Research Library

Home Research Library Non-verbal methods for assessing grief and mental…

Psychological challenges & wellbeing | Grief
Non-verbal methods for assessing grief and mental health in children and individuals with additional communication needs: A scoping review

Published: Feb 2026

Authors

Noreen Hopewell-Kelly, Silvia Goss, Mala Mann, Linda Machin, Timothy Pickles, Freya Field, Letizia Perna, Lucy Selman, Emily Harrop

Abstract

Introduction:

Bereavement affects individuals in diverse ways, and the support they require can vary significantly. For grief to be effectively recognised and addressed in both clinical and research settings, appropriate and validated assessment tools are essential. However, there is a notable gap in child-specific tools, particularly those that use non-verbal approaches to support young children and individuals with Special Educational Needs (SEN), who may have limited verbal communication.

Aims:

This scoping review aims to explore and map existing evidence on grief and mental health assessment tools that incorporate non-verbal methods. The focus is on tools used with children aged 11 and under, and with older children or adults who have additional learning or communication needs, in therapeutic and research contexts.

Methods:

We conducted a scoping review using Arksey and O’Malley’s five-stage framework. Searches were carried out across five databases – CINAHL, Medline, PsycINFO, Cochrane Library and Scopus – from their inception to 7 December 2023. Data from eligible studies were analysed using descriptive statistics and content analysis.

Findings:

From 1498 screened papers, 22 articles were included. Most described mental health tools rather than grief-specific assessments. Five key themes emerged: tool development processes; language and item selection; use of visual imagery; response format design and psychometric properties, including feasibility and utility. These features illustrate how non-verbal methods can support communication and engagement in assessment.

Conclusion:

This review highlights current approaches to assessing grief and mental health in children and individuals with SEN using combinations of verbal and non-verbal methods. It provides a foundation for future development of accessible, structured grief assessment tools tailored to these populations and underscores the urgent need for such resources in practice.

Plain language summary

Exploring the non-verbal methods that are used to assess and explore grief, mental health and wellbeing with children and people with additional communication needs: A scoping review
This scoping review examined the existing research on therapeutic and support tools that use non-verbal methods to engage with and assess the grief and mental health needs of young people, particularly those with special educational needs (SEN). The review identified 22 relevant articles, which we analyzed and identified five main themes: these were, (1) the development of these tools and approaches, (2) how the tools work using key verbal and non-verbal features, (3) the use of visual representation and imagery, (4) the response options available, and (5) the effectiveness and performance of the tools. The review found that there is a lack of accessible, structured grief assessment tools that use non-verbal methods for bereaved young children and those with SEN. The findings provide an evidence base for further developments in this field, highlighting the need for more research and the creation of such tools to better support these populations.

Access

Web link: https://doi.org/10.1177/263235242514132

Research Library