were
developed by Koocher (1974) in exploring children's general concep
tual understanding of death. The 12 questions concerning death
attitudes were modified to some extent from the Early Adolescent
Death Attitude Scale (Fauquet, 1980). In developing the EADAS,
Fauquet (1980) established face validity, content validity, and
construct (factorial) validity. A rather extensive three phase
process of developing and selecting the items was completed by four
reviewers who were counseling professionals of the following
description:
a university professor who teaches a course in counseling
research, a counselor education doctoral student who has
had varied experiences with death in his role as an
instructor and as a hospital chaplain, a doctoral student
who is working in the field of gerontology, and a practic
ing school counselor with ten years' experience working
with early adolescents, (p. 19)
Among the criteria for the items was the establishment of a
fourth grade readability level as determined by a reading specialist
through readability analysis. The EADAS was administered as a pencil
and paper test.
The children in this study, however, were not asked to read the
statements, but to listen and respond to them in a structured inter
view procedure. Oral responses were recorded by the interviewer.


21
Factor analysis of children's death concepts as defined by
Kane (1979) evidenced an increasing multiplicity in the components
during the early childhood years. In general, children acquired
Realization by age 3; Separation and Immobility be age 5; Irrevoc
ability, Causality, and Dysfunctionality, and Universality by age
6; Insensivity by age 8; and Appearance was added by age 12. Kane
(1979) emphasized that the addition of components in each cluster
was not in any particular order. Thus, a one-to-one sequence of
component acquisition could not be established.
Kane (1979) also differentiated as to whether the children
were experienced or inexperienced with death. This was established
through postinterview contacts with the parents. The following
criteria were used:
A child was considered to be experienced if, after the
age of 18 months, he had known at least one intimate such
as a parent, sibling, or close friend, or four non
intimates who had died, or if he had seen at least one
dead person, or had gone to at least one funeral or
funeral home, or had been greatly affected by the death
of a nonintimate. A child was considered to be in
experienced if he had encountered death before he was
18 months old or had never encountered it. (p. 145)
Kane (1979) found that the experienced 3 to 6 year olds evidenced
the presence of the death components at a significantly greater degree
than the inexperienced peers. Children 7 through 12 years of age
manifested the same concepts whether they were experienced or not.
However, the older children generally evidenced the presence of most
of the concepts anyway, and a differentiation would be more difficult
to establish, if indeed it existed. Bolduc (1972) also found that
children who have had experiences with death evidenced significant


67
Table 8
Differences in Responses Relative to Rural-Urban Setting
Rural Urban
Concepts
Attribute major cause of death to old age
45%
76%
Attribute major cause of personal death to
illness, heart attack, and similar reasons
33%
16%
Report a belief that things are buried
after death
42%
19%
Report a belief in continuation of life
after death
30%
51%
Attitudes
Express denial regarding personal death
85%
24%
Express denial regarding impersonal death
76%
49%
Express denial regarding environment of death
58%
24%
Express anxiety regarding personal death
39%
24%
Express acceptance regarding personal death
27%
51%
Express acceptance regarding environment of
death
67%
76%


APPENDIX A
PARENT CONSENT
Dear Parent:
In order to better understand and help children, it is important
to learn their thoughts and attitudes on many subjects. As you
know, there recently is more discussion about attitudes toward life
and death by adults.
I would like to ask permission for your child to participate in
a research project to explore children's attitudes concerning death.
This will be through a 20 minute individual discussion. If you agree
to let your child participate, you may withdraw your permission at any
time. Your child's identity will be known only to me and to school
persons who help arrange for your child to talk to me. I would also
like to ask permission to review your child's cumulative folder and
to check the information, such as status of the family members, with
your child.
A copy of this study is available at the school. If you have any
questions or would like to know the results, a conference can be
arranged with me through the school secretary. My phone number is
listed below, and you can feel free to call me at any time to discuss
this research. There is no monetary compensation for participation
in this project.
92


Concept of Death (Koocher, 1974)
Natural Aggressive
Suicidal
Other
1.How do things die?
2.How do you think you will die?
3.What happens to things when they die?
Burial End of Life Deterioration Continuation Other
4.What will happen to you when you die.
No Return Return Other
5. Can dead things come back to life?
6. Can you come back to life after you die?
Attitudes Toward Death
Yes No Sometime Other
y£>
1. Would the death of a friend scare you?
2J Would you ever want to go where a friend is dead?


54
that the children did not meet the selection criteria. Thirty-five
fourth grade children and 35 fifth grade children yielded valid
interviews that were used in the data analysis.
A total of five parent conferences were held following the
interviews with the children. Four conferences were by parent request
and one was by the request of the researcher. In one of these cases,
it was decided to eliminate the child's interview from the sample due
to situational adjustment difficulties in the child. It should be noted
that this child's parents were already in the process of pursuing
appropriate treatment.
Demographic Data
A total of 31 male (44 percent) and 39 female (56 percent) students
were interviewed. Thirty-seven children (53 percent) were from the
urban school and 33 children (47 percent) were from the rural school.
The grade point averages of the children were as follows: 21 percent
had an A average, 63 percent had a B average, and 16 percent had a C
average. Only 9 percent of the children had ever been retained in
grade level.
The age data revealed that 16 percent of the children were in the
range 8 years 9 months to 9 years 6 months old, 54 percent of the
children were in the range 9 years 7 months to 10 years 6 months old,
and 30 percent were in the range 10 years 7 months to 11 years 1 month
of age. In terms of ethnic characteristics, 93 percent of the children
were Anglo-American, 6 percent were Afro-American, and 1 percent were
Asian American.


75
Table 12
Differences in Responses Relative to None, One,
or Multiple Deaths of Pets
None
One
Multiple
Concepts
Report a belief in continuation of life
after impersonal death
36%
37%
60%
Report a belief in continuation of life
after personal death
29%
49%
67%
Report a belief in burial after impersonal
death
36%
37%
6%
Report a belief in burial after personal
death
36%
41%
0
Report a belief in deterioration after
death
0
7%
27%
Report a belief that things do not return
to life after death
43%
78%
73%
Attitudes
Express denial regarding environment of
death
22%
44%
47%
Express fear regarding impersonal death
50%
73%
67%
Express anxiety regarding environment
of death
64%
44%
47%
Express anxiety regarding impersonal
rlpath
57%
88%
73%


89
this sensitive area, it is recommended for the control of many of
the variables of data collection.
In regard to the training of professionals in counseling,
education, and mental health, there should be significant emphasis
on understanding children's concepts and attitudes toward death.
In addition to the usual professional skills in mental health
services, there should be allocation of at least part of a course to
focus on the salient issues and related research regarding death
concepts and death attitudes. Current curricula could be evaluated
carefully to provide for the inclusion of valid information concerning
children's concepts of death and death attitudes. There needs to be
awareness of the available research and information concerning the
differential concepts and attitudes among normal aggressive, and
suicidal children in regard to their own deaths and the deaths of
others.
Self-clarification of students' perceptions and attitudes con
cerning death should be encouraged. Appropriately structured and
supervised opportunities for such exploration should be provided.
For instance, students may be encouraged to recall their own
experiences concerning death, dialogue with their colleagues concern
ing the emotional effects and intellectual conclusions, increase their
own awareness of sensitive or problem areas, and clarify lingering
issues concerning death of self or others.
It is important to realize that the information and voluminous
recent writings on death and dying for adult populations may have
very limited applicability to children's concepts and attitudes


41
death of normal, suicidal, and aggressive children. Zeligs (1974)
t'l.
and Orbach and Glaubman (1977) have postulated that suicidal
behavior in the young could be partly attributed to the child's
concept of death. It was suggested (Orbach & Glaubman, 1977) that
suicidal children would likely evidence a more idiosyncratically
distorted view of death than would normal children or children with
other disturbances, such as problems of impulse control and aggression.
In 1978 Orbach and Glaubman individually interviewed 21 children,
ages 10 to 12, who were either suicidal, aggressive, or normal accord
ing to school records and school services. All of the children were
of low socioeconomic status; 20 were of Middle-Eastern origin, and
one was of European origin. They lived in Ramat-Gan, Israel. The
children were also matched for cognitive functioning by their per
formance on the Similarities subtest of the WISC. The children were
then administered structured questionnaire based on a modified
version of questions used in Koocher's (1974b) study. They were as
follows:
One set consisted of questions about impersonal death,
namely: How do things die?; What happens to things
when they die?; Can dead things come back to life?
The other set contained the same questions about per
sonal death, namely: How do you think you will die?;
What will happen to you when you die?; Can you come
back to life after you die? (p. 405)
The responses for the first questions in the two sets were categorized
as (a) natural death, (b) aggressive or brutal death, or (c) suicide
and self-destruction. The categories for the second question were
(a) burial process, (b) cessation of life activities or life process,
(c) deterioration of the body, (d) continuation of the life process or


64
of the females and 55 percent of the males reported some fear in
regard to the death of another. Also, more females (46 percent)
than males (32 percent) expressed denial in regard to the environment
of death. Considerably more females (56 percent) than males (42
percent) also expressed fear in regard to their own death. More
females (79 percent) than males (70 percent) also tended to deny
death in regard to themselves. Table 6 summarizes the data in this
area.
Table 6
Differences in Responses Relative to Sex
Males Females
Concepts
Attribute major cause of personal death
to illness, heart attack, and similar
reasons CCjj^
19%
28%
Report a belief that things deteriorate
26%
5%
after death f
Report a belief that things continue to
35%
46%
exist after death (5^
Attitudes
Express denial regarding personal death
70%
79%
Express denial regarding environment of
death
32%
46%
Express fear regarding personal death
42%
56%
Express fear regarding impersonal death
55%
77%


90
concerning death and dying. The literature for adults is important
to the extent that it enables clarification of thinking and feelings
concerning death. However, such perspectives and conclusions must
be very guarded in application to children.
There is not enough research and expertise related to the
professional practice concerning many aspects of normal and abnormal
children's concepts and attitudes toward death to make very extensive
recommendations. The practitioner must, of course, be cognizant of
all the available information concerning children's concepts of
death. The practitioner must have a great deal of self-awareness in
regard to the multiplicity of death issues. Further, the practitioner
must be very selective in using commercial materials. Any structured
experiences must be conducted with considerable caution and with
detailed knowledge of children's social, emotional, and academic
adjustment. It is important for the practitioner to be especially
aware of the verbalizations, fantasies, and behaviors of disturbed
children toward death, should any significant death concerns manifest
themselves.
Children want to have their questions answered concerning death.
They need to explore their own feelings and attitudes, and to
experience support from family or other significant adults who
have a healthy clarity of their own feelings concerning death issues.
Then, the child may be provided with support and appropriate
responsiveness should a death occur. If a child seems to be
experiencing significant difficulties in areas related to death
concerns, including their own deaths, it would be prudent to refer


63
the death of a friend. Four out of five children indicated anxiety
over the death of a friend. Very importantly, 71 percent of the
children also expressed acceptance of another's death.
There was some variability of attitudes concerning the environ
ment of death. Approximately one in five children expressed denial
or fear. Only one-third of the children expressed anxiety. Almost
40 percent of the children indicated acceptance of the environment of
death.
Differential Trends Relative to Sex, Grade,
School, GPA, and Retention
Although there may be some question concerning the validity of
the chi square analyses due to the sparse number of responses in
several cells of the tables, certain trends and characteristics are
suggested. Analysis of the data indicated that the children's views
of death and death attitudes may tend to be different in some respects
relative to the demographic characteristics of sex, grade, school,
grade point average, and retention.
In regard to responses relative to sex, minor differences were
noted (refer to Table 6). For instance, more females (28 percent)
than males (19 percent) attributed the cause of their personal death
as being due to illness, heart attacks, and similar reasons. Signifi
cantly more males (26 percent) than females (5 percent) stated that
things deteriorate after death. On the other hand, more females (46
percent) reported that things continue to exist in some manner after
death than did males (35 percent). In regard to attitudes, 77 percent


22
differences in their death concepts as compared to those who had no
experiences with death.
Contrary to Nagy's (1948) results, in which the inevitability
of death occurred to children at age 9, Kane (1979) found this
belief occurring frequently in children by age 6, and consistently
in children 8 years of age and older. Also contrary to Nagy's
(1948) investigations in which personification of death was expressed,
Kane (1979) found no such form of reification. Thus, there appeared
to be some significant differences in the concepts of death as
expressed by American middle class white children in the 1970's as
compared to the concepts of death of Hungarian children of post World
War II.
In studying children in kindergarten through the fourth grade,
White, Elsom, and Prawat (1978) also found that children's concepts
of irrevocability, universality, and cessation of bodily processes
in regard to death were related to the children's age and intellectual
development. White et al. (1978), however, isolated a rather inter
esting differentiation in their study. After determining the child's
intellectual conceptual level by presenting three conservation tasks
taken from the Concept Assessment Kit by Goldschmid and Bentler
(1968), a story was read to the children. Half of the children
heard a version in which the main character, an elderly woman who
dies, is a kind, likeable, and friendly person who always says "hello"
to children. Half of the children heard a version in which the
elderly woman is unkind, mean to her pets, and yells at children.
The researchers found that the children's understanding of death was


CHAPTER I
INTRODUCTION
Background
The view of children's attitudes toward death as a developmental
concept has received relatively little attention in the professional
literature. Only in the last ten years or so has the topic of
"death and dying" emerged as a significant area of research in the
scientific community and as a "visible" topic of interest in popular
literature. While there has been a rather sudden proliferation of
books and articles on death in response to the needs and interests
of adults, there has been very limited generation of material
addressing this area as it relates to children. A close scrutiny
of both professional and popular literature yields rather limited
information or guidance for parents or professionals concerning
children's concepts, views, or attitudes concerning death. Further,
little of the information has been based on scientific investigation,
as compared to the singular or collective opinions of professionals
in the varied fields of education, psychology, medicine, sociology,
anthropology, religion, and philosophy. Some authors (Fauquet, 1980;
Kubler-Ross, 1975; Moody, 1975; Wass, 1976) have asserted that the
topic of death has been characteristically ignored, denied, or evaded
1


35
frequently investigated areas appeared to be those of fear of death
(Bailis & Kennedy, 1977; Bell, 1975; Boyar, 1964; Gold, 1974;
Levitn, 1974; Mueller, 1976; Nelson & Nelson, 1975), and death anxiety
(Alexander & Alderstein, 1959; Nelson & Nelson, 1975; Rowe & Loesch, 1978;
Tempier, 1970). Attitudes concerning denial of death have been
investigated by Gold (1974) and Nelson (1975). Attitudes concerning
the acceptance of death have been studied by Kurlychek (1976).
A few studies (Ackerly, 1967; Alexander & Adlerstein, 1959;
Beauchamp, 1974; Blake, 1969; Levinson, 1967; Rochlin, 1965) have
alluded to children's fear of death. For example, Rochlin (1965)
presented the following thesis:
children very early, perhaps around three or four, become
aware that they will die but due to their overwhelming fear
of death, they erect elaborate defenses against this
concept. Thus the young child describes death as reversible
and temporary in order to master the realization of death.
(in Ackerly, 1967)
Beauchamp (1974), who studied the death perceptions of 3 and 5
year old children in the Midwest, reported that the older children
exhibited less fear than did the younger children.
Gartley and Bernasconi (1967), who interviewed 60 children 5h
to 14 years of age, concluded that "children can accept death matter-
of-factly, but acquired a fear of death by observing the behavior of
adults" (p. 85). Cox (1979) and Zeligs (1967) findings also supported
the view that children's death attitudes are affected by the parents
and adults in their environment. On the other hand, Dugan (1977),
who administered the Taylor Manifest Anxiety Scale and the Lester
Fear of Death Scale to adolescents and their parents, reported that
"fear of death in parents did not significantly influence that


