Factsheets: Grief: Children

• Overview
• Birth to One Year
• One to Two Years of Age
• Preschool Child: Three to Five Years of Age
• School Age Child: Six to Nine Years of Age
• Pre-Adolescent and Adolescent: 10 to 18 Years of Age
• Bibliography
• For Additional Information

Overview

The death of a family member or friend can be a painful, confusing and often frightening experience at any point in one's life. Yet, to suffer this loss as a child brings with it a unique and perhaps more complex set of issues and intricacies. Lack of emotional maturity and limited coping capabilities may render a child emotionally unable to work through the grief that accompanies the death of a loved one.

The definition of grief encompasses the "psychological, social, and somatic reaction to the perception of loss" (Grief Resource Foundation, p.1). In examining the grief of a child, the various developmental stages of growth must be considered individually. While these stages may not be exact, they are representative for most children.

Birth to One Year

Opinions seem to vary somewhat on concepts of death and response to grief for infants up to six months of age. Some professionals believe that children do not respond to death, as their memory capacity for relationships is not yet developed and they cannot respond to their loss. Others believe that while children in their first six months of life are not able to conceptualize death or grieve for a specific loss, they will feel some anxiety as the death may interfere with their basic needs (Grief Resource Foundation, p.3). Most experts concur that from six months to one year of age, a child is at least vaguely aware of the absence of a parent or guardian and, thus, may experience some limited grief (Papenbrock and Voss, p.5).

During this developmental stage a child may respond by crying, altering her/his sleeping or eating schedules, changing her/his bowel and bladder patterns and perhaps withdrawing emotionally (Papenbrock and Voss, p.5).

• Additional touching, holding and cuddling;
• Strict adherence to usual schedule. (Papenbrock and Voss, p.6).

One to Two Years of Age

Although children still have no means of conceptualizing or attributing meaning to death, the loss of a primary caregiver will usually result in the experience of some displeasure or depression. In addition, during this developmental stage, children usually respond to the probable change in their environment and the emotional state and grief of those around them. (Grief Resource Foundation, p.1).

Similar to the previous developmental stage, a child may become more irritable, show a change in eating, sleeping, bowel/bladder patterns, withdraw emotionally, and perhaps show a temporary delay in development. Protest, despair, and detachment are the three general phases comprised in this stage (Grief Resource Foundation, p.3).

• Provision of a stable environment;
• Adherence to normal schedule;
• Additional comforting, touching, hugging and holding;
• Play time with present caregiver;
• Expressions of love. (Papenbrock and Voss, p.5).

Preschool Child Three to Five Years of Age

Preschool children have a limited understanding of death; they perceive death as temporary and reversible. They believe the dead person is sleeping and can be awakened, broken and can be fixed, or gone and will return. At this stage, they have no concept of personal death - they believe death only happens to other people (Grief Resource Foundation, p.1).

• Periods of anger, sadness, anxiety, outbursts and conversely, indifference;
• Eating and sleeping disturbances, bowel and bladder difficulties, stomach aches, and/or headaches;
• Regressive behavior such as thumb sucking, excessive clinging, etc;
• Heightened fears, especially the fear of abandonment;
• Fantasies of guilty that he/she somehow caused death (Papenbrock and Voss, p.7);
• Excessive questions about the death and an openness to discuss the death, even with strangers (Papenbrock and Voss, p.2).

• Additional holding, touching, hugging and expressions of love;
• Acceptance of child's reactions;
• Reassurance that they are not to blame for the death and that they will be taken care of;
• Communication—children need an honest explanation about the death and clarification that death is not temporary;
• Professional support may be sought if disruptive or uncommon behavior persists. (Grief Resource Foundation, p. 3-7).

School Age Child Six to Nine Years of Age

Children in this age group have a clearer understanding of death. By the time a child is nine-years-old, they usually come to understand the reality of death in terms of its irreversibility, though they may still believe it only happens to other people. They may be interested in the physical and biological aspects of death. They may believe that thoughts can make things happen, even accidents and death. Children in this developmental stage usually alternately confront and deny their grief, as they are often unprepared for the length of the grieving process (Grief Resource Foundation, p.2).

