Children's Grief

The following is a brief introduction to children’s grief and how to remain supportive to children through the grieving process. Please keep in mind that every child grieves differently, and that these are merely guidelines. If you have questions or concerns about your child’s grief, please contact your child’s pediatrician.

Birth through Two Years:
Concept of Death: Infants and toddlers have no conception of death but are very sensitive to their environment and the people around them. They are especially sensitive to the emotions of their caregivers and will recognize separation from primary caregivers and changes in schedule or routine.

Grief Response: You may notice increased crying, clinging, thumb sucking, attachment to special toys or stuffed animals and temper tantrums. Infants may also show signs of regression, changes in sleep patterns and may have less energy/engagement with others.

What You Can Do: It is important to maintain routine as much as possible and increase physical closeness (cuddling, hugs, etc). It is also a good idea to save some special keepsakes and pictures to share with your infant later in life.

Preschoolers, 3 to 5 years:
Concept of Death: Children this age believe that death is temporary and reversible. They may ask questions about the deceased as if he or she is still living (ex: “When will dad be home?” or “How does grandma eat now?”). Preschoolers do not understand the mechanisms of death and may believe that they can cause death through thoughts or wishes. Preschoolers may also fear that they or their caregiver will “catch” the death.

Grief Response: In addition to the reactions seen in birth to two year olds, preschoolers may also have questions related to death, nightmares, difficulty verbalizing feelings and periods of sadness interspersed with “normal” play periods. They may also engage in play that involves death themes, aggressive behavior, limit testing and disobedience. It is not unusual to notice grieving preschoolers having changes in eating habits and bedwetting as well.

What You Can Do: It is important not to use ambiguous terms for death such as “sleep,” “passed away,” or “taken a final trip,” as these phrases can cause children to be afraid on their next vacation or at bedtime. Instead use concrete terms like “dead,” and explain that this means the whole body of the deceased stopped working and the deceased can no longer see, hear, feel smell or taste. Emphasize that their loved one was “very, very sick, hurt old” and that you and your child cannot “catch” the death. Answer their questions honestly. Reassure the child that he did not cause the death. Try to maintain routines and schedules as much as possible. Give extra physical closeness (cuddling, hugs, etc) whenever possible.

Early School, 6 to 9 years:
Concept of Death: School-aged children are beginning to understand that death is final and that when someone dies they cannot come back. This reality can be frightening and they may begin to fear the death of other loved ones. This is the age when images of the boogeyman, skeletons, ghosts, etc. begin to accompany the idea of death.

Grief Response: School-aged children may have many questions related to death, and they may be specifically interested in details about the dying process. Grieving children this age also may have difficulty verbalizing feelings, periods of sadness interspersed with “normal” play periods, nightmares and other sleep disturbances, feelings of guilt, learning issues and unusual physical complaints or signs or illness. They may also play out their understanding of death and/or write about it, display aggressive behavior, engage in limit testing and disobedience, show some regression and have extremes of attachment – either becoming very clingy or very withdrawn.

What You Can Do: Speak honestly with your child, discuss their fears and concerns and reassure them that they did not cause the death. If your child asks you if you will die tell him/her that you are taking good care of yourself and expect to live a long time. Reassure your child that it is okay to feel sad and it is okay to be happy and feel good too. Encourage your child to commemorate the death in some way (planting flowers, drawing a picture, etc).

Late School, 9 to 12 years:
Concept of Death: Children this age understand that death is final and irreversible. They are very curious about the details of death and may ask many questions or they may avoid conversations about the death, their emotions and the deceased.

Grief Response: Grieving children this age also may have periods of sadness interspersed with “normal” play periods, nightmares and other sleep disturbances, feelings of guilt and an overwhelming concern with their own body. Late school-aged children may also try to take on characteristics or the role of the deceased. They may also display aggressive behavior, engage in limit testing and disobedience, show anger towards the deceased, withdraw from friends or have a desire to join the deceased (suicidal thoughts). Grades may suffer during the period of grief.

What you can do: Be honest about the death and answer all questions honestly. Make yourself available to listen. Help children understand that a wide range of emotions is acceptable and encourage expression of these feelings. Allow children some time alone to process.

Adolescents, 12 to 18 years:
Concept of Death: Adolescents have a more adult understanding of death.

Grief Response: Adolescents often feel the need to take on more adult responsibilities including the role and responsibilities of the deceased. They may also be critical of how the adults around them are handling the funeral and memorial arrangements, as well as how others are reacting to the death. Teens may have fears and worries about the future, their own death, death of loved ones and friends, show increased limit testing and disobedience, increased risky/impulsive behaviors and have troubles in school. In addition, adolescents tend to have some of the more “traditional adult mourning,” including showing signs of depression, denial, regression, sleep disturbances, anger towards others or the deceased and varying opinions and doubts about religion. Teens often look outside the family to peers for support.

What you can do: Encourage expression of emotions. If adolescents are uncomfortable talking about death, try offering a journal or paints. Encourage participation in normal adolescent activities such as sports and time with peers. Be available but do not take control and force adolescents to talk or grieve in a certain way. Allow them to find their own path.

A few general tips:

  • Offer children the chance to go to the funeral or wake. Even children as young as five can benefit from a ritualized way of “saying goodbye.” If your child wants to attend, make sure to prepare them for what they will see there, how people will be acting and what will be said and done. It can also be helpful to think of another adult who can check in with your child at the funeral/wake to see how he or she is doing and offer him or her a break if needed. If your child does not want to attend, do not force them to go.
  • Try not to worry about saying the “right” words or “being strong” for the children. It is okay to cry in front of your children. This shows them it is acceptable for them to cry, too.
  • Try not to push children to talk about the death. Most children tell us how they feel in one way or another, usually through behavior.
  • Try not to shut children out of the family grieving process by sending them to a babysitter – this is a time to bring them closer to family to learn how to grieve and feel comfort from those they love.
  • Always tell the truth when talking about death with your children. If you don’t know the answer to a question, “I don’t know,” is an appropriate response.
  • It can be helpful to use third-person language with children to help them feel less threatened. Say, “Many children feel…” instead of “Do YOU feel…”
  • Notify the child’s school or daycare that the child has experienced a loss and may be “out of sorts” for a while.
  • As with any situation where a child may feel vulnerable, it is helpful to offer them choices to restore a sense of control. For younger children, offer concrete, simple choices like, “Which sock do you want to put on first?” or, “Do you want grape juice or apple juice with lunch?” With older children and teenagers you can offer broader choices such as, “What do you want for dinner?” or, “What would be fun for you today?”

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