101
Bruce, M. Animism vs. evolution of the concept "alive." Journal of
Psychology, 1941, 12^ 81-90.
.V Buhrmann, M. V. Deathits psychological significance in the lives
of children. South African Medical Journal, 1970, 44(20),
586-9.
> Carmichael, L. Manual of child psychology (1st ed.). New York:
John Wiley & Sons, 1946.
Chasin, B. H. Neglected variables in study of death attitudes.
Sociological Quarterly, 1971, J2^, 107-13.
-^Childers, P., & Wimmer, M. The concept of death in early childhood.
Child Development, 1971, 42(4), 1299-301.
% Coleman, J. C., & Hammen, C. L. Contemporary psychology and human
behavior. Glenville, IL: Scott, Foresman, 1974.
Cox, M. L. The child and death. Archives of the Foundation of
Thanatology, 1979, 7j3), 60.
Dugan, M. N. Fear of death: The effect of parental behavior and
personality upon the behavior and personality of their children
(Doctoral dissertation, University of Notre Dame, 1977).
Dissertation Abstracts International, 1977, 38(10-B), 28315.
(University Microfilms No. 77-19520, 246)
-V-English, H. B., & English, A. C. A comprehensive dictionary of psycho
logical and psychoanalytic terms (8th ed.). New York: David
McKay, 1966.
-)( Erickson, E. Identity and the life cycle. New York: International
Universities Press, 1959.
^Erikson, E. Childhood and society (2nd ed.). New York: Norton, 1964.
^Erikson, E. Identity, youth and crises. New York: Norton, 1968.
Escamilla, A. L. Depressive reactions in children upon the loss of
parental figures through death or divorce. Neurologia,
Neurocirugia, Psiguiatria, 1977, 18(4), 211-221.
Fauquet, B. Early adolescent death attitude scale. Unpublished
manuscript, 1980.
7 Formanek, R. When children ask about death. Elementary School Journal,
1974, 75, 92-97.
Garfinkel, B. D., & Golombek, H. Suicide and depression in childhood
and adolescents. Canadian Medical Association Journal, 1974, 110
(11), 1278-1281.
J^Gartley, W., & Bernasconi, M. The concept of death in children.
Journal of Genetic Psychology, 1967, 110(1), 71-85.
17


Abstract of Dissertation Presented to the Graduate
Council of the University of Florida in Partial Fulfillment of
the Requirements for the Degree of Doctor of Philosophy
CHILDREN'S ATTITUDES TOWARD DEATH
By
Bonnie Andersen Engel
June, 1981
Chairperson: Janet J. Larsen
Major Department: Counselor Education
The purpose of this dissertation was to assess and evaluate
normal children's concepts and attitudes toward death. The sample
for the study was composed of 35 fourth grade and 35 fifth grade
students attending one urban and one rural school. Each child
participated in individual structured interviews. Children's views
concerning the causes and events related to personal death (death
of self) and impersonal death (death of another) were explored.
There was also investigation of their attitudes of death denial,
fear, and anxiety, their acceptances regarding personal and impersonal
death; and their attitudes toward the environments of death.
The results indicated that these children viewed old age and
illness as the primary causes of death. Almost 80 percent of the
children expressed denial (i.e., aversion) regarding the environment
vii


85
relationship of religious or spiritual views in regard to children's
concepts of death seems to warrant some consideration. Blum (1976),
Chasin (1971), Gartley and Bernasconi (1967), Mclntire et al. (1972),
O'Brien (1979), and Zweig (1977) have alluded to or investigated
children's views or concepts concerning death relative to religious
training. However, mixed results are reported in the studies
yielding no clear conclusions at this time.
Children's Views Concerning Conditions After Death
Perhaps the most striking feature of these data was the rela
tively little variability of children's responses in comparing
personal and impersonal deaths. There was no more than a 7 percent
(5 out of 70) difference in any of the seven categories describing
conditions after death. Approximately one-half of the children
reported that burial or burial with continuation or deterioration
will happen after death. A significant percentage of children
(almost half) reported the view of a continuation of life in some
manner after death. Most commonly, this was described as "go to
heaven" or "go to heaven or go down there." These views corroborate
the work of Orbach and Glaubman (1978, 1979) and Zeligs (1974) as it
relates to normal children compared to aggressive children and pre-
suicidal children.
On the other hand, do 50 percent or so children who did not
describe some type of continuation after death believe that death
is indeed final? This issue becomes more complex in viewing the
children's responses to the questions, "Can dead things come back to


3.
Can you tell me what a cemetary is?
(A cemetary is a place where people
are buried.)
4. Does a cemetary make you upset?
5. Would you be willing to go where a
friend is dead?
6.Do you sometimes feel this way?
I don't like to think about how I
will die?
7.If a friend died, do you feel you would
ever want to talk about it with anybody?
8. Are you afraid of dying?
9. Do you feel it does not bother you to
think about how you may die?
10.Are you scared to go to a cemetary?
Do you worry about dying?
12. Would you want to visit a dying friend
in the hospital?
Does the thought of a friend dying upset
you?
Yes
No
Sometime
Other
00


34
experienced children 3 to 6 years of age seemed to manifest more of
the measured components of death concepts than those 3 to 6 year
olds who were not experienced with death in their life. No differ
ential effects were found in children 7 to 12 years of age. Zweig
(1977) found that experiences with death influenced the attitudes
and concepts of death of 8 to 12 year olds. Bolduc (1972), in
studying the attitudes and concepts of death in 9 to 14 year olds,
found experience with death to be an influential factor. On the
other hand, Mclntire et al. (1972) who studied the death concepts of
children 5 to 18 years of age, found no apparent effect of experience
on children's avowed concepts of death. Thus, the results in this
area were rather contradictory, although the research tended to
suggest that experiences with death did affect children's death
attitudes and death concepts.
Children's Attitudes Toward Death
There appeared to be very limited research concerning children's
attitudes toward death. The only instruments which even approached
the early adolescent level were the Attitude Toward Death Scale
(Hardt, 1975) for 13 to 26 year olds and the Early Adolescent Death
Attitude Scale (Fauquet, 1980) for children in the sixth, seventh,
and eighth grades.
In older populations, mainly college students and adults, investi
gations of death attitudes have been approached through a variety of
models and dimensions. However, there did appear to be four broad
divisions which emerge from the literature on this topic. The most


93
Your cooperation and that of your child can be very helpful
in better understanding children's needs and attitudes in this area.
Please indicate your answer below, sign and witness this form,
and return it with your child tomorrow. A copy of this consent will
be returned to you.
Thank you very much for your assistance.
Sincerely,
I have read and understand the procedure described above. I
give permission for my child, to
participate in the procedure.
Signatures: Child
Parent
Witness
Researcher
Bonnie Bell
271-6 Schucht Village
Gainesville, FL 32603
Home phone: 904-373-1549


56
Scale for Children Revised. The incidence of the parents occupations
is recorded in Table 1.
Table 1
Occupational Status of Mothers and Fathers
Category
Mothers
Fathers
1. Not employed
34%
9%
2. Professional and technical workers
7%
19%
3. Managers, officials, proprietors,
clerical workers, and sales workers
40%
30%
4. Craftsmen and foremen
1%
24%
5. Operatives, service workers, farmers
and farm managers
10%
13%
6. Laborers, farm laborers, and farm
foremen
7%
6%
Questions Related to Children's
Concepts of Death
The purpose of this study was to explore children's concepts of
death. Using questions initially designed by Koocher (1974), there were
analyses of the children's responses concerning personal and impersonal
death. Table 2 summarizes the analyses of the data regarding what
children viewed as causes of death. Most of the children (70 percent)
reported that the cause of death of other things (i.e., animals) was
usually due to old age, illness, or both. More importantly, nearly
90 percent of the children stated that their own deaths were expected


31
children with the facts of death earlier than was usual in past
times, they did not investigate this variable in their study.
Hornblum (1978) and Mclntire et al. (1972) reported no differential
effects of television viewing on children's conceptions of death.
Mclntire et al. (1972) found no significant differences even when
there was factor analysis of the total number of hours of television
viewing and type of favorite program: aggression, fantasy, or
reality. On the other hand, Zweig (1977) reported that her results
indicated that children learn more about death from the media and
reading than from religious training or school.
The matter of the effects of religion on children's concepts of
death has received very little attention in the literature. Gartley
and Bernasconi (1967) speculated on possible effects due to early
religious training, although they did not investigate this factor.
Mclntire et al. (1972) investigated the death concepts of 598
children, ages 5 to 18 years, who attended youth classes at either
a Roman Catholic elementary school, a Protestant Sunday school, or
a Jewish Temple. The children's religious affiliation was found to
be a significant variable in several measured aspects of their
acquaintance and concepts of the cause, imagery, and finality of
death. When asked "Why do people die?" there were significant
differences evident in the responses of the Catholic children at
the 6 year through 11 year range. At the age of 6 years, 33 percent
of the Catholic children gave the cause as "because they are bad."
However, no children in this or any other group attributed a known
death to moral guilt. At the age of 11 years, 22 percent of the


43
The results favor the assumption that distortions in
the death concept are specific and, therefore, can
be attributed to a defensive process, "(p. 671)
Orbach and Glaubman (1978, 1979) repeatedly emphasized that a
discussion of the concepts and meaning of death must be an essential
part in the treatment of suicidal children.
Mclntire et al. (1972) reported one of the more striking statistics
from their interviews with the 598 Midwestern children 5 to 18 years of
age. When asked, "Are there times when you really wished you were
dead?" 238 (40 percent) of the children replied "occasionally" and
18 (3 percent) said "frequently." Those admitting frequent death
wishes held less naturalistic views of death, evidenced more fantasy
and imagery (such as reincarnation), and were more likely to believe
in reversibility and cognizance for themselves after death. Ten of
the 18 children reported that their death wishes were most often
percipitated by family arguments or fear of punishment, and most often
characterized by anger or sadness. Fourteen of the 18 children
were Protestant. All of them were over the age of 10 years.
Thus, there was considerable evidence which suggests that suicide
has become a matter of increasing frequency and concern among children
and adolescents. Further, since very few studies have focused on the
relationship between children's concepts of death and thoughts of
suicide, continued investigation of children's concepts, thoughts,
and attitudes toward death certainly seemed warranted.


57
to be from these causes. Approximately 10 percent believed that death
was likely to occur from aggressive causes, such as a car accident or
getting shot or kidnapped. A small percentage (6 percent) believed
that death comes when "God decides." No children reported suicide as
a cause of death.
Table 2
Children's Views of the Causes of Death
Causes
Impersonal Personal
(How do (How do you think
things die?) you will die?)
1.
Old age
24%
61%
2.
Illness, heart attack,
cancer, etc.
34%
24%
3.
Old age and illness
13%
3%
4.
Aggressive causes (car
accident, etc.)
10%
9%
5.
Old age and aggressive
causes
9%
1%
6.
Suicidal causes
0
0
7.
God decides
6%
1%
8.
Other
4%
0
Table 3 summarizes the data analyses regarding children's views as
to what happens after death in reference to other things (impersonal
death) and themselves (personal death). Thirty percent of the
children stated that things and themselves would be buried after
death. Approximately 50 percent expressed a belief in some kind of


20
Kane (1979) discerned three stages in the children's concept
development. Stage One was characterized by the presence of the
components of Realization, Separation, and Immobility. Death was
mainly a description: lying down with immobility. Egocentricity
and magical thinking was evident. The children believed they could
make someone dead by their behavior, wish, or label. At Stage Two,
death was viewed as specific, concrete, and dysfunctional. The
beginnings of logical thought were evident. Besides further develop
ment of the aforenamed components, there was inclusion and development
of the remaining components of Irrevocability, Causality, Dysfunc-
tionality, Universality, Insensitivity, and Appearance. However, the
components were not interrelated. Early in Stage Two, the children
tended to believe that death was externally caused, although internal
causes of death were recognized later. Except for violence, death
was viewed as a part of old age and very far away. At Stage Three,
the children began to interrelate the components. The children's
conceptualizations were more abstract, logical, and reality-based.
Some children considered the existential issues of life and death.
Death was a definition, an internally caused state characterized by
dysfunctionality, inactivity, and insensitivity. The stages were
shown to develop year by year. Kane (1979) further stated that the
stages were related to Piagetian preoperational, concrete operations,
and formal operations stages. The youngest children in Stage One
organized their thinking in terms of structure; those in Stage Two
thought in terms of function; those in Stage Three evidenced abstrac
tion.


UNIVERSITY OF FLORIDA
3 1262 08554 6629


66
Table 7
Differences in Responses Relative to Grade
Fourth
Fifth
Concepts
Attribute major cause of personal death to
illness
31%
17%
Attribute major cause of personal death to
aggressive causes
3%
14%
Attribute major cause of impersonal death
to old age
16%
9%
Attribute major cause of impersonal death
to aggressive causes
0
20%
Report a belief in continuation of life
after death
49%
34%
Report a belief in end of life after death
0
14%
Attitudes
Express denial regarding personal death
0
20%
Express fear and anxiety regarding personal death
Express anxiety regarding impersonal death
14%
3%
Express acceptance regarding environment of
death
80%
63%
In comparing the attitudes expressed between urban and rural
children, some differences were noted. Table 8 summarizes the data
in this area. More urban children (76 percent) believed that they
will die of old age than did rural children (45 percent) who suggested


76
you?" 57 percent of the children who had never known the death of a
pet responded yes; 57 percent of the children who had known the
death of one pet responded yes; and 73 percent of the children who
had known multiple deaths of pets responded positively. Sixty-four
percent of the children who experienced no deaths of pets reported no
anxiety in regard to the environment of death. On the other hand,
approximately 45 percent of the children who had experienced deaths
of pets expressed no anxiety. There were no clear differentiations in
regard to the attitude of acceptance toward death.
Interview Closure Activities
At the conclusion of the specific questions investigating death
concepts and attitudes, a few open-ended questions for closure and
a drawing activity were provided. The children were asked, "Is
there anything else you would like to tell me about this?" Seventy-
three percent of the children responded negatively. The children
were also asked, "Is there anything you would like to ask me?"
Fourteen percent of the children did have questions, 86 percent of
the children did not. Table 13 summarizes the questions. When asked,
"Is there anyone else you would like to talk with more about living
and dying?", 13 of the children responded positively, mainly naming
a parent. Table 14 specifies the persons the children identified for
further discussion. Finally, the children were asked to draw a
picture of anything they would like to draw before leaving. Ninety-six
percent of the children drew pictures of themes typical of their


62
over the death of another. One third (33 percent) of the children
indicated anxiety in the environment of death. Almost half (49 per
cent) reported experiencing no anxiety in the environment of death
(specifically a cemetary). Eighteen percent reported the experience
of such anxiety sometimes.
Acceptance
In regard to the attitude of acceptance toward death, 61 percent
of the children reported some sense of acceptance in regard to their
own deaths. Twenty-nine percent did not indicate such acceptance.
Ten percent reported acceptance sometimes. Many of the children (71
percent) reported acceptance of the death of another. Twenty-three
percent did not. Six percent expressed acceptance of the death of
another sometimes. Thirty-seven percent expressed acceptance toward
the environment of death. Twenty-eight percent did not. Five per
cent of the children reported such acceptance of the environment of
death sometimes.
Comparison of Attitudes Within Personal Death, Impersonal
Death, and the Environment of DeatF
There was a range of attitudes expressed by the children concern
ing their own death. The majority of the children (77 percent)
expressed occasional denial of personal and half expressed fear.
One-third of the children expressed anxiety and one-third expressed
acceptance of their own deaths.
In general, there was less variability of attitudes concerning
impersonal death (death of another). Approximately half of the
children expressed denial and 67 percent expressed fear concerning


IS
with a recognition of death as a natural process. In response to the
/ question of what will happen when one dies, Koocher grouped the
responses into the following non-exclusive categories:
references to being buried alive were given by 52% of
the children; references to being judged, going to
heaven or hell, or other hints at any sort of after
life by 21%; references to having a funeral by 19%;
specific predictions of how death would occur by 10%;
references to some aspect of sleep by 7%; references
to being remembered by others by 5%; references to
reincarnation by 4%; and references to cremation by
3%. (p. 409)
In contrast to the findings of Nagy (1948), Koocher (1974)
found no personification type responses given in reference to what
might happen at the time of death. Weininger (1979) speculated
that Nagy's (1948) findings concerning children's personification of
death perhaps had its source "in specific cultural situations--the
armies, bombs, and threat of imminent death of World War II Hungary"
(p. 397). On the other hand, Kastenbaum (1965) theorized that the
personification of death by 5 to 9 year olds was a necessary emotional
compromise. The children created a person or image of death in order
to make death more controllable.
Kane (1979) investigated the death concepts of 122 mid-America,
middle class white children, ages 3 to 12 years, through 10
components of the death concept which she described as the following:
1. Realization is the awareness of death, of the state of being
deceased, or an event which happens. Death can happen to someone,
or it can be something which makes the living die.
2. Separation deals with the location of the dead and is con
cerned with the child's idea of where the dead are: i.e., "In the
trees," "Under the ground."


