Key Points for This Section

A child's grief process is different from an adult's. Several factors can affect how a child will cope with grief. Children at different stages of development have different understandings of death and the events near death. Most children who have had a loss have three common worries about death. Did I make the death happen? Is it going to happen to me? Who is going to take care of me? Talking honestly about the death and including the child in rituals may help the grieving child. Explain the death and answer questions. Use the correct language. Include the child in planning and attending memorial ceremonies. There are books and other resources with information on helping a grieving child.

A child's grief process is different from an adult's.

Children do not react to loss in the same ways as adults. These are some of the ways children's grief is different:

• Children may seem to show grief only once in a while and for short times. This may be because a child is not able to feel strong emotions for long periods of time. A grieving child may be sad one minute and playful the next. Often families think the child doesn’t really understand the loss or has gotten over it quickly. Usually, neither is true. Children’s minds protect them from what is too much for them to handle emotionally.

• Mourning is a process that continues over years in children. Feelings of loss may occur again and again as the child gets older. This is common at important times, such as going to camp, graduating from school, getting married, or having children.

• Grieving children may not show their feelings as openly as adults. Grieving children may throw themselves into activities instead of withdrawing or showing grief.

• Children cannot think through their thoughts and feelings like adults. Children have trouble putting their feelings about grief into words. Strong feelings of anger and fears of death or being left alone may show up in the behavior of grieving children. Children often play death games as a way of working out their feelings and worries. These games give children a safe way to express their feelings.

• Grieving adults may withdraw and not talk to other people about the loss. Children, however, often talk to the people around them (even strangers) to see how they react and to get clues for how they should respond to the loss.

• Children may ask confusing questions. For example, a child may ask, "I know grandpa died, but when will he come home?" This is a way of testing reality and making sure the story of the death has not changed.

Several factors can affect how a child will cope with grief.

Although grief is different for each child, several factors can affect the grief process of a child:

• The child's age and stage of development.
• The child's personality.
• The child's previous experiences with death.
• The child's relationship with the deceased.
• The cause of death.
• The way the child acts and communicates within the family.
• How stable the family life is after the loss.
• How the child continues to be cared for.
• Whether the child is given the chance to share and express feelings and memories.
• How the parents cope with stress.
• Whether the child has ongoing relationships with other adults.

Children at different stages of development have different understandings of death and the events near death.

Infants

Infants do not recognize death, but feelings of loss and separation are part of developing an awareness of death. Children who have been separated from their mother may be sluggish and quiet, may not respond to a smile or a coo, may have physical symptoms (such as weight loss), and may sleep less.

Age 2-3 years

Children at this age often confuse death with sleep and may feel anxiety as early as age 3. They may stop talking and appear to feel overall distress.

Age 3-6 years

At this age children see death as a kind of sleep; the person is alive, but only in a limited way. The child cannot fully separate death from life. Children may think that the person is still living, even though he or she might have been buried. The child may ask questions about the deceased (for example, how does the deceased eat, go to the toilet, breathe, or play?). Young children know that death is physical, but think it is not final.

The child’s understanding of death may involve "magical thinking". For example, the child may think that his or her thoughts can cause another person to become sick or die.

Grieving children under 5 may have trouble eating, sleeping, and controlling the bladder and bowel.

Age 6-9 years

Children at this age are often very curious about death, and may ask questions about what happens to the body when it dies. Death is thought of as a person or spirit separate from the person who was alive, such as a skeleton, ghost, angel, or bogeyman. They may see death as final and scary but as something that happens mostly to old people (and not to themselves).

Grieving children can become afraid of school, have learning problems, show antisocial or aggressive behavior, or become overly worried about their own health and complain of imaginary symptoms. Children this age may either withdraw from others or become too attached and clingy.

Boys often become more aggressive and destructive (for example, acting out in school), instead of showing their sadness openly.

When one parent dies, children may feel abandoned by both the deceased parent and the living parent, whose grief may make him or her unable to emotionally support the child.