The child may disavow death, and utilize denial as a defense mechanism. Subsequently, children may not questions or discuss death and appear unaffected. In actuality, children in this developmental stage encounter strong feelings of loss, yet it is often difficult for them to express these emotions (Grief Resource Foundation).

Children may have difficulty eating and sleeping, stomachaches, headaches, excessive fearfulness and/or guilt. Children may be angry, and anger may be directed at certain people who "caused" death or allowed it to happen (i.e., God, doctors, nurses, etc.). Children's grieving process may be further complicated by school environment and the following may occur:

• school performance may decline;
• a child may be unable to concentrate;
• a child may direct anger towards teacher or classmates;
• physical ailments may occur prior to or during school; and
• classroom behavior may be inappropriate. (Papenbrock and Voss, p.8).

Honest, open discussions about death are crucial. Children in this developmental state need information. Encourage the child to express his or her anger and share your own feelings. Be supportive and provide physical affection.

Contact the child's teachers and encourage them to maintain contact with you regarding the child's progress. As children in this age group tend to approach and them retreat from the reality of death, parents and caregivers need to be aware of, and sensitive to, this on-again, off-again aspect of grieving (Grief Resource Foundation, p.8).

Pre-Adolescent and Adolescent—10 to 18 Years of Age

At this stage, older children and adolescents have a more mature view of death and understanding of its irreversibility and of mortality. They also understand personal death, though adolescents usually view themselves as immortal. Adolescents often have an increased interest in personal purpose in life ("meaning of life"), and in what happens after death. Death may be romanticized. Some experts are concerned that as children continually view death through movies and television, their perceptions of the finality of death and the experience of dealing with such loss are jaded, and they believe it is easier to manage than it is in reality (Grief Resource Foundation, p.2).

• Guilt, anger, confusion, depression, and shock;
• Crying, stomachaches, headaches, insomnia, and exhaustion, as well as dramatic reactions such as temporarily not eating, sleeping, etc.;
• Decrease in school performance;
• Change in peer group;
• Possible drug use and/or sexual promiscuity.

The biological and emotional changes brought on by puberty during this developmental stage further complicate reactions to loss and the grieving process. There is a great tendency for this age group to be very egocentric; thus, they are inclined to be preoccupied with how the death affects them personally and give little consideration to its impact on others. As assertion of independence during this developmental stage is of considerable importance - the loss of a parent or guardian may shock a child into realizing how much this person was needed (Grief Resource Foundation, p.3). This may especially affect a son who has lost his father or a daughter who has lost her mother, and may be extremely overwhelming (Papenbrock and Voss, p.9).

• Assist in helping a child verbalize her/his grief;
• Promote discussion of death and grief and listen to what a child is saying;
• Encourage the child to release grief in healthy ways (i.e., discussion, physical activity, etc.);
• Validate concerns and emotions;
• Establish limits on behavior and consequences of violating limits;
• Provide peer support group and/or professional help depending on a determination of the individual child's needs. (Papenbrock and Voss, p.10).

When children encounter death, especially the death of a parent or guardian, their ability to grieve and their grieving process is greatly effected by their stage of developmental growth. While children's grief processes may vary throughout their early life and adolescence, an adult's ability to be honest, to listen, to be supportive and to be there for the children will sustain them during this difficult time and help facilitate a healthy process of grieving.

Bibliography

Grief Resource Foundation, Helping Children Cope With Loss. Dallas, 1990.

Papenbrock, Patricia L., and Robert F. Voss. Children's Grief: How to Help the Child Whose Parent Has Died. Redmond, WA: Media Publishing Co., 1988.

Grollman, Earl A. Talking About Death. Boston: Beacon Press, 1990.

For additional information, please contact:

The Dougy Center
3909 SE 52nd Street
Portland, OR 97206
(503) 775-5683

The Good Grief Program
Boston Medical Center
One Boston Medical Center Plaza
Boston, MA 02118
(617) 414-4005

Your local prosecutor’s office, law enforcement, or state Attorney General’s office. Check in the Blue Pages of your local phone book under the appropriate section heading of either “Local Government,” “County Government,” or “State Government.”

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Copyright © 2000 by the National Center for Victims of Crime. This information may be freely distributed, provided that it is distributed free of charge, in its entirety and includes this copyright notice.