40
cause of death among this nation's youth. The incidence has nearly
tripled over the past 20 years. Green (1978) has associated self
destructive behaviors in children 5 to 12 years of age to factors
of child abuse. Paulson, Stone, and Sposto (1978) conducted a
three year study of 662 children, 12 years of age and under, who
were identified as self-abusive or suicidal and in treatment at the
UCLA Neuropsychiatric Institute. Pfeffer (1978) reported that over
100 suicidal children 6 to 12 years of age were treated at the Child
Psychiatry Inpatient Service at Bronx Municipal Hospital in the
previous four years. The National Clearinghouse for Poison Control
Centers (1968) and several researchers (e.g., Mclntire & Angle, 1973;
Sobel, 1970; Teicher, 1970; Springthorpe, Oates, & Hayes, 1977)
reported increasing admissions of children under 12 years of age to
poison centers and/or emergency hospitals for accidents and
"accidental overdoses." The National Center for Health Statistics
reported 170 confirmed child suicides in 1975. In the State of
Florida in 1977, five suicidal deaths were reported by children in
the 5 to 14 year old range. Schnake (1972) estimated the ratio of
suicide attempts to actual suicides is 50 to 8, while Jacobs (1971)
estimated the ratio at 50 to 7. Jacobziner (1960) estimated the
proportions at 50 to 1, while still higher ratios are cited by
Tuckman (1962) at 120 to 1. Thus, there was considerable evidence
suggesting serious and significant increase in suicidal attempts and
suicidal behavior in children.
In the last few years Orbach and Glaubman (1978, 1979a, 1979b)
produced some very interesting studies investigating the concepts of


28
1. Is life or death seen as a recurrent process?
2. Does life or death come from the outside to a person
or thing (external process)? Or does it come from
the inside, and is it seen as an internal process?
3. Is there neither basis for considering life or death
either as a recurrent or irrevocable or as an
internal event. (Safier, 1964, p. 288)
Basically, Safier (1964) found a decrease in "animism" and "death"
scores with increase in age. As children's concepts of death improved,
so also did their concepts of life. Safier stated, "The judges'
conclusions seemed to support a common rationale underlying Piaget's
stages of animism and Nagy's stages of death conception" (1964, p.
294).
Another approach to clarifying children's concepts of death was
implemented by Weininger (1979) who compared children's verbalizations
about death and dying with their behavior and comments in structured
play situations. Weininger (1979) combined the four questions used by
Koocher (1973, 1974a, 1974b) with two differently structured play
situations to determine the children's perception of death. Weininger
(1979) examined the verbal and play responses of 30 boys and 30 girls
ages 4 to 9 years old living in a middle class urban area. In a
small empty classroom, there was a tape recorder, a small table and
two chairs, and the following play materials: a mother and a father
doll, a child doll, a pretend stethoscope, a pretend hypodermic
needle, candy pills, a pretend thermometer, a blanket, a pillow,
a double bed, a box with a lid, 2 inch glass of water. The play
procedure was described as follows:
the interviewer presented all the materials, saying that
"the doll is very sick and the doll is going to die."
The interviewer gave the child time, and, if necessary,
helped the child to play out the situation, encouraging


51
Elementary school children vary widely in their reading skills.
Therefore, the limitation of reading was eliminated as a factor
through the structured interview format.
Reliability
In order to establish inter-rater reliability, two other certified
school psychologists were asked to evaluate and categorize the
responses of three children. Comparison was made with the judgment
of the researcher regarding the categorization of the responses.
Although no reliability procedure as such was used in this study,
these modified items are based on those developed in the EADAS
(Fauquet, 1980), in which reliability was established by test-retest
procedures using the Pearson Product Moment Correlation Coefficients
and by determining the internal consistency of the instrument by
comparing split half variances using Cronbach's Alpha reliability
coefficient. The total test-retest reliability was r = .77 (p < .01).
The reliability coefficient (split-half) was r = .89 (p < .01).
It is believed that children at the pre-adolescent level are
more responsive to the structured interview approach than to a
Likert-type scale using paper and pencil. In that adequate rapport
in the interview situation was clinically established and in that
the factor of readability level was essentially eliminated the
present format was determined to be adequate for data collection
with normal children at the fourth and fifth grade levels.
It was assumed that the data indicated the attitudes of normal
elementary children toward death through self-report. The children's
responses were spontaneous, honest, and accurate because of the


9
Moriarity, 1967; Orbach & Glaubman, 1978; Smith, 1976). Thus, there
are numerous implications for further research related to children's
attitudes toward death.
Increased knowledge of children's attitudes toward death also
would have significant impact on the training and practice of
counseling, school psychology, and other areas of mental health.
If such attitudes were known, it would be possible to "sensitize"
professionals to the characteristics and needs of children concerning
their attitudes toward death. Intervention and facilitation of more
healthy attitudes might also be developed by skillfully trained profes
sionals. It might also be possible to identify some children who
may be pre-suicidal based in part on their expressed attitudes toward
death. The implementation of formal classes in death education may
also be prudently and appropriately pursued. It would be possible
to provide guidance to parents, teachers, and other caregivers con
cerning children's attitudes toward death. On occasions when death
of a classmate or a classmate's parent or sibling is experienced, it
would be possible to facilitate an appropriate response based on valid
information regarding children's death attitudes. Thus, there are
multiple practical implications which may occur in the areas of train
ing and practice based on further knowledge of children's death
attitudes.
Purpose
The purpose of this study was to explore normal children's
attitudes toward death. Specifically, there was investigation of


Principal's Letter
Dear Parents,
R. L. Ward Highlands Elementary is very fortunate to have
been selected as one of the few schools participating in a recent
educational research study. Ms. Bonnie Bell, a doctoral candidate
at the University of Florida who has ten years experience in public
education, will personally conduct the structured interviews of the
study.
As principal, I would like to express my support for this
project and encourage you to consent to your child's participation.
If you have any questions, please call me or Ms. Bell.
Sincerely,
C. M. Glanzer


Copyright 1981
by
Bonnie Andersen Engel


47
conditions for the interview process. (The structured interview is
recorded in Appendix B.) The interviews were conducted by the
researcher who is certified by the Department of Education as a
school psychologist, a school counselor, and an elementary teacher.
She has had nine years experience as a school psychologist mainly in
the elementary school setting.
The nature of this topic made it especially important for the
structured interview to be conducted skillfully and sensitively. It
was important that the child felt comfortable in the situation and
trusting of the interviewer. Attention was given to the adequacy and
appropriateness of the environment. It was characterized by privacy,
comfort, safety, and familiarity. It was also important that the
child develop feelings of trust, openness, and spontaniety. Thus,
the initial part of the interview was designed to emphasize the
examiner's acceptance, positive regard, and interest in the child.
The child's responses and preferences were accepted readily thereby
facilitating the development of a warm rapport. Only after rapport
was adequately developed in the judgment of the interviewer were the
questions on death attitudes asked. In the atmosphere of acceptance,
warmth, and trust, it was anticipated that the child's responses
were, therefore, relatively honest and accurate.
Data Collection
As much as possible, the demographic data on each child included
the following: date of birth, sex, ethnic origin, grade, grade


55
Because attitudes toward death might be related to religious
beliefs, inquiries of religious preference were made. The
expressed religious preferences were as follows: 34 percent were
Baptist, 13 percent were Methodist, 4 percent were Presbyterian, 11
percent were Catholic, and 24 percent expressed other preferences.
The other 13 percent reported no preference or did not attend church.
In all cases, the children were living with their biological
mothers. Also, 80 percent were living with their biological fathers.
Of those children who were from homes where the parents were divorced,
almost 60 percent of the children were three years old or younger
at the time of the divorce. In regard to siblings in the home,
approximately 10 percent of the children had no siblings, almost
60 percent had one sibling, and approximately 30 percent had three
or more siblings. This included natural, step, and half siblings
by family structure.
When asked whether they presently owned or have ever owned a pet,
84 percent of the children reported yes and 16 percent reported no.
When asked whether they had ever had a pet die. 80 percent responded
positively. In 21 percent of the cases, the children had acquaintance
with death of pets in two or more instances. Twenty percent of the
children had no such incident in their lives with pets of their own.
The employment of the parents was noted. Approximately three-
fourths of the mothers were gainfully employed outside the home.
Ninety-three percent of the fathers were employed outside the home.
The parents' occupations were categorized by the same criteria of the
five condensed categories as recorded in the Weschler Intelligence


86
life?" and "Can you come back to life after you die?" Nearly three-
fourths of the children stated that dead things come back to life
and approximately half of the children expressed such a view in regard
to themselves. Analysis by sex suggests that almost half of the
females expressed a belief in continuation of life after death as
compared to one-third of the males. Also, fourth graders tend to
express the view of continuation more often than fifth graders (49
percent to 34 percent). Further, approximately 50 percent of the
urban children expressed a view of continuation of life compared to
one-third of the rural children. Children with lower GPA's also view
continuation of life more frequently.
In contrast, Nagy (1948) found that nine to ten year olds tended
to view death as a permanent and irreversible process. Melear's (1973)
results support this finding. Kane (1979) reported that death was
viewed as irrevocable and dysfunctional by children when they are
six years of age. On the other hand, Mclntire et al. (1972) presents
data which support this study. Mclntire et al. (1972) stated, "the
belief in spiritual continuation peaked at the ages of 13 to 14
years" (p. 530). The perception of continuation was as high as 93
percent in 11 to 12 year olds. Blum (1975) also found that Christian
(Catholic) children tended to believe more in after life significantly
more than Jewish children. Thus, there does not appear to be a clear
definition of children's concepts in this area. Certain demographic
variables such as age, sex, environment (urban or rural), GPA, and
religion seem to have some relationship to children's views concerning
some nature of continuation of life after death.


70
Table 9
Differences in Responses Relative to Grade Point Average
A
B C
Concepts
Attribute major cause of death to illness
13%
39% 45%
Report a belief in coming back to life after
personal death
33%
55% 82%
Attitudes
Express denial regarding personal death
67%
C\J
00
Express denial regarding environment of death
27%
39% 64%
Express anxiety regarding personal death
27%
27% 55%
Express anxiety regarding impersonal death
80%
77% 100%
Table 10
Differences in Responses Relative to
Retention
Retention
No Retention
Concepts
Attribute major cause of death to illness
50%
22%
Report a belief in continuation of life
after death
67%
40%
Attitudes
Express fear regarding environment of death
0
27%
Express anxiety regarding personal death
17%
33%
Express acceptance regarding personal death
67%
44%
Express acceptance regarding impersonal death
100%
80%


83
relevance of these factors with a large N would also be appropriate.
These many characteristics are, of course, applicable to normal
children in basically regular classroom settings.
Conclusions
Children's Concepts Concerning Causes of Death
Analyses of the data concerning children's concepts of the
causes of personal and impersonal death, conditions after personal
and impersonal death, and the finality of personal and impersonal
death reveal a significant range of responses in most of the areas
of exploration.
In regard to children's views of how other things die compared
to the causes of their own death, the view of one's own personal
death being due to old age was expressed nearly three times more
frequently than old age being the cause of death of animals. Perhaps
old age is believed to be a more acceptable and less threatening way
to die than the other possible causes such as illnesses, heart
attacks, or aggressive causes. This concept is further supported
in comparing the differences in responses concerning personal and
impersonal deaths as being due to illness, heart attacks, cancer,
and related causes. Specifically, illness was reported as the cause
of death for other things more (34 percent) than it was reported as
the cause of one's own death (24 percent).
It is important to note that approximately 10 percent of normal
children apparently attribute aggressive causes, such as car accidents,
being kidnapped or killed, to a possible actual cause of either


2
in our society for a rather long period of time. However, interest in
this topic through bona fide scientific investigation has clearly
emerged. Moreover, serious researchers have become increasingly
aware of the opportunity to examine children's concepts and attitudes
toward death as a fundamental and significant area of inquiry and
clarification.
The first investigations concerning children's concepts of death
occurred approximately four decades ago. Although Schilder and
Wechsler (1934), Bender and Schilder (1937), and Anthony (1940)
presented articles mainly of case report and theoretical nature,
Maria Nagy (1948) pioneered the first comprehensive study of children's
views concerning the nature of death through individual interviews
with a large number of subjects (n = 378). Using adjusted formats
of written composition, drawing, and/or structured interviews, Nagy
assembled 484 protocols from Hungarian children 3 to 10 years of age
in Budapest, Hungary, and its environs. Nagy found evidence for
differential stages in children's understanding of death. Children
3 to 5 years of age generally denied death as a regular and final
process. They viewed it as a temporary state, with varying "degrees"
of death. The children were aware that they were alive, but they
also imagined that dead people were alive. Children 5 to 9 years of
age tended to personify death. Death was viewed as a person walking
around trying to catch people and carry them off. Children 9 to 10
years of age tended to view death as a permanent, inevitable,
irreversible, and internal process.