Age 9 and older

Children aged 9 and older know that death cannot be avoided and do not see it as a punishment. By the time a child is 12 years old, death is seen as final and something that happens to everyone.

Most children who have had a loss have three common worries about death.

Children coping with a loss often have these three questions:

Did I make the death happen?

Children often think that they have "magical powers". If a mother is irritated and says, "You’ll be the death of me" and later dies, her child may wonder if he or she actually caused the mother’s death. Also, when children argue, one may say (or think), "I wish you were dead." If that child dies, the surviving child may think that those thoughts caused the death.

Is it going to happen to me?

The death of another child may be very hard for a child. If the child thinks that the death may have been prevented (by either a parent or a doctor) the child may fear that he or she could also die.

Who is going to take care of me?

Since children depend on parents and other adults to take care of them, a grieving child may wonder who will care for him or her after the death of an important person.

Talking honestly about the death and including the child in rituals may help the grieving child.

Explain the death and answer questions.

Talking about death helps children learn to cope with loss. When talking about death with children, describe it simply. Each child should be told the truth using as much detail as he or she is able to understand. Answer questions in language the child can understand.

Children often worry that they will also die, or that their surviving parent will go away. They need to be told that they will be safe and taken care of.

Use the correct language.

When talking with the child about death, include the correct words, such as "cancer," "died," and "death." Using other words or phrases (for example, “he passed away,” “he is sleeping,” or “we lost him”) can confuse children and cause them to misunderstand.

Include the child in planning and attending memorial ceremonies.

When a death occurs, children may feel better if they are included in planning and attending memorial ceremonies. These events help children remember the loved one. Children should not be forced to be involved in these ceremonies, but encourage them to take part when they feel comfortable doing so. Before a child attends a funeral, wake, or memorial service, give the child a full explanation of what to expect. A familiar adult or family member may help with this if the surviving parent's grief makes him or her unable to.

There are books and other resources with information on helping a grieving child.

The following books and videos may be helpful with grieving children:

1. Worden JW: Children and Grief: When a Parent Dies. New York, NY: The Guilford Press, 1996.

2. Doka KJ, ed.: Children Mourning, Mourning Children. Washington, DC: Hospice Foundation of America, 1995.

3. Wass H, Corr CA: Childhood and Death. Washington, DC: Hemisphere Publishing Corporation, 1984.

4. Corr CA, McNeil JN: Adolescence and Death. New York, NY: Springer Publishing Company, 1986.

5. Corr CA, Nabe CM, Corr DM: Death and Dying, Life and Living. 2nd ed., Pacific Grove: Brooks/Cole Publishing Company, 1997.

6. Grollman EA: Talking About Death: A Dialogue Between Parent and Child. 3rd ed., Boston, MA: Beacon Press, 1990.

7. Schaefer D, Lyons C: How Do We Tell the Children? Helping Children Understand and Cope When Someone Dies. New York, NY: Newmarket Press, 1988.

8. Wolfelt A: Helping Children Cope with Grief. Muncie: Accelerated Development, 1983.

9. Walker A: To Hell with Dying. San Diego, CA: Harcourt Brace Jovanovich, 1988.

10. Williams M: Velveteen Rabbit. Garden City: Doubleday, 1922.

11. Viorst J: The Tenth Good Thing About Barney. New York, NY: Atheneum, 1971.

12. Tiffault BW: A Quilt for Elizabeth. Omaha, NE: Centering Corporation, 1992.

13. Levine JR: Forever in My Heart: a Story to Help Children Participate in Life as a Parent Dies. Burnsville, NC: Mountain Rainbow Publications, 1992.

14. Knoderer K: Memory Book: a Special Way to Remember Someone You Love. Warminster, PA: Mar-Co Products, 1995.

15. de Paola T: Nana Upstairs and Nana Downstairs. New York, NY: GP Putnam’s Sons, 1973.