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The objective of this study was two-fold: (a) to investigate the qualitative differences in children's death-related thinking regardless of nationality, and (b) to discover what qualitative differences exist between Swedish and U.S. children in their concepts of death. Phase I of the study included a sample of 316 Swedish and U.S. children, ages 4-19, 53 percent of which were girls. Phase II consisted of a cross-cultural comparison of 124 Swedish and 122 U.S. children matched for age and sex. The children participated in this study as intact classroom groups. They were asked to draw what they thought of when they heard the word “death”, or, in the case of the young children, the word “dead”. They were also asked to give a brief verbal commentary on what they had drawn. Each child's drawing and comments were analyzed as a unit. The drawings were assigned to one of ten qualitatively different categories identified post hoc. The categories were found to be age-related and in accord with previous studies of the development of concepts of death in children. The cross-cultural comparison indicated considerable similarities in the qualities of Swedish and U.S. children's depictions of death. Some cross-cultural differences were also observed, but these are differences in frequency or emphasis rather than in quality of depictions. More Swedish children depicted cultural and religious practices and symbols, whereas more U.S. children depicted violent causes of death. Possible explanations of these differences are suggested, and recommendations for future cross-cultural research in this area are made.

In an attempt to expand our knowledge of what death means to children, 112 children, ranging in age from 4 to 18 years, drew a picture of what the word “death” means to them and attached a comment to explain their drawing. Three themes were evident in the drawings, resulting in these categories: (a) violence or aggression, (b) religious and cultural symbols, and (c) the experience of dying. The themes were significantly related to age, with the drawings of the youngest children more likely to portray violence and the drawings of the oldest children more likely to portray themes of the experience of dying. This relationship to age may be due to age-specific sociocultural contexts that provide children at each age with a certain type of information about death and dying. Several children described the dying process with images similar to those used by people who describe a “near death” experience. These descriptions seem to reflect universal, archetypical ideas about the experience of dying.