The energy and form of this
dissertation are dedicated to Ram


of death and personal death. They also expressed anxiety concernina
impersonal death (e.g., death of a friend). Approximately half the
children expressed some fears relating to personal and impersonal
death. Psychological "acceptance" of personal and impersonal death
was expressed by approximately 65 percent of the children. A pre
ponderance of children expressed a mixture of all the measured
attitudes of denial, fear, anxiety, and acceptance in regard to the
death of a friend. These attitudes were consistently expressed
significantly more concerning impersonal death as compared to
personal death. Forty percent expressed "acceptance" of the environ
ment of death.
The results were also analyzed relative to sex, grade level,
urban-rural setting, grade point average, retention in grade, pet
ownership, and acquaintance with death of a pet. Approximately 15
percent more females than males consistently expressed fear and denial
of death. More rural children expressed denial of death than did
urban children. Also, significantly more urban children than rural
children expressed psychological acceptance of death. Children with
decreasing grade point averages expressed denial and anxiety of death
increasingly more often.
The results of this study indicate that normal children expressed
a.wide variety of attitudes toward death. These were primarily
characterized as denial or acceptance. It was also noted that there
was relatively little fear and anxiety of death expressed by these
children.
vm


84
personal (death or self) or impersonal (death of other things) death.
In evaluating the emotional adjustment of children particularly con
cerning death, this finding should be viewed with care.
Although not a common response, the view of aggression as a
cause of death also may not necessarily be a deviant response.
Such a view would likely need to be evaluated in the context of
additional evaluative data relative to the child's emotional adjust
ment. It is important to compare this finding to Orbach and Glaubman
(1978) who reported that "aggressive children . gave significantly
more frequent responses of aggression and brutality as a cause of
death, and suicidal children gave more such responses than normal
children" (p. 852).
It is also interesting to note that none of the children attributed
suicidal causes to either their personal deaths or to the deaths of
other things. This finding also corraborates the work of Orbach
and Glaubman (1978) who found that (normal) children seldom identified
suicide as a cause of death. However, suicidal children named
suicide and self-destruction significantly more as a cause of death.
Thus, there is the strong indication that children who suggest
suicide as a possible cause of death may indeed by pre-suicidal.
Some attention must be given to the 6 percent (four children)
who stated that other things die because "God decides." Although
the data are too sparse to draw any conclusions, perhaps there is the
implication that children accept God's decisions for the fate of
other living things more readily than for the conditions of their own
lives. Further, investigation of the conditions of the role or


Demographic Data . . 54
Questions Related to Children's Concepts of Death .... 56
Questions Related to Children's Attitudes Toward Death . 59
Denial 59
Fear 61
Anxiety 61
Acceptance 62
Comparison of Attitudes Within Personal Death,
Impersonal Death, and the Environment of Death .... 62
Differential Trends Relative to Sex, Grade, School, GPA,
and Retention 63
Influences of Ethnic, Social, and Familial Characteris
tics 71
Differential Trends Relative to Ownership and
Acquaintance with the Death of a Pet 72
Interview Closure Activities 76
Clinical Impressions 79
CHAPTER V
DISCUSSION 82
Limitations Regarding Generalizability 82
Conclusions 83
Children's Concepts Concerning Causes of Death .... 83
Children's Views Concerning Conditions After Death . 85
Children's Attitudes Toward Death 87
Implications 88
APPENDIX A PARENT CONSENT 92
B STRUCTURED INTERVIEW 95
REFERENCES 100
BIOGRAPHICAL SKETCH 108
vi


52
structured interview design. The structured interview design
provided for an adequate environmental setting, an age appropriate
manner of administration, and a child-centered format of inter
action.
Methodological Limitations
To some extent, one may question whether self-report fully
reflects the child's concepts and attitudes concerning death and
suicide. Also, the sample of one or two questions in each area may
seem rather limited. However, one must consider the general tendency
of children to be rather direct and honest in an accepting environ
ment, as well as their limited attention span in task-oriented
situations.


6
Boyar, 1964; Gold, 1974; Levitn, 1974; Mueller, 1976; Nelson & Nelson, 1975)
and death anxiety (Alexander & Alderstein, 1959; Nelson & Nelson, 1975)
Rowe & Loesch, 1978; Templer, 1970). Attitudes concerning denial
of death have been investigated by Gold (1974) and Nelson and Nelson (1975).
Attitudes concerning acceptance have been studied by Kurlychek (1976).
Thus, the areas of fear, anxiety, denial, and acceptance which have
received investigation in older populations do not appear to have
been investigated in reference to young children.
There was significant information in the medical literature which
addressed the many issues of caring for the terminally ill child and
the needs of the family. In many cases, there was specificity as to
the child's particular illness, such as cancer, leukemia, or congenital
heart disease. The topic of the sudden traumatic death of children
was also addressed. However, the medical and psychiatric literature
has not yielded research on the attitudes of normal children concern
ing death and dying.
The topic of bereavement in children has received some attention
in the literature. Stein (1974) reported that "during childhood one
out of every 20 children in the United States will lose a parent to
death and that by the age of 16, one of every five children will
have lost at least one parent." Kastenbaum (1972) stated that the
death of a parent has the "single and longest lasting" effect on
children. He further suggested that "bereavement in early childhood
has been implicated as the underlying cause of depression and suicide
attempts in later life" (Kastenbaum, 1975, p. 186). Moriarity (1967)
reported that his studies suggested that the case histories of a large


46
The principal was asked to select three fourth grade classes
and three fifth grade classes in which he/she judged the receptivity
and cooperation of the teacher to the research project to be optimal.
The principal was also asked to write a cover letter to the parent
consent form expressing support for the research study (see
Appendix A). In a teachers' meeting, the nature of the study and
the criteria for selecting the children was explained. Teachers
were asked to identify eight students in their classes who met
criteria. Parent consent forms were sent home with a request for
return the next day. There were five or more consent forms returned
for each class yielding a total N of 70.
Procedure
In November of 1980, cooperation on this study was solicited
from the Director of Student Services, School Board of Marion County,
as to how to proceed further in the school system. Subsequent
contacts were made with the Supervisor of School Psychology Services,
the Supervisor of School Counseling Services, and the appropriate
school principals. The logistics were discussed in detail with the
school principals and teachers in the identified schools. A copy of
the research proposal was provided to each school. The school
personnel and researcher developed a schedule as to the time and
setting of the interviews. The structured interviews were conducted
in a private room of the school guidance and administrative area.
Each interview required approximately 20 minutes. There was insured
freedom from distractibility, privacy, and additional optimal


Fifty-four percent stated that they could come back to life after they
died. Most of the remaining children held opinions to the contrary.
Table 4
Children's Views Concerning
Life After
Death
Yes
No
Other
Impersonal
Can dead things come back
to life?
70%
26%
4%
Personal
Can you come back to life
after you die?
54%
43%
3%
Questions Related to Children'
s Attitudes
Toward Death
A second purpose of this study was to investigate children's
attitudes toward death. Questions adopted from Fauquet (1980) were
modified to examine the presence of the attitudes of denial, fear,
anxiety, and acceptance in regard to death of self, death of other,
and the environment of death. Refer to Table 5 for a summary of
the data.
Denial
In examining the attitude of denial toward death in children,
most 77 percent of the children report some denial in regard to their
own death. There was considerably less denial in reference to the
death of another. Forty percent of the children reportedly experienced


106
Schilder, R., & Weschler, D. The attitudes of children toward death.
Pedagoqical Seminary and The Journal of Genetic Ps.ycholoq.y, 1934,
45, 406-51.
Schnake, R. Difference between suicide rates. Nature, 1972, 220, 1252.
^Schneider, P., & Schneider, R. Young children's reaction to death and
dying (Doctoral dissertation, Deutsche Akademie for Psychoanalyse,
Berlin, 1975). Dissertation Abstracts International, 1977, 38
(4-B), 03160. (University Microfilm No. 77-38, 03l60)
Shaw, M. E., & Wright, J. M. Scales for the measurement of attitudes.
New York: McGraw-Hill, 1967.
Smith, D. F. Adolescent suicide: A problem for teachers? Phi Delta
Kappan, 1976, 57, 539-541.
^Sobel, R. The psychiatric implications of accidental poisoning in
childhood. Pediatric Clinics of North America, 1970, T7 653-685.
T Springthorpe, B., Oates, R., & Hayes, S. Non-accidental childhood
injury presenting at a hospital casualty department. The Medical
Journal of Australia, 1977, 2, 629-632.
H Stein, S. B. About dying. New York: Dansbury Press, 1974.
^Swain, H. L. The concept of death in children (Doctoral dissertation,
Marquette University, 1976). Dissertation Abstracts International,
1976, 37_(2-A), 898-899. (University Microfilms No. 76-16880)
*Teicher, J. D. Children and adolescents who attempt suicide. Pediatric
Clinics in North America, 1970, 1_7(3), 687-96.
Templer, D. I. The construction and validation of a death anxiety scale.
Journal of General Psychology, 1970, 82, 165-177.
Tuckman, J., & Cannon, H.E. Attempted suicide in adolescents. American
Journal of Psychiatry, 1962, 119, 228-232.
^Wass, H. Dying: Facing the facts (1st ed.). Washington: Hemisphere,
1976.
Wechsler, D. Manual for the Wechsler Intelligence Scale for Children-
Revised. New York: The Psychological Corporation, 974
Weininger, 0. Young children's concepts of dying and dead. Psychological
Reports, 1979, 44(2), 395-407.
^Weisman, A. D. On the value of denying death. Pastoral Psychology,
June 1972, 24-32.
)f White, E. A. A description of kindergarten through fourth grade students'
conceptions of death (Doctoral dissertation, Oklahoma State University,
1977). Dissertation Abstracts International, 1977, 37(9-A), 5721,
(University Microfilm No. 77-05208)
17


80
questions concerning their concepts and attitudes toward death. Most
children responded rather quickly and spontaneously. Some children
responded slowly, with apparent thoughtful deliberation. In
general, there was more hesitation and reflection on questions
concerning the death of a friend than on the questions concerning
the environment of death or personal death.
The closure activities were particularly useful. The few children
who had additional comments seemed to find the opportunity to do so
an important one. The closing remarks usually focused on more
detailing of the events surrounding the death of a relative or pet.
When given the opportunity to ask the researcher questions,
approximately 13 percent (n = 10) of the children chose to do so.
Examples of these questions are listed in Table 13. It is interesting
to note that over half the questions reflected a need for information.
Two of the nine children expressed related concerns over the possible
dangers of their parents' smoking. Several questions reflected a
healthy curiosity over the researcher's interest and activities in
this area. The two questions relating to the researcher's ability
"to read other people's minds" were apparently prompted by a classroom
teacher's remarks which stated such. These questions are viewed as
extraneous artifacts of the investigation.
It is interesting to note the persons whom the children identified
for further discussion. More than half the normal children identified
their parents. This likely reflected very healthy positive relation
ships in the family constellation. The two identifications of
medical personnel seemed to again reflect the children's need for


32
Catholic children stated that selection by God as the reason people
die, although only 2 percent of the Protestant and Jewish children
gave this as a reason. Mclntire et al. (1972) also attempted to
determine children's views of what happens after death. The children
who had lost a pet were asked, "Do you think the pet knows you miss
it?" For all children, there was a drop in this belief at 7 years
and at 13 years of age. However, some differences were noted at the
ages of 15 to 16 years. Twenty-eight percent of the Protestant
children and 12 percent of the entire group attributed cognizance
to the pet. Further, at all ages, the belief in cognizance or
awareness after death for self was much less than that attributed
to the pet. Mclntire et al. reported the following:
Catholic school children, ages 11 to 12 years, for example,
93% gave the response of spiritual continuation without
cognizance to the pet. Coexistence of these two responses
ws interpreted as a belief in personal spiritual continua
tion. ... In all four groups, the belief in spiritual
continuation peaked at the ages of 13 to 14 years, and
then decreased in all but those interviewed at the Catholic
school. ... In both the Protestant and Catholic children
the 7 year old was most likely (p < .01) to accept death
as total cessation; this corresponded with the decrease in
fantasy of imagery at the same age. By the age of 8, death
as a total cessation was less acceptable with responses of
increasing belief in spiritual immortality, (p. 530)
It was further added that frequency of religious instruction within
the various church groups did not seem to have any apparent effect on
the children's avowed concepts of death. There was also some investi
gation of the children's imagery of what happens to the body after
death. Mclntire et al. (1972) reported that "the concept of dis
integration to ashes or dust was clearly a factor of religious
education," although no more specificity in this area was given.


79
special interests, such as people, cars, scenes with trees and flowers
and other content. However, 4 percent drew pictures of a death
related scene.
Clinical Impressions
In most cases, the children were informally met at the classroom
door by the researcher and escorted to the private conference room.
On the way, the researcher identified herself as the one who had
sent the note home for the child's parents to sign the preceding day.
The children were asked if their parents had made any comments con
cerning the consent form. The children often shrugged as though it
was a rather insignificant event. They usually stated that the
parents had asked the child whether he/she had a willingness to
participate in the interview. The researcher often asked what the
child decided and the response was commonly, "Sure" or "It's OK with
me." The mood of the children seemed to be one of willing cooperation,
relaxation, and interest, except in one case in which the data could
not be obtained.
During the structured interviews all children readily responded
to the initial activity of drawing a picture of a person. This
activity seemed to give the children opportunities to become
accustomed to the setting and to focus on a self-directed task which
did not require much interpersonal interaction. In most cases, rapport
was established with ease. The format of the structured interview
typically proceeded with a continued sense of interest and cooperation
on the part of the child. Very few asked for clarification on the


74
they die?" 60 percent of the children who experienced multiple deaths
of pets reported continuation of life as compared to approximately 35
percent in both of the other categories. Further, only 6 percent of
the children who had experienced multiple deaths of pets reported
burial as compared to approximately 36 percent of the children in both
of the other categories. When asked, "What will happen to you when
you die?" no children who had experienced multiple deaths of pets
reported burial, while approximately 40 percent of the children in the
other two categories reported burial for themselves. In response to
the same question, 27 percent of the children who experienced
multiple deaths of pets reported deterioration, while no children
who had one pet die made such a report. Seven percent of the children
who had never experienced the death of a pet made such a report.
Attitudes of children toward death of a pet are reported in
Table 12. Children who had never experienced the death of a pet
expressed denial of the environment of death only half as often as
those children who had experienced deaths of pets (22 percent to approxi
mately 45 percent). Children who had experienced deaths of pet(s)
fear of the death of another more frequently (17 percent to 23 percent
more) than did children who had not experienced any deaths of pets,
about half of whom expressed fear. On the other hand, children who
had experienced deaths of pets expressed fear less frequently in regard
to their own death (10 to 18 percent less frequently) than did children
who had never known the death of a pet. Children who had experienced
deaths of pets generally expressed anxiety over the death of another
more often than those who had not experienced death of a pet.
Specifically, when asked, "Does the thought of a friend dying upset


CHAPTER V
DISCUSSION
Limitations Regarding Generalizability
It is important to determine appropriate limits for generalization
of the results of this study. The present results can appropriately
be generalized to normal Anglo-American children in the fourth and
fifth grade classes who reside in urban or rural settings. However,
the differential trends of these characteristics as well as the child's
sex, grade point average, retention history, ownership of a pet, and
acquaintance with death of a pet should be kept in mind.
In that 93 percent of the children were Anglo-American it is
prudent to draw conclusions from the data only as they relate to
Anglo-American children in the United States. Even though there
were minor distinctions between the responses of the children in
urban and rural settings, between fourth grade and fifth grade
children, between males and females, and among grade point averages,
there should certainly be a recognition of these factors in the
population. In that there appeared to be no clear distinctions in
the responses from children of varying social-familial descriptions,
guarded acceptance of any implications of the data as they relate
to those areas is appropriate. Further study of the possible
82


58
continuation of life. Most of these responses were "Go to heaven."
Twenty percent of the children reported that things deteriorate when
they die. However, only 10 percent reported that they would deteriorate
when they died. One percent or less expressed the belief that
death was the total end of life.
Table 3
Children's Views of Conditions After Death
Impersonal Personal
(What happens to (What will happen
Conditions After Death things when to you
they die?) when you die?)
1.
Burial
30%
31%
2.
Burial and continuation
7%
3%
3.
Burial and deterioration
6%
3%
4.
Continuation
41%
48%
5.
Deterioration
14%
7%
6.
End of life
1%
0
7.
Other
0
7%
Table 4 summarizes the data analyses regarding children's views
as to whether dead things can come back to life and as to whether they
can come back to life after they die. Seventy percent of the children
reported that they believed dead things could come back to life.


