Grieving children

Developmental Clues

1-3 years old
Children react to the emotions around them. They won't understand, but they will react. They don't understand permanence, so they will ask the same questions repeatedly. They receive security from hearing the same answer to the same question. They cannot grasp abstractions such as heaven. They will worry about who will care for them and may try to communicate feelings via bodily complaints such as "I'm not hungry" or "My tummy aches."

3-6 years old
Death is viewed as temporary and equated with sleeping. Simple questions require simple answers. Regression and increased aggression are common. It's still hard to discern between a short absence and a long one but the separation is difficult. They will repeat the same questions as they try to understand.

6-9 years old
Six-year-olds may still view death as reversible – watch for magical thinking. They may somehow feel responsible for the death through thoughts, actions, or wishes. At this age the capacity for guilt is developing. Children express feelings through behavior. Cause and effect is forming; there is some understanding of what death involved and this may result in a fear of death. Children in this age range may fear forgetting so may identify with the deceased in order to remember them. They may personify – put into monster form to grasp – the supernatural and are often fascinated by physical facts. Denial, constant questions, feelings of guilt, and feeling very different from others are common reactions. Reassurance and a sense of security are important.

9-12 years old
Independence is developing as relationships with peers increase in importance and clearer understanding about death is forming. A lot of questions and perhaps fears related to the result of death are common. Secondary issues such as "Will we have to move?" or "What will we do about vacation this year?" are of concern. Life is seen in a black and white manner. Children this age often separate right from wrong, and death may be viewed as punishment. Grief may go unrecognized as pseudo-adult like behavior is assumed. There is a tendency to intellectualize and act as if it doesn't matter. A fear of abandonment keeps them on this cognitive level, so stress your support and availability to them. Physical complaints, tendency of fearfulness, denial, or anxiety are common responses.

 Developmental stages     Reactions Suggestions
2-3 years
Sense adults' reactions
Won't remember the deceased
Cannot grasp concept of death
Depends on nonverbal    communications
Realizes when someone is missing    
 
Fear of abandonment/rejection
Crying
Clinginess
Anxiety
 
Tell a story
Draw a picture
Encourage play – dolls, puppets
Coloring books on life cycles
Provide physical comfort
Concrete language
Maintain routine
Minimize change
Allow participation
3-6 years
View death as temporary
Question cause of death
Can't grasp concept of heaven
May equate loss with punishment
Matter-of-fact curiosity
Can't put feelings into words
 
Regression, e.g., thumb sucking or  toilet training problems
Increased aggression
Escape into play
Can appear unaffected
Fearful
"Who will take care of me?"
 
Model your own grief
Brief, honest explanations
Avoid euphemisms ("dead" not  "sleeping," etc.)
Read books to explain
Discipline consistently
Spend time with the child
Maintain routine
Give child choice to attend funeral
6-9 years
Magical thinking
Unrealistic fears
Fascinated by physical details
Grasps finality of death
Expresses feeling through behavior
 
Anger
Blames self – guilt
Feels helpless and responds with  increased aggression
Reaction can be delayed   
 
Set aside a daily "check-in" time to talk
Physical touch
Self-disclosure of similarities
Normalize feelings
Discuss life cycles
9-12 years
Realizes irreversible nature of death
Realizes the disruptive changes that  result
Wants black and white answers
Grief may be unrecognizable
 
Guilt
Withdrawal
May have physical symptoms –
 headache, stomach-ache, etc.
Lack of concentration
Reluctant to admit feelings
 
Provide truthful answers – don't shield
Assess areas of guilt
Acknowledge changes in routine
Connect with other peers who have had  loss
Suggest ways to release emotions
Make collage to represent loved one

Prepared by PATHways Center for Grief & Loss, Hospice of Lancaster County
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