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When children grieve How parents can help

In the spring of 2005, Dawn Kearns saw troubling changes in her daughter Hannah, then a third-grader at Lincoln Elementary in Fargo. She suffered frequent headaches, cried easily, reacted differently and her grades fell. "Then in May, I got a call from a concerned teacher. She, too, could see Hannah was struggling. That's when I knew I had to act," said Kearns. "I now realize Hannah was showing the classic symptoms of a child struggling with grief. I knew she needed help or she might spiral downward quickly."

In the spring of 2005, Dawn Kearns saw troubling changes in her daughter Hannah, then a third-grader at Lincoln Elementary in Fargo. She suffered frequent headaches, cried easily, reacted differently and her grades fell. "Then in May, I got a call from a concerned teacher. She, too, could see Hannah was struggling. That's when I knew I had to act," said Kearns. "I now realize Hannah was showing the classic symptoms of a child struggling with grief. I knew she needed help or she might spiral downward quickly."

Hannah's grief stemmed from a major change in the family: her parents' separation in May 2005 and subsequent divorce. Wondering what would happen next, she watched as her dad moved out of their Fargo home and into a nearby apartment, then several months later to another state. "At first, it was still easy to see him," said Hannah. "I could just slip on my shoes and run over there, but that changed when he moved to Colorado. And Lucy, our dog, went with him." Today, Hannah can talk more easily about the changes that year, but then, she kept her jumbled - often unidentified - feelings inside.

Children "show" grief
Michelle Jorgensen, M.D., child and adolescent psychiatrist at MeritCare in Fargo said the inability to verbally express grief is the key difference between children's' and adults' grief. "Most children aren't yet able to verbalize what they're experiencing, so instead of saying 'I'm really sad that Grandma died,' or 'I miss my dog,' a child will have stomachaches, headaches, trouble sleeping, poor performance in school, regressive behaviors such as urine accidents - but really it's grief. It's just that they don't have the words to describe what they're going through, " she said.

Dr. Jorgensen pointed out that what all children grieve may surprise parents. 'All kinds of things can trigger grief, including moving, the loss of friends, changing daycares, the loss of a babysitter, the death of a goldfish, even the loss of baby teeth," she said. "For some children these changes pose no difficulty at all, but for others, they can be very difficult."

Divorce -related loss adds a couple additional factors - feelings of anger and parents occupied with their own issues and emotions. Kearns would be the first to say it's a complex mix. "As a parent, you like to think you know a lot and can handle everything on your own, but I knew when it was time to suck up my pride and say, ' We need help,'" said Kearns, a senior staffing specialist at Manpower in Fargo.

She reached out and found several resources: school counselor Nancy Tisor, a support group at a school for children of separated or divorced parents, and a "Children of Divorce, "educational series at MeritCare. "I learned that it's okay to be afraid and you don't have to go through things alone, " said Hannah. "There are people you can talk to and it will help." Both Hannah and her mother appreciated strong support from church, friends and family, especially Hannah's grandparents in Fargo.

When to seek help
For Kearns, it was a call from school that confirmed Hannah was struggling, but for other parents it may be a visit to the pediatrician's office. "Often the physical ailments prompt a trip to the pediatrician's office," said Dr. Jorgensen. "When the pediatrician doesn't find a reason for the physical ailment, the pediatrician and parents will then focus on what else is going on, including changes in the child's life and other factors that might be influencing the behavior."

For parents who already know a child's physical ailment relates to grief, Dr. Jorgensen encourages talking with the child. "Always, a good first question is, ;Do you want to talk about it?'" said Dr. Jorgensen. "And in the meantime, keep doing all the good parenting strategies like making sure the radio is off in the car so kids can talk if they want to and sharing family meals to allow conversation."

Grief typically subsides with time. "When you see a child experiencing grief through stomachaches, headaches, crying, not eating well, acting out and sleeplessness, you should expect things to get a little better after a couple weeks and significantly better by three or four months out," she said. "If you're not seeing improvement, over time, seek professional help so the grief doesn't move into long-term depression." Dr. Jorgensen also cautioned, "And people should always seek immediate help if a child talks about harm or harming himself or herself or wanting to be dead in order to be with the person or pet who has died. That's on the far end of the spectrum, it is a less common reaction to grief, but if it happens to you, there's no waiting on that, we need to take seriously all threats or attempts of self harm," said Dr. Jorgensen.

Getting beyond grief
Whether it's prompted by divorce, death or other life changes, a child's grief needs an outlet. "Encourage the child to talk about the person or pet, look at pictures, write a poem, have a ceremony, plant a tree, make a memory book, draw a picture - all of these are ways that children can express grief," said Dr. Jorgensen.

Hannah experienced two more losses after her parents' divorce: the death of a baby cousin and the death of a great grandmother. She faced both with a new level of openness and acceptance. As Hannah said, "One thing I've learned is it's always okay to ask if you have a question."

For Hannah and her mother, the year 2006 far outshines 2005. Both participate in Girl Scouts, plus Hannah enjoys competitive swimming, choir and spending time with family and friends. She still thinks about her dad, but without the intense grief. Now she thinks about new ways to say connected, realizing it's different than it used to be. "Mom put his number in speed dial, so I can call him whenever I want, and she put stationery in a drawer so I can write him, " said Hannah. "And sometimes when I think about him, I look at pictures."