72
Differential Trends Relative to Ownership and
Acquaintance with the Death of a Pet
There were several instances in which children who owned pets
tended to respond differently from those children who did not own
pets. Table 11 summarizes the data in this area. More children who
owned pets reported illness as a cause of death, including their own
death, as compared to such reports from only 9 percent of the children
who had never owned a pet. Forty-three percent of the children who
owned pets reported a continuation of life after things die as
compared to 27 percent of those children who had not owned pets
making such reports. Also, 17 percent of those children who had
owned pets described some kind of deterioration after death, while
none of the children in the other category did. Twice as many children
who had never owned pets (55 percent) reported that burial is what
happens to things after they die. Similar frequencies of responses
were noted between the two groups of children in regard to what
happens after personal death in the areas of burial and continuation
of life in some manner after death. In regard to attitudes, children
who owned pets tended to have less denial concerning the death of
another and in regard to the environment of death as compared to
children who did not own pets. Also children who owned pets expressed
fear of the environment of death less frequently (18 percent less) than
children who did not own pets.
There was an examination of the responses regarding children who
never had a pet die, experienced the death of one pet, or experienced
two or more deaths of pets. When asked, "What happens to things when


48
point average, and number of retentions. Further, efforts were
made to secure the following data from the structured interview
and/or the report of school personnel: number of siblings, sibling
position of the child, status of the parents or caregivers (natural
or step), and parents' vocations. Data were collected concerning any
recent events which may have been traumatic to the child in the
areas of loss or separation. Specifically, this information focused
on indication of loss of parent or significant others through death,
divorce, or separation. Reported death of one or more pets was
noted also.
Nature of the Data
The scoring concerning the six questions on concept of death has
been developed by Koocher (1974b). The exact questions and scoring
were used with the exception of one addition of an "other" category
in the first set. The first two questions were the following:
1. How do things die?
2. How do you think you will die?
The above questions were scored according to the following categories
A. Natural Causes (e.g., old age)
B. Aggressive Causes (e.g., murdered)
C. Suicidal or Self-destructive causes (e.g., killed himself)
D. Other (e.g., I don't know)
The next two questions were the following:
3. What happens to things when they die?
4. What will happen to you when you die?


81
accurate information relating to their concerns over health, life,
and death.
The final activity of drawing a "picture of anything you would
like" provided an opportunity for spontaneous self-expression. It
is important to note that 96 percent of the pictures were not death
related drawings. The majority of the drawings were judged to be
clinically healthy drawings with content such as trees, houses,
nature scenes, cars and other vehicles, and so forth. In those cases
of death related scenes, the researcher further examined the child's
adjustment to determine whether there was need for concern. In the
two cases in which concern was warranted, conferences with the
children's parents were scheduled. Further responsible action was
pursued.
The parent conferences were cordial. All the parents expressed
genuine interest in the healthy adjustment of their children. A few
inquired whether their child evidenced apparent difficulties in the
area of death and dying which may need special attention. In two
cases, parent awareness of their child's attitudes seemed advisable.
In one instance, a discussion regarding provision for the child's
safety in the event of the parents' deaths seemed advisable. Appro
priate professional services were advised and scheduled in a second
case. Most parents stated that they believed the interview with their
children had been a very positive, constructive event. They expressed
strong interest regarding their children's healthy adjustment in all
areas of life, including the matters of death and dying.


69
averages. Children with lower GPA's also increasingly viewed
themselves as able to come back to life after they die. The
percentage of children who responded positively to that concept
were as follows: 33 percent of those with A averages, 55 percent
of those with B averages, and 82 percent of those with C averages.
There was also a slight trend for children with lower GPA's to
express the attitude of denial in reference to their own deaths.
Sixty-seven percent of the A students expressed such denial; 77 per
cent of the B students did; and 82 percent of the C students did so.
A similar trend, but less obvious, was also suggested in regard to
denial of the death of another.
A stronger trend of increasing denial toward the environment of
death was noted as children's GPA's become lower. Specifically, 27
percent of the A students reported such denial; 39 percent of the B
students did; and 64 percent of the C students stated denial of the
environment of death. More students (55 percent) with GPA's of C
seemed to experience anxiety of their own deaths more than did
students with GPA's of A (27 percent) or B (27 percent). Also, more
C students (100 percent) reported anxiety over the death of another
than did A students or B students.
There were some differences in responses among children who were
retained as compared to those who were not retained (refer to Table
10). Half of the children who were retained viewed illness as the
cause of their deaths as compared to 22 percent of those who were not
retained. Sixty-seven percent of those who were retained reported a
view of continuation of life after death as compared to approximately


33
The investigators also found differential effects of religion regard
ing questions on the meaning of life and on suicide ideation. These
areas are discussed later in the chapter in the section on suicide.
Blum (1976) interviewed 155 children ages 7, 9, 13, and 18
years old. Half of the children were Catholic and half were Jewish.
Half attended religious Parochial schools and half attended public
schools. Blum (1976) also found that children's concepts of death
changed with age. He further found significance in the factor of
religion. For children in the formal operations stage, Blum reports
the following:
It was Catholicism (vs. Judaism) and a parochial-school
background (vs. a public-school background) that were,
in certain circumstances, related to more abstract levels
of thinking about an after-life. Finally, regarding
belief vs. non-belief in an after-life, Jews and
Catholics were very distinguishable at all ages, with
Catholics believing significantly more than Jews.
(p. 5248)
It was interesting to note that in adult populations, religious
activity and religious beliefs seemed to affect one's attitude toward
death. For example, Swenson (1965) found that "persons engaged in
frequent religious activity or demonstrating a fundamentaliStic
type of religion evidenced a very positive or forward looking death
attitude whereas those with little religious activity or interest
either evaded reference to death or feared it" (p. 109). Similar
results were reported by Chasin (1971), although there appeared to
be differential effects related to sex, level of education, and
income levels.
As discussed earlier, Kane (1979) investigated the effects of
children's experience with death on their death concepts. In general,


CHAPTER II
REVIEW OF RELATED LITERATURE
The review of the literature pertaining to this study concerning
children's attitudes toward death provided a theoretical basis for
the study. Attention was given to research which has investigated
children's concepts of death from a developmental view, particularly
from a Piagetian and a psychoanalytic theoretical basis; research
which has investigated the effects of various factors such as
socio-economic level, race, television viewing, and experience with
death on children's concepts of death; research which has investigated
children's attitudes toward death; and relevant research which has
investigated children's perceptions of death as may be related to
suicide.
Children's Concepts of Death From a Developmental View
Since the first comprehensive study (Nagy, 1948) of children's
concepts of death, developmental stages have been evident consistently
in the literature in this area. Through individual interviews with
378 Hungarian children ages 3 to 10 years, Nagy (1948) found evidence
for differential stages in children's understanding of death.
Children 3 to 5 years of age generally denied death as a regular
13


68
that cause. About twice as many more rural children than urban
children (33 percent to 16 percent) attributed the causes of their
own deaths to illness, heart attack, or other similar reasons.
Considerably more rural children (42 percent) viewed things as being
buried after death than did urban children (19 percent). On the
other hand, more urban children (51 percent) viewed a continuation
of life after death than did rural children (30 percent) who expressed
such a view. More rural children (76 percent) than urban children
(49 percent) expressed the attitude of denial in regard to another's
death. Almost twice as many rural children (58 percent) than urban
children (24 percent) expressed denial in regard to the environment
of death. Also, more rural children (39 percent) than urban children
(24 percent) reported anxiety over their own deaths. Eighty-five
percent of the rural children compared to 68 percent of the urban
children expressed the attitude of denial in regard to their own deaths.
On the other hand, 51 percent of the urban children expressed more
acceptance of their own deaths as compared to 27 percent of the rural
children. Also, more urban children (76 percent) expressed more
acceptance of the environment of death as compared to 67 percent of
the rural children.
There was some differentiation of children's attitudes relative
to their grade point averages (.refer to Table 9). Children with
lower GPA's increasingly viewed illness as the cause of death of
other things. The percentages who attributed death due to illness
were 13 percent of those children with A averages, 39 percent of those
children with B averages, and 45 percent of those children with C


ACKNOWLEDGMENTS
Warm appreciation is expressed
to Dr. Janet Larsen, committee chairperson,
Dr. Larry Loesch,
Dr. Michael Resnick, and
Dr. William Brievogel
for their unending support and guidance;
to Cathy, Carl, Jo Dolley, Bob A., Jim E., Henry, Geraldine, Lee,
Linda, Don, and Frank.
for their abundance of encouragement;
to my parents and professors
for providing the firm foundation of both vision and
determination;
to Mickey Singer and Amrit
for reminding me of love, perfection, and clarity of
perspective;
to the fourth and fifth grade students, their parents and teachers,
Mr. Glanzer and Mrs Marcos, assistant principals, and especially
Dr. Lee Rowell of Marion County Public Schools
for so willingly participating in this research endeavor;
to Leila Cantara
for excellence in typing services and warm sensitivity in
the fragile finalities.


78
Table 14
Persons
Identified by Children to Ask Further Questions
Child
Identified Person
Child #2
Parents
Child #8
Neighbor (who had a recent death in
family)
Child #13 Doctor or Mother or Nurse
Child #26 Mother
Child #47
Parents
Child #49
Anyone
Child #52
Parents
Child #56
Mother
Child #58
Anyone
Child #68
Doctor


4
Consistent with the research concerning concepts of death since
Nagy (1948), much of the recent research in the field further yielded
evidence for stages of development in children's concepts of death.
Mclntire, Angle, and Struempler (1972) attempted to measure the views
of causes, images, and finality of death in children 5 to 18 years of
age of three different religious affiliations: Catholic, Protestant,
and Jewish. Children up to the age of approximately 6 years viewed
death as reversible, and viewed dead pets or persons as having
cognizance. Seven to 9 year olds viewed death as irreversible and
considerably fewer children believed in cognizance after death. A
second drop in the percentage of children who accepted cognizance was
evident in 13 year olds. It was also noted that death was not viewed
as a total cessation of life activities until the children were 7
years old.
Weininger (1979) used the techniques of structured interview
and structured play with 4 to 9 year olds to examine the relationship
of children's concepts of death as expressed verbally and as expressed
in play. In this study, the children evidenced increasing accuracy
in their understanding of death and dying with increasing age.
However, the data indicated that corresponding continuity between
play expression and verbal expression regarding these concepts was
not evident until the children were 8 to 9 years of age.
Thus, several studies (Gartley & Bernasconi, 1967; Kastenbaum,
1965; Mclntire et al., 1972; Nagy, 1948; Weininger, 1979) consistently
concluded that children's concepts of death develop in relatively
distinctive, identifiable stages. Children up to the age of 6 years


3
Rochlin (1959, 1965) later corraborated these findings with
American children 3 to 5 years of age. Rochlin (1965) theorized
that in response to their overwhelming fear of death, children
construct elaborate defenses such as the ideas of reversibility,
temporariness, and continuing existence in places like heaven or
hell.
Kastenbaum (1965) similarly interpreted the personification of
death by 5 to 9 year olds as a necessary emotional compromise. He
stated that the person or image of death is created by the children and
modified by culture in order to make death more remote or more con
trollable. Weininger (1979) also speculated that the data obtained
from the older children in Nagy's (1948) research was strongly
affected by the cultural conditions of World War II Hungary.
On the other hand, Gartley and Bernasconi (1967), who studied
60 American Catholic children 51/2 to 14 years of age, did not observe
the concepts of reversibility or personification of death. These
researchers speculated that "early religious teaching and television
may acquaint the child with the facts of death earlier than was
usual in times past" (Gartley & Bernasconi, 1967, p. 85). Like the
other studies, the children's concepts of death did seem to solidify
and standardize with increasing age. Mclntire, Angle, and Struempler
(1972) found no differences in children's avowed concepts of death
as related to total hours a week of television watching or type of
favorite program (aggression, fantasy, or reality). Rochlin (1965)
also commented that children's concepts of life after death or places
people go after death seem to arise spontaneously and without
necessarily any formal religious education.


12
Concept "A general meaning, an idea, or a property, that can
be predicted of two or more individual items" (English & English,
1966, p. 104).
Denial "Denial is a mental mechanism. ... Its function is
to dispense with a perceived danger. ... It is a process requiring
constant revision of facts and constant correction of perceptions.
It nullifies part of a reality and restores a state of previous
harmony" (Weisman, 1972, p. 25).
Environment of Death The setting in which the dying or dead
person is known to be present, such as a cemetary or a hospital in
which a friend or acquaintance is dying.
Fear A specific feeling that is experienced "in the face of a
present, anticipated, or imagined danger or pain. There is a real or
imaginary threat to one's well being or survival" (Wood, 1976, p. 22).
Normal Those children in regular class who are achieving
academically at an A, B, or C level, who have been retained only once
or not at all, and who are determined to exhibit adequate adjustment
in learning, behavioral, and social areas in the professional judgment
of the classroom teacher.
Suicide "The deliberate act of self-injury with the intention
that the injury should kill" (Garfinkel & Golombek, 1974, p. 1278).


91
these children for services to a qualified counselor, therapist, or
psychologist.
This study of children's concepts and attitudes toward death
has yielded insights, questions for research, implications for
theory, and directions for training and practice. With increased
knowledge and sensitivity to the needs of children, the competent
professional will more readily and more skillfully respond to
children regarding the important matter of the universal experience
of death and dying.


APPENDIX B
STRUCTURED INTERVIEW
Name Date
School Grade
Date of Birth Age Ethnic 0.
Religion Retentions GPA
"Hello, My name is Bonnie Bell. Today I
am visiting your school to learn more about children who are in your
grade. I'd love to see how you draw! Would you please draw a picture
of a person here? (Present plain sheet of paper and pencil. Allow
child to draw. Keep drawing on the table during the interview.)
"That's really a very fine drawing. Do you like to draw? Your mother
(or other caregiver) has said that it's O.K. for me to ask you questions
about your family and about how you feel about living and dying. Is
it O.K. with you if I ask you some of these kind of questions?
(If child refuses, then terminate the interview.) "If later you
decide that you want to stop talking, just tell me and we'll stop.
Do you understand? O.K., let's begin.
Do you have any brothers or sisters?
Tell me their names and how old they are:
95


23
not affected by the story. However, the children's views concerning
the cause of death were influenced. It is reported:
Twenty two percent of the children who heard the story
about the unkind woman attributed her death to some
unkind act she committed. Some children, for example,
claimed she died because she yelled at the school
children and some because she would never laugh.
Of the children who heard the story about the nice
woman, only one subject out of 85 attributed the
woman's death to her own behavior, claiming, perhaps
whimsically, that she died because she laughed too
much. There was, then a significant relationship
between a child's perception of the attractiveness of
the story character and a child's understanding of
the cause of that character's death, x2(l) = 18.36,
p < .001. (p. 309)
Mel ear (1973) who interviewed 41 children 3 to 12 years of age
in Greeley, Colorado, found children's death concepts to be generally
consistent with those reported in other studies which suggested a
developmental view. Mel ear (1973) categorized the responses into
four stages. The first stage was characterized by relative ignorance
of the meaning of the word death as evidenced by children 3 and 4
years of age. (However, one may question the limited sample of six
children at this age range from which such a conclusion is drawn.)
In the second stage, 4 to 7 year olds viewed death as a temporary
state in which the dead can be revived, experience feelings, and
engage in biological functioning. Five to 10 year olds, in the third
stage, viewed death as final, but the dead were able to see, hear,
feel, and in other ways function biologically. (Again, Melear (1973)
reported only four children in this category, and one may question
the size of the sample.) The fourth stage was characterized by the
view that death was final with the cessation of all biological func
tioning. In other words, a more realistic concept of death was


73
Table 11
Differences in Responses Relative to Pet Ownership
Own Pet No Pet
Concepts
Attribute major cause of personal and
impersonal death to illness
Report a belief in continuation of life
after impersonal death
Report a belief in deterioration after
death
Report a belief in burial after impersonal
death
Attitudes
Express denial regarding impersonal
death
Express fear regarding environment of
death
38%
9%
43%
27%
17%
0
27%
55%
59% 73%
22% 36%


27
a stove was alive because "it cooked." In the second stage,
children 6 to 8 years of age attributed life to anything that
moved at the time it was moving. For example, a ball was alive
while it was rolling. Clouds, cars, and bicycles were alive while
they were moving. At Stage Three, children 8 to 11 years of age
attributed life to anything that moved on its own accord, such as
the sun and moon. Mechanical devices were not considered alive
because an operator was required to move them. At Stage Four,
children 11 years of age and older attributed life and consciousness
to animals alone or to plants and animals. The age limits were some
what indefinite, but Piaget asserted that there was definite model
development in these stages.
Safier (1964) examined the responses of three groups of boys in
San Francisco who were ages 4 to 5, 7 to 8, and 10 to 11. She
administered the following ten stimulus words: dog, ball, tree,
bike, boy, moon, mother, ocean, car, cloud. For each word presented
at random, the following questions were asked:
1.
Does
a
live? Is it a
2.
Does
a
hurt when hit?
3.
Does
a
grow up?
4.
Does
a
die?
In the second part of the interview, the children were asked their
rationale for their responses. Two independent judges evaluated the
tape-recorded conversations in reference to the following questions:


BIOGRAPHICAL SKETCH
Bonnie Andersen Engel, daughter of Earl Charles Engel and
Hazel Irene Andersen Engel, was born August 31, 1946, in Elgin,
Illinois. Her family subsequently lived in Cocoli and Curundu,
Panama Canal Zone, until 1957. Upon returning to Hampshire,
Illinois, Bonnie attended the public schools and graduated as
Salutatorian in 1964. She graduated cum laude from Carthage College,
Kenosha, Wisconsin, 1968, with a dual major in psychology and
elementary education. After completing a Master of Arts degree
in Psychology at Bradley University, Peoria, Illinois, Bonnie
served an internship in school psychology in Springfield. Two years
later, she was employed by the West Georgia Educational Services
Cooperative. Since 1974, Bonnie has been employed as a school
psychologist in Volusia County, Florida.
Additional professional activities have included presidential
positions of the Central Florida Association of School Psychologists
and the Florida Association of School Psychologists, presentations
at numerous conventions, faculty member for NOVA University, Mental
Health Consultant for Gainesville Job Corps, and contract services
with the Florida Department of Education.
In completing her doctoral studies, Bonnie has served as a
student assistant in school psychology and an evaluation specialist
108


CHILDREN'S ATTITUDES TOWARD DEATH
BY
BONNIE ANDERSEN ENGEL
A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL
OF THE UNIVERSITY OF FLORIDA IN
PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR
THE DEGREE OF DOCTOR OF PHILOSOPHY
UNIVERSITY OF FLORIDA


25
to know is what it feels like"); or refusing to think ("I think it
is a word that should be thought only when it occurs").
3. Projection. The death of an "other" leaves one grateful
for one's own life, indeed more fully alive.
4. Curiosity. Questions do not cease and some remain silly
even in adolescence. Wrote one: "I think it is the fear of the
unknown. What's going to happen? Will I just be there with no
thoughts, then all of a sudden someone blows a horn and up I come
or will I be conscious every minute? I would like for someone to
tell me what it's like and what happens afterward? Maybe if I trust
God and be a good little girl I will not fear the answers and not ask
so many questions."
5. Personification. "Will death call your name to go?"
6. Propitation. The death of the self being too traumatic to
express, they could approach it only one step removed. "If I lost
one of my parents, death would probably be hard to accept because I
am close to both of them."
7. Dare-devi1ry. No mention was made of this, possibly because
it is an action language.
8. Substitution. A remnant of this appeared as: "A new life
is born each day just as an old life dies each day."
9. Contempt with laughter. "I went on a dare one time with this
friend who knows a guy who works at the, you know, morgue. He puts
his lunch right on the body in the cold room to keep it like in an ice
box. He laughed and said: 'It's all right. He won't eat much.' But
I didn't care for that too much."


102
Gold, M. S., & Allendorf, R. H. The encounter with death.
Humanitas, 1974, J_0, 43-59.
^Goldschmid, M. L., & Bentler, P. M. Dimensions and measurement of
conservation. Child Development, 1968, 39^, 787-802.
> Gomez-Osorio, H. Emergencies in infantile psychiatry. Revista
Columbiana de Psyiquiatria (Bogata), 1978, _7(2), 183-203.
Green, A. H. Self-destructive behavior in battered children.
American Journal of Psychiatry, 1978, 135(5), 579-82.
Hansen, Y. Development of the concept of death: Cognitive aspects
(Doctoral dissertation, California School of Professional
Psychology, 1972). Dissertation Abstracts International, 1973,
34(2-73), 853. (University Microfilms No. 73-255, 20)
^Hardt, D. V. Development of an investigatory instrument to measure
attitudes toward death. Journal of School Health, 1975, 45(2),
96-99. ~
^/Harnik, J. One component of the fear of death in early infancy.
International Journal of Psychoanalysis, 1930, JJ_, 485-491.
Hornblum, J. N. Death concepts in childhood and their relationships
to concepts of time and conservation (Doctoral dissertation,
Temple University, 1978). Dissertation Abstracts International,
1978, 39(4-A), 2146. (University Microfilms No. 78-173, 06)
Huang, I., & Lee, H. W. Experimental analysis of child animism.
Journal of Genetic Psychology, 1945, 66, 69-74.
> Jacobinzer, H. Attempted suicides in children. Journal of Pediatrics,
1960, 56, 519-525.
^Jacobs, J. Adolescent suicide (1st ed.). New York: Wiley-Interscience,
1971.
Kalmbach, C. A. The relationship between the cognitive level of the
child and his/her conception of death (Doctoral dissertation,
Florida State University, 1979). Dissertation Abstracts
International, 1979, 39(11-B), 5518^ (Universtiy Microfilms No.
79-355, 18B)
Kane, B. Children's concepts of death. Journal of Genetic Psychology,
1979, 134(1), 141-153.
Kastenbaum, R. L. Time and death in adolescence. In H. L. Fiefel
(Ed.), The meaning of death. New York: McGraw-Hill, 1965.
y Kastenbaum, R.L.The kingdom where nobody dies. In Annual editions:
Readings in human development. Guilford, CT: Dushkm, 1975,
184-188.


87
Children's Attitudes Toward Death
In focusing on children's attitudes concerning their own deaths,
there seems to be considerably more denial than fear in that
approximately three-fourths of the children expressed the former
and only half expressed the latter. Further, only about 30 percent
of the children reported anxiety. Perhaps the defense mechanism of
denial enables the child to control anxiety about personal death.
There seems to be the attitude of acceptance of death among the
majority of children. Six out of ten children responded negatively
when asked, "Does it bother you to think how you may die?"
There seems to be generally more intensity in all the attitudes
concerning the death of a friend. Approximately 55 percent of the
children would even want to talk about the event or want to talk about
it sometimes. A considerable number of children expressed fear (67
percent) and anxiety (79 percent) concerning the death of a friend.
Further, 71 percent of the children also expressed acceptance to the
point of visiting a dying friend in the hospital. Thus, the attitudes
toward the death of another seem to be more intense, more mixed, and
perhaps more conflicting. Overall, there seems to be more interest
in the death of another than in one's own death for fourth and fifth
graders.
A rather consistent acceptance of the environment of death was
expressed. Sixty percent of the children reported no fear or anxiety
about going to a cemetary. Forty to eighty percent of the children
indicated a willingness to go where a friend is dead. Perhaps there
is a basic acceptance of the reality of death that is tolerated more


15
or universal. They exhibited more fear of death than the five year
olds, and attributed death to such causes as anger, naughtiness,
and wishful thinking. On the other hand, the five year olds viewed
death as universal, irreversible, and due to more realistic causes.
Swain (1976) studied the concepts of death of children 2 years
to 16 years of age through a semi-structured individual interview
format. The 2 to 4 year olds viewed death as reversible rather than
final, improbably or escapable rather than inevitable, and not
personally applicable to them. Children 5 to 7 years old expressed
the belief that death was inevitable and applicable to them personally,
but at a time remote from today. Like the younger children the 5 to
7 year olds tended to emphasize the accidental and punishing nature
of death. In general, the 5 to 7 year old children also demonstrated
less magical thinking and a greater reliance on biological and social
reality.
Anthony (1940) summarized a series of investigations of children
3 to 13 years of age in England over a two year period. Anthony
found that thoughts of death were frequent in children's fantasies.
For example, approximately 50 percent of the children in a story
completion task made reference to death in completing the story even
though the concept did not appear in the story stem. Anthony (1940)
distinguished five stages in children's concepts of death from
ignorance of the meaning of the word to a clear definition in logical
or biologically essential terms. Anthony (1940) observed differen
tial stages in children's concepts of death which generally parallelled
Piaget's theory on the development of children's understanding of
causality.


65
In regard to differences relative to grade, concepts and
attitudes were explored. (Refer to Table 7.) Little or very
little difference was noted between the two grades. More fourth
graders (16 percent) than fifth graders (9 percent) attributed old
age as being the major cause of death for other things. Also,
more fifth graders (20 percent) attributed aggressive causes to the
death to other things while no fourth graders named such a category.
More fourth graders (31 percent) than fifth graders (17 percent)
viewed illness and related causes to their own deaths. More fifth
graders (14 percent) than fourth graders (3 percent) also attributed
their own deaths to aggressive causes, such as car accidents. More
fourth graders (49 percent) than fifth graders (34 percent) expressed
the view of some nature of continuation of life after death. Several
fifth graders (14 percent) expressed a view of the end of life at
death while no fourth graders expressed such a view. In regard to
death attitudes, 20 percent of the fifth graders expressed denial
in regard to their own deaths while no fourth graders did so except
on the basis of "sometimes." Almost 20 percent more fifth graders
than fourth graders also expressed fear and anxiety in regard to
their own deaths. On the other hand, more fourth graders (14 percent)
expressed anxiety in regard to the death of another than did fifth
graders (3 percent). More fourth graders (80 percent) than fifth
graders (63 percent) also expressed acceptance of the environment of
death.


96
Are you living with your real mother?
Are you living with your real father?
(If not) Who takes care of you at home?
Are you related to this person?
(If applicable) How old were you when your folks split up?
Are they divorced? Separated?
Does your mom work at a job outside your house?
What does she do?
Does your dad work at a job outside your house?
What does he do?
Do you have a pet?
Did you ever have a pet die?
How did that make you feel?
I'd like to talk with you a while about living and dying. Is that OK
with you? (If child refuses, terminate
session.)


11
activities such as media center instruction, group guidance, music,
speech therapy, etc., the format of individually interviewing
children away from the classroom setting seemed to permit a sense
of routine procedure to the child. Further, the individual interview
situation better enabled the establishment of rapport, privacy, and
personal attention.
Definition of Terms
To clarify the terms and concepts of this study, the following
definitions were used:
Acceptance "A willingness or openness to understand a topic;
to have particular ideas about or to consent to think about a topic"
(Fauquet, 1980, p. 5).
Anxiety A generalized "feeling of apprehension which tends to
be elicited by situations in which the individual feels threatened
. . the nature of the threat may or may not be clearly perceived"
(Coleman & Hammen, 1974, p. 124).
Attitude "A relatively enduring system of affective, evaluative
reactions based upon and reflecting the evaluative concepts or beliefs
which have been learned about the characteristics of a social object
or class or social objects" (Shaw & Wright, 1967, p. 10).
Cemetery A place where people are buried.
Children Persons 8 years 6 months to 11 years 0 months of age
as of September 1 1980..


19
3. Immobility has to do with the child's notions concerning
the movement of the dead. The dead may be seen as totally inactive
or partially or completely active.
4. Irrevocability has to do with the child's idea of death as
permanent and irreversible, or temporary and reversible.
5. Causality is a belief of what brought about the state of
death, whether from internal causes, such as heart attacks or external
causes such as guns or a combination of the two.
6. Dysfunctionality deals with the ideas about bodily functions
other than the senses. A child could believe that the dead are totally
dysfunctional, or that they are partially or completely functional.
7. Universality deals with the child's ideas of mortality. A
child could have notions that everybody dies, or that nobody dies, or
that there are exceptions.
8. Insensivity is a consideration of mental and sensory functions
such as dreaming, feeling, thinking, and hearing. Ideas may be held
that the dead are totally insensate or partially or completely sensate.
9. Appearance is the notion of the way the dead look. Ideas
could be held that a dead person cannot or does not look as though he
were alive or, to the contrary, that he looks the same.
10.Personification is a notion of death as concretized and
reified as a person or thing.
During the course of the study it became apparent that a
child could be aware, recognize, or realize death as
having a substance. The Realization component was seen,
therefore, to include Personification, and Personifica
tion was dropped as a separate component, (p. 144)


CHAPTER IV
RESULTS
The present data were derived from the purposes of this study:
specifically, an exploration of normal children's attitudes toward
death. Normal children's general concepts of death and of the
attitudes of fear, denial, anxiety, and acceptance in reference to
death of self, death of other, and the environment of death were
investigated. There was also an examination of various demographic
variables which have sometimes been shown to be related to normal
children's death concepts and death attitudes.
Sampling Procedure
The children sampled were randomly selected according to the
previously specified criteria from three fourth grade classrooms
and three fifth grade classrooms in each of two schools. In each
of the 12 classrooms, eight parent consent forms, with supporting
letters by the school principals, were sent home. No less than five
were returned in every class. All children who returned affirmative
consent forms were initially interviewed. However, two interviews
were eventually eliminated because more careful scrutiny revealed
53


45
The age range was 7 years 6 months to 10 years 11 months, as of
September 1, 1980. Children who had been retained and who were
performing at an average level academically were included in the
sample. Average was defined as "C" or better, or 2.0 or higher on
a 4.0 scale, in the combined subjects of reading and mathematics.
However, children who had been retained or who were performing
below average academically; that is, below "C" or 1.9 on a 4.0
scale were not included. Children who were identified by the school
Child Study Team as possibly educable, trainable, or profoundly
mentally handicapped were not included. However, those who were
receiving resource room delivery of special education services, e.g.,
speech, learning disabilities, and other categories of Exceptional
Student Education were included in the sample. Children who were
known to have experienced separation or loss of a parent or close
friend, or a trauma related to death in the last two years were also
ruled out. Thus, by the criteria, all of the children were function
ing intellectually within the dull normal range or higher, and were
not so severe in their learning, behavior, or other maladjustment
problems so as to warrant full-time special education services in a
setting other than the regular classroom.
The children were attending the public schools of Marion County,
Florida. One school was selected from a suburban area in a community
of approximately 120,000, and one school was selected from a rural
area. Both schools had a pupil population between 450 to 800.
There was selection of alternative schools in each category in case
a local principal chose not to participate in the research project.


29
the child in a free fashion to play with the materials
and to say what was happening. Following this play,
the interviewer said, "the doll is very sick and is now
dead" and encouraged the child to play out the situation
as the child perceived it. ... All children were
encouraged to respond both in terms of vocalization and
in terms of play and gesture, (p. 400)
As a preface to asking Koocher's (1974) questions, the interviewer
generally stated, "I would like to find out what children think about
dying, and I wonder if you have ever thought about this." The play
procedure or the interview procedure were done in random fashion.
Weininger (1979) summarized the results as follows:
The children's play indicated increasing accuracy in their
understanding of the concepts of dying and dead. Their
answers to the questions also indicated accuracy increased
with age. There were, however, differences between their
play understanding, and their verbal expressiveness.
Children's play frequently contradicts what they say about
dying and death, sometimes indicating a more complex
understanding than verbal expression would suggest, some
times reflecting a failure to grasp freely the concepts
they speak about. Concepts of dying and death are hard
for children to understand and accept; the data indicate
that it is not until 8 or 9 years that play and verbal
expressions come to terms with each other, (p. 395)
Thus, there were a number of studies which examined children's
concepts of death in the context of Piaget's stages of logical thinking
through the use of individual interview and structured play format. In
general, the results appeared to be relatively consistent in supporting
a developmental evolution in children's concepts of death throughout the
childhood years.
The Influence of Various Factors Concerning
""Children's Concepts of Death
Some studies (Beauchamp, 1974; Bolduc, 1972; Gartley & Bernasconi,
1967; Hornblum, 1978; Mclntire, Angle, & Struempler, 1972; Plotz &


TABLE OF CONTENTS
ACKNOWLEDGMENTS iv
ABSTRACT vi i
CHAPTER I
INTRODUCTION 1
Background 1
Need for the Study 7
Purpose 9
Rationale 10
Definition of Terms 11
CHAPTER II
REVIEW OF RELATED LITERATURE 13
Children's Concepts of Death From a Developmental View . 13
The Influence of Various Factors Concerning Children's
Concepts of Death 29
Children's Attitudes Toward Death 34
Research Concernii.g Suicide and Children 39
CHAPTER III
METHODOLOGY 44
Sample Selection 44
Procedure 46
Data Collection 47
Nature of the Data 48
Data Analysis 49
Validity 50
Reliability 51
Methodological Limitations 52
CHAPTER IV
RESULTS 53
Sampling Procedure 53
v


61
denial in regard to talking about the death of a friend. Fourteen
percent of the children expressed a willingness to discuss the
death of a friend sometimes. Forty-six percent reported a clear
willingness to do so. There appears to be even less tendency for
the children to deny the environment of death, since only 14 percent
reported denial in this area. On the other hand, 81 percent of the
children did not express denial in this area.
Fear
In reference to the attitude of fear toward death, more (67
percent) children reported a sense of fear over death of a friend
than over their own death (50 percent). Thirty-seven percent of the
children stated that they were not afraid of dying. In regard to the
environment of death, only 24 percent reported that they were afraid
to go to a cemetary. Many of these qualified their responses by
expressing the fear of doing so alone or at night. Sixty percent of
the children stated that they were not afraid to go to a cemetary.
Sixteen percent apparently experienced the fear sometimes.
Anxiety
In examining the attitude of anxiety toward death, 31 percent of
the children stated that they did worry about their own death.
Approximately one-third (30 percent) worried about dying sometimes.
Thirty-nine percent of the children reported that they do not worry
about dying. Many children (79 percent) indicated that they experienced
anxiety over the thought of a friend dying. Twelve percent reportedly
experienced such anxiety sometimes. Only 9 percent reported no anxiety


77
Table 13
Questions Children Asked the Researcher
Child
Question
Child #1
"Is it true when you die they'll burn you?"
Child #13
"If a person smokes, how long 'til they die?"
Child #16
"How do diseases get started?"
(Later, child expressed worry over mother
smoking.)
Child #18
"Do ghosts come back to families?"
Child #22
"How old do people get?"
"Can you die of a heart attack?"
"Could God bring you back to life?"
"Can you read other people's minds?"
Child #24
"How can you read people's minds?"
Child #25
"How do you feel about dying?"
Child #35
"Why do you ask children these things?"
"Do you work here?"
Child #38
"How do you feel about it?"


49
The above questions viere scored in one of these categories:
A. Burial (e.g., put 'em in the ground.)
B. End of Life (e.g., It's all over.)
C. Deterioration (e.g., It gets rotten.)
D. Continuation of Life Processes (e.g., You still know
what's going on.)
E. Other (e.g., I never thought about it.)
The next questions were as follows:
5. Can dead things come back to life?
6. Can you come back to life after you die?
The responses to these questions were scored as follows:
A. Mo return
B. Return in Any Form (e.g., I might be an angel.)
C. Other (e.g., I really couldn't say.)
The subsequent questions which focused on death attitudes yielded
responses in one of the following categories: Yes, No, Sometimes, or
Other.
Data Analysis
Since this was basically a descriptive study, frequency distribu
tion of the various responses to each of the auestions concerning con
cepts of death (Koocher, 1974a) was calculated. In reference to each of
the attitudinal dimensions of denial, fear, anxiety, and acceptance, a
frequency distribution was calculated for grade level, GPA, retention in a
grade, sex, ethnic origin, urban-rural setting, pet ownership, acquaintance


30
Plotz, 1979) gave attention as to whether factors such as sex, socio
economic level, religion, and television viewing affected children's
concepts of death. The results tended to be consistent in most of
the measured factors.
Beauchamp (1974) found no differences in children's concepts of
death as a function of sex. On the other hand, Zweig (1977) found
significant sex differences in the death attitudes of children 8 to
12 years old. It was interesting to note that Chasin (1971) who
studied the death attitudes of adults did find sex differences.
Further, this factor was differentially influenced by level of educa
tion and religious orthodoxy.
Plotz and Plotz (1979) reported that children have many miscon
ceptions about death which are culturally induced. For example,
there may have been an overemphasis on violence. However, the
researchers suggested that this factor needs further study. Zweig
(1977) also reported some effect from cultural differences as well
as racial differences. On the other hand, Beauchamp (1974) found
no significant differences in children's concepts of death as a
function of social class. Chasin (1971), however, found that higher
income (over $10,000) populations were differentially affected in
their death attitudes as a function of religious orthodoxy. However,
the death attitudes of lower income ($10,000) populations were not
differentially influenced.
Some attention has been given to examining the effects of
children's television viewing on their concepts of death. Although
Gartley and Bernasconi (1967) speculated that television may acquaint


109
with Children's Developmental Services, Pediatric Clinic, Shands
Teaching Hospital. Her subspecialization has been early childhood
education.


39
Other studies (Cox, 1979; Escamilla, 1977; Gomez-Ossorio, 1978;
Pinette, 1977; Zeligs, 1967) generally agreed that children's
emotional reactions to death were largely determined by their age
and developmental stage, their personal experiences, and the
parents' responses to death. Pinette (1977) stated that "the
limited understanding of the child is in itself a built in protec
tion for the child against being plunged into the depressed condi
tion that the adult might enter" (p. 6). On the other hand, Dugan
(1977) presented data which supported the contrary point of view in
regard to adolescent populations. Dugan (1977) used instruments,
including the Taylor Manifest Anxiety Scale and the Lester Fear of
Death Scale, to determine the nature of the fear of death in adoles
cents and their parents. This researcher stated the following:
Results indicated that fear of death in parents did not
significantly influence that attitude in children, nor
was children's general anxiety score affected. It was
concluded that the nature of the fear of death in
children is extremely complex and that: (1) adolescents
do not correlate viewpoints with parents even though
they are influenced by them; (2) unconscious death fear
plays a major role in the psyche; (3) people tend not to
think or are unable to think of the reality of their
personal death even though they have confronted it in
a specific life incident; and (3) this inability to think
of or grasp the reality of personal death is especially
true of persons who are in no immenent danger of death
(adolescents), (p. 239)
Research Concerning Suicide and Children
In 1946 in The Manual of Child Psychology, Carmichael spoke of
adolescent suicide as "a rarity." In 1979 the American Association
of Suicidology reported that suicide was ranked as the second leading


105
ftPaulson, M. J., Stone, D., & Sposto, R. Suicidal potential and
behavior in children ages 4 to 12. Suicide and Life Threatening
Behavior, 1978, 8(4), 225-42.
Pfeffer, C. R. Psychiatric hospital treatment of suicidal children.
Suicide and Life Threatening Behavior, 1978, 8(3), 150-60.
^Pfeffer, C. R., Conte, H. R., Putchik, R., & Jarrett, I. Suicidal
behavior in latency-age children: An empirical study. Journal
of the American Academy of Child Psychiatry, 1979, 18(4), 679-92.
^Piaget, J. The child's conception of the world. New York: Harcourt
Brace, 1929.
^ Pinette, R. L. The child and death. Archives of the Foundation of
Thanatology, 1977, 6^(4), 6.
Plank, E. N., & Plank, R. Children and death: As seen through art and
autobiographies. Psychoanalytic Study of the Child, 1978, 33,
593-620.
^fPlotz, C. M., & Plotz, R. L. Family attitudes toward death -- with
emphasis on young children. Archives of the Foundation of
Thanatology, 1979, 1(3), 90.
^'Ringel, E. The pre-suicidal syndrome. Suicide and Life Threatening
Behavior, 1976, 6(3), 131-49.
Rochlin, G. The loss complex: A contribution to the etiology of
depression. Journal of the American Psychoanalytic Association,
1959, 7, 299-316:
Rochlin, G. N. Griefs and discomfort: The forces of change. Boston:
Little, Brown, 1965.
Rowe, K. B., & Loesch, L. C. An affective-education experience for
helping children reduce their anxiety about death. Humanist
Educator, 1978, J6(3), 103-110.
Russell, R. W., & Dennis, W. Studies in animism: I. A standardized
procedure for the investigation of animism. Journal of Genetic
Psychology, 1939, 55, 389-400.
1 Russell, R. W. Studies in animism: II. The development of animism.
Journal of Genetic Psychology, 1940, 56, 353-366.(a.)
Russell, R. W. Studies in animism: IV. An investigation of concepts
allied to animism. Journal of Genetic Psychology, 1940, 57_, 83-91. ft)
^Rutzky, H. Children's responses to death. Archives of the Foundation
of Thanatology, 1979, _7(3), 101.
p^Safier, G. A. A study of the relationship between life and death
concepts in children. Journal of Genetic Psychology, 1964. 105.
283-294. ^


26
10. Acceptance of inevitability. "Some people think that it
is best not to know, but I feel you can appreciate life more and get
more out of it."
11. Despair. "When I think of death I think of living. I
think about the things I should have done but didn't, the places I
wanted to see but never did. Ordinary things like I should have
treated my sister and brother better or I should have gotten better
grades in school and the little bad things I did that upset my
mother."
12. Transmutation to idealism. "Death is something most people
hate to think about, but it is also something we have to accept. What
we should do is to make the best of our lives before it is too late."
Other psychoanalytic studies and writings (Ackerly, 1967; Menninger,
1938; Pfeffer, 1978; Pfeffer, Hope, Conte, Plutchik, & Jerrett, 1979;
Ringel, 1976) interpreted concepts of death in reference to suicide.
This topic will be discussed in more detail later in this chapter.
A few studies (Bruce, 1941; Huang & Lee, 1945; Klingberg, 1957;
Klingensmith, 1953; Russell, 1939, 1940a; Safier, 1964) have examined
children's concepts of animism as it relates to their concepts of
death. Piaget (1929) described animism as the mental phenomenon.in
children in which life and consciousness is attributed to certain
inanimate objects. According to Piaget, this was partially due to
the child's view of objects as extensions of himself or herself.
Piaget identified four stages in the development of the concept of
animism. In Stage One, children up to 6 or 7 years of age attributed
life to anything that demonstrated activity in any way. For example,


CHAPTER III
METHODOLOGY
The assessment of death attitudes among elementary school age
children occurred through structured interviews in the school
setting. Self-reports in reference to discussions of self, a
"friend," and the environment of death were used in the explora
tion of the death attitudes of denial, fear, anxiety, and acceptance.
Each of these attitudinal dimensions were assessed in terms of
the following frames of reference (as developed by Fauquet, 1980);
death of self, death of other, and the environment of death. In
the Early Adolescent Death Attitude Scale, Fauquet (1980) further
included the frame of reference of the death ritual. However, this
aspect was omitted in this study because it was believed that children
in this study were likely to have had only limited exposure or
experience with death rituals.
Sample Selection
For the purposes of this study, normal elementary school children
were those in regular classes in the fourth and fifth grades who were
determined to exhibit adequate adjustment in learning, behavioral,
and social areas in the professional judgment of the investigator.
44


71
40 percent of those who were not retained. Commensurate attitudes and
percentages were also evident in regard to the view that one could
come back to life after death. No children who were retained reported
fear of the environment of death, while 27 percent of those who had
never been retained reported such fear. Twice as many students who
were never retained (33 percent) express anxiety over their own
deaths as did students who had been retained (17 percent). All
students who had been retained reported acceptance of death in regard
to another while 80 percent of the non-retained students expressed
acceptance. Approximately two-thirds of the retained students
reported acceptance of their own death while only 44 percent of
the students who had never been retained expressed acceptance.
Influences of Ethnic, Social and Familial Characteristics
In that 93 percent of the children were Anglo-American, an
interpretation of the differential responses by ethnic group did not
seem warranted.
There were no differential trends relative to the children's
religious preference.
There appeared to be no differential trends in the children's
responses relative to the married or divorced status of the parents,
employment status of the parents, or the number of siblings in the
family. The homogeniety of the population in some characteristics
and the considerable scatter in other characteristics were perhaps
factors in the limited distribution of the data relative to these
characteristics.


107
} White, E. A., Elsom, B., & Prawat, R. Children's concepts of death.
Child Development, 1978, 49(2), 307-310.
^Wood, J. T. What are you afraid of? Englewood Cliffs, NJ: Prentice-
Hall, 1976.
^rZeligs, R. Children's attitudes toward death. Mental Hygiene, 1967,
51_, 393-96.
Zweig, A. R. Children's attitudes toward death (Doctoral dissertation,
Northwestern University, 1977). Dissertation Abstracts International,
1977, 37^7-A), 4249-4250. (University Microfilm No. 77-01393)
1


88
readily by children in the context of the environment of death.
Perhaps visiting the environment, namely a cemetary or "where a
friend is dead," enables the child to process or integrate the death
event into a greater sense of reality or acceptance.
Imp!ications
The exploration of children's concepts and attitudes toward death
has several important implications for theory, training, practice,
and research. The present study basically corraborates the develop
mental aspect of children's concepts of death. The children's
concepts of death seem generally consistent with much of the previous
research (e.g., Anthony, 1940; Kalmbach, 1979; Koocher, 1973, 1974a,
1974b; Melear, 1973; White, 1978) that has been done using the
Piagetian model. Some aspects of the data concerning children's
attitudes toward death may be interpreted rather readily in the
framework of Psychoanalytic Theory, particularly in the context of
defense mechanisms and the dynamics of personality adjustment.
However, many questions concerning normal children's attitudes toward
death still remain for research to answer.
There needs to be further investigation regarding the development
of the concepts of death and the intensities of attitudes. This
should include a clarification of possible relationships among the
demographic variables such as ethnic and cultural background, age and
grade level, grade point average, sex, urban-rural environment,
religious training or orientation, or other aspects of the children's
lives. Because the interview process seems to be very effective with


37
Perhaps this belief is an effort to overcome anxiety produced by
the realization that death is final and universal" (p. 360).
Only one study made some investigation of children's acceptance
of death. Rutzky (1979) examined the attitudes toward death of
children who grew up in concentration camps. Like other death
concepts, the children's responses varied according to their age.
Rutzky (1979) stated the following:
It is reported that the same mechanism and reactions
are observed in those who witnessed killing and mass
murders as in American children growing up in a peace
ful environment. Children from concentration camps
were not found to accept death more readily, even though
their environment introduced them to loss repeatedly and
might have inured them to death."(p. 101)
Anthony (1940) and Plotz and Plotz (1979) made some attempts to
discern the meanings children attribute to death on both the cognitive
and emotional level. Anthony (1940) suggested that children associated
death with "inner fears and feelings about separation, loneliness,
agressive impulses, and birth" (p. 46). Plotz and Plotz (1979)
suggested that children's attitudes toward death may have been
associated with cultural factors.
Thus, there were relatively few studies which yielded any signi
ficant information concerning children's attitudes toward death.
Further, many of the comments appeared to be more speculative and
interpretive than descriptive. Other writings (Anthony, 1940;
Harnik, 1930; Kotsovsky, 1939; Menninger, 1938; Osipov, 1935)
theorized about children's feelings and reactions toward deaths mainly
from a psychoanalytic basis. However, little substanitive investiga
tion was offered to support the theories.


10
normal children's general concepts of death as initially structured
by Koocher (1974). Further, there was investigation of death
attitudes of denial, fear, anxiety, and acceptance in reference
to death of self, death of other, and the environment of death.
There was examination of the demographic factors which may relate
to children's death attitudes.
Rationale
The structured interview technique has been used with young
children consistently more than any other type of assessment. From
the early work of Nagy (1948), to the pivotal studies conducted by
Koocher (1973, 1974) and Orbach and Glaubamn (1978, 1979), the
format of self-report concerning questions about death with young
children has been most commonly used. There has been some pairing
with other tasks, such as Piaget's conservation problems, the WISC
Similarities Subtest, or structured play activities, but the indivi
dual interview procedure seemed to be a key part of sound methodology
with young children in evaluating their concepts and attitudes about
death. Therefore, it was the method of choice for this study.
Recognition had to be given to the special sensitivity of this
topic. In that some authorities (Kubler-Ross, 1975; Moody, 1975;
Wass, 1976) asserted that there has been a tendency for people in this
society to ignore, evade, or deny the topic of death, it seemed
prudent to use a methodology which enabled maximum sensitivity, support,
and response to the child. In that many of today's elementary children
experience periods of leaving the regular classroom for various


103
4 Kastenbaum, R. L., & Aisenberg, R. The psychology of death. New York:
Springer, 1972.
XKlagsbrun, F. Youth and suicide: Too young to die. Boston:
Houghton Mifflin, 1976.
^cKlingberg, G. The distinction between living and not living among 7 to
10 year old children, with some remarks concerning the so-called
animism controversy. Journal of Genetic Psychology, 1957, 90,
227-228.
Klingensmith, S. W. Child animism: What the child means by "alive."
Child Development, 1953, 24, 51-61.
$ Koocher, G. P. Childhood, death, and cognitive development. Develop
mental Psychology, 1973, £, 369-75.
> Koocher, G. P. Conversations with children about death: Ethical
considerations in research. Journal of Clinical Child Psychology,
1974, 3, 19-21. (a)
4 Koocher, G. P. Talking with children about death. American Journal
of Orthopsychiatry, 1974, 44, 404-411. (b)
Kotsovsky, D. The psychology of the fear of death. Psychological
Abstracts, 1939, 1_3, 134.
^Kubler-Ross, E. Death: The final stage of growth (1st ed.).
Englewood Cliffs: Prentice-Hall, 1975.
4 Kurlychek, R. T. Assessment of death acceptance: A proposed scale.
Psychology, 1976, 1_3, 19-20.
Levinson, B. M. The pet and the child's bereavement. Mental Hygiene,
1967, 51(2), 197-200.
-^Levitn, D. Death education and change in student's attitudes.
Unpublished manuscript, 1974.
Maurer, A. Maturation of concepts of death. British Journal of
Medical Psychology, 1966, .39(1 ), 35-41.
-^Mclntire, M. S., & Angle, C. R. Psychological "biopsy" in self
poisoning of children and adolescents. American Journal of
Diseases of Children, 1973, 126, 42-46.
Mclntire, M. S., Angle, C. R., & Struempler, L. J. The concept of death
in midwestern children and youth. American Journal of Diseases of
Children, 1972, 123(6), 527-32.
/5


36
attitude in children, nor was children's general anxiety score
affected" (p. 230).
Blake (1969) investigated the death attitudes of adolescents
as compared to older people as they related to the psychosocial
developmental stages proposed by Erikson (1958, 1959, 1964).
Adolescents reported more fear of death than older people. However,
the older people tended to use denial more than the adolescents.
Religious versus non-religious did not appear to be a factor. It
should also be noted that these populations were white, Protestant,
and middle-class.
O'Brien (1979) studied The Effects of Inclusion and Exclusion in
Mourning Rituals on the Development of Children's Conceptual Under
standing and Attitudes About Death. A questionnaire was administered
to 174 children in an inner-city public school, a parochial school,
and a Sunday school in the first, third, fifth, and seventh grades.
O'Brien (1979) found that middle-class children were more likely to
view death as painful and scary. Also, older children who had
participated in mourning rites evidenced increased anxiety in regard
to death.
Although little specificity is given, Melear (1973) placed some
focus on clarifying the death anxiety of 41 children 3 to 12 years
old among other issues related to their concepts of death. Melear
(1973) reported that some degree of death anxiety was evident in 12
percent of the 3 to 7 year old children, and in 75 percent of the 5
to 12 year old children. He commented, "all of the children, except
one, who exhibited anxiety also expressed a belief in an afterlife.


24
expressed. It was interesting to review the ages of the children
in this stage as reported by Melear (1973). Of the 21 children,
two were between 4 and 5 years of age, one was between 5 and 6
years, and the remainder viere 6 years and older.
Other studies which found children's views of death to be a
developmental phenomenon were those by Anthony (1940), Blum (1976),
Childers and Wimmer (1971), Gartley and Bernasconi (1967), Hornblum
(1978), Mclntire, Angle, and Struempler (1972), Nass (1956), O'Brien
(1979), Swain (1976), and Weininger (1979).
Some portion of the literature (Buhrmann, 1970; Maurer, 1966;
Plank & Plank, 1978; Schilder & Wechsler, 1934; Schnieder & Schneider,
1977) interpreted children's developmental concepts of death based
on Psychoanalytic Theory. For example, Plank and Plank (1978) .
examined children's art and autobiographies to discern the process
of building up defenses, the rejection and denial of death, and
children's reactions to catastrophies. In Maturation of Concepts of
Death, Maurer (1966) outlined 12 developmental steps illustrated by
quotations from various essays. Briefly, the maturational steps
were the following:
1. Awareness. The primal terror was there, less among the
brighter and so great among the dull that they feared direct mention
of it. . "When I think of death, right away I am horrified.
Sometimes when I see a dead person, they seem so unreal."
2. Denial. This may take many forms: childlike whistling in
the dark ("My grandfather ain't never going to die"); reversals
("Death is a triumph"); clinging to attributes of life ("All I want


104
Melear, J. D. Children's conceptions of death. Journal of Genetic
Psychology, 1973, 123(2), 359-60.
^ Menninger, K. Man against himself. New York: Harcourt Brace, 1938.
^:Miya, T. M. The child's perception of death. Nursing Forum, 1972, 11,
214-20.
Moody, R. A. Life after life (3rd ed.). Covington: Mockingbird
Books, 1975.
t
J Mori arty, D. Loss of loved ones: The effect of death in the family
on personal development. Springfield, IL: Charles C. Thomas,
1967.
^Mueller, M. L. Death education and death fear reduction. Education,
1976, 97(2), 145-148.
Nagy, M. The child's theories concerning death. Journal of Genetic
Psychology, 1948, 73, 3-27.
Nagy, M. The child's view of death. In H. Feifel (Ed.), The meaning
of death. New York: McGraw-Hill, 1959, p. 81.
-^Nass, M. L. The effects of three variables on children's concepts of
physical causality. Journal of Abnormal and Social Psychology,
1956, 53, 191-96.
^ National Clearinghouse for poison control centers: Statistics, 1968.
^Nelson, L. D., & Nelson, C. C. A factor analytic inquiry into the
multidimensionality of death anxiety. Omega, 1975, 6^(2), 171-178.
^O'Brien, M. The effects of inclusion and exclusion in mourning rituals
on the development of children's conceptual understnading and
attitudes about death. Archives of the Foundation of Thonatology,
1979, 7(3), 74.
Orbach, I., & Glaubman, J. Suicidal, aggressive, and normal children's
perception of personal and impersonal death. Journal of Clinical
Psychology, 1978, 34(4), 850-857.
^Orbach, I., & Glaubman, H. The concept of death and suicidal behavior
in young children: Three case studies. Journal of the American
Academy of Child Psychiatry, 1979, J8(4), 668-78. (a)
^Orbach, I., & Glaubman, H. Children's perceptions of death as a
defensive process. Journal of Abnormal Psychology, 1979, 88(6),
671-674. (b)
- Osipov, N. W. Fear of death. Psychological Abstracts, 1935, 9^, 534.
Ik


17
of equal representation in sexes, and composed of 20 percent non-
white children. Koocher also sought to obtain an estimate of the
children's intellectual level by administering the Similarities
Subtest of the Wechsler Intelligence Scale for Children. In order
to classify the children according to their level of cognitive
functioning by a Piagetian model, each child was tested with three
conservation tasks (i.e., mass, number, and volume) and one task in
hypothesis formation. Koocher's criteria were the following:
If the child failed one or more of the conservation tasks,
he was placed in the "preoperational" group. If he
passed all three of those, but failed the hypothesis
formation task the child was classified as "concrete-
operational." If the child dealt with all four tasks
successfully, he was classified as "formal operational."
(p. 405)
In an individual interview format, each child was administered the
Similarities subtest, the conservation tasks, and asked the following
questions: "What makes things die?" "How do you make dead things
come back to life?" "When will you die?" "What will happen then?"
Koocher found no statistical differences attributable to race or sex.
The results did, however, reflect developmental differences across
children's ages. Koocher reported that children 7 years of age and
under generally evidenced fantasy reasoning, magical thinking, and
realistic causes of death marked by egocentric reasoning. Death was
viewed as reversible and impermanent by this age group. Children 7
to 12 years of age described the infliction of death with or without
intention, such as through weapons, poison, or assault. Children 12
years of age and older cited relatively abstract clusters of specific
possibilities of death. These included physical deterioration, often


5
viewed death as reversible, temporary, and characterized by life
activities such as feeling, talking, and motion. Children 7 to 10
years of age generally accepted the concept of irreversibility,
although death was not viewed in a personal way. Some studies
(Kastenbaum, 1965; Nagy, 1948; Rochlin, 1959, 1965) suggested that
children 7 to 10 years of age viewed death as like a person who
caught people, while such personification was not evident in other
studies (Gartley & Bernasconi, 1967; Mclntire et al., 1972). At
the age of 10 or 11 years, most children tended to view death as
permanent, irreversible, and inevitable. Commensurate with the
evidence supporting developmental stages in children's views of
death, some studies (Formanek, 1974; Hansen, 1973; Koocher, 1974)
have related Piaget's theory of intellectual development to children's
emerging concepts of death. Thus, there has been general consistency
in the conclusions of researchers concerning children's concepts of
death.
However, there has been minimal research concerning children's
attitudes toward death. Most death attitudes studies have focused
on adult populations, particularly college students. Only two
assessment instruments have been developed to measure death attitudes
at the early adolescent level: the Attitude Toward Death Scale
(Hardt, 1975) and the Early Adolescent Death Attitude Scale (Fauquet,
1980).
In reviewing the literature concerning death attitudes, four
broad divisions seemed to emerge. The most frequently investigated
areas were the fear of death (Bailis & Kennedy, 1977; Bell, 1975;


14
and final process, death was viewed as another kind of existence
in changed circumstances. Death was also seen as temporary and in
varying "degrees." The children were aware that they were alive,
and they imagined that dead people were alive also. "Living" and
"lifeless" were not yet distinguished. Thus, a sense of animism
was attributed to the dead.
Other studies (described later) have investigated the child's
concept of animism in detail. Nagy (1948) found that children 5 to
9 years of age tended to personify death. Death was viewed as a
person walking around trying to catch people and carry them off.
Death was also viewed as an eventuality, but the children endeavored
to keep it distant from themselves. Children 9 to 10 years of age
tended to view death as a permanent, inevitable, irreversible, and
internal process. The perceptible result of death was the dissolu
tion of bodily life. Animism and egocentrism were not characteristic
of this age group.
Rochlin (1959, 1965) corraborated Nagy's findings concerning
young children's concepts of death at the 3 to 5 year age range.
Rochlin (1965) theorized that in response to their overwhelming fear
of death, children constructed elaborate defenses such as the ideas
of reversibility, temporariness, and continuing existence in places
like heaven or hell.
Beauchamp (1974) studied the death perceptions of 3 and 5 year
olds. She found that the two groups differed significantly on the
concepts of universality, irreversibility, causality, and fear of
death. Three year old children did not view death as irreversible


8
emerge in stages over rather identifiable age levels, it was also
important to determine whether children's attitudes toward death
develop and mature over time. While there appeared to be various
attitudes toward death evident in the adult population, it was
important to determine whether a similar variety was manifested in
the population of normal children, or whether the attitudes were
relatively invariant. Furthermore, it seemed useful to ascertain
possible factors related to the emergence, modification, or change of
death attitudes in children. Increased information concerning
children's death attitudes would also better enable one to explore
the implications as they relate to such models as Psychoanalysis,
Piagetian theory, Behaviorism, and others. Thus, several ramifica
tions would emerge as increased information concerning children's death
attitudes is discovered.
Increased knowledge concerning children's attitudes toward death
would also yield further implications in subsequent research. It
would be important to determine the intensity, stability, or
flexibility of children's death attitudes, and the factors related
to such dimensions. The influence of socioeconomic level, cultural,
ethnic, and religious background also merited investigation. Further
research concerning the influence of traumas on children's attitudes
toward death would need to be pursued. There also would need to be
considerable investigation of the premise that death attitudes may be
related to children's and adolescents' behaviors in such areas as
delinquency, depression, drug usage, and suicide, as suggested by some
researchers (Fauquet, 1980; Kastenbaum, 1975; Klagsbrun, 1976;