Childhood Grief: The Influence of Age On Understanding

I have a daughter who is three years old.  She sees the world in a delightful way.  Everything is pink and sparkly.

Yesterday she walked up to me with a skeptical look and asked, "Where is your mother?"

Hmmm...I paused for a minute wondering where this question came from.  After a moment I simply responded, "she died".

"Oh," she said "I wonder when she's going to get up and feel better again"...and with that she waltzed away and I was left thinking it might be nice to be three for a while.  

Childhood Grief and Developmental Stages

Age has a large influence on childhood grief and how children understand and react to the death of a family member, friend, pet, or close adult.  It is good to know where a child is likely to fall developmentally.  This will help you to better understand how they view the loss and will help you to make age appropriate choices about language and interventions.

Of course age won't help you to predict exactly how a child will react, other factors will have an impact as well.  Maturity, past experiences, education level, socio-economic status, what part of the world you live in, and access to support resources are merely a few of the many factors that influence us all.

We advise with children of any age or background you should do the following:

1. Acknowledge their presence, their importance, their opinions, thoughts, and feelings.
2. Be patient and open minded.  Allow them to grieve in their own way.
3. Be available - Sit with the child, listen to them, and answer their questions.
4. Reassure them the circumstances that led to the death were extreme and it is unlikely other adults in their lives will die any time soon (unless this is untrue).
5. Let them know that a range of different emotions are normal.
6. Validate their feelings and do not minimize them.
7. Check in with other adults involved in their life - teachers, school counselors, coaches.

We have put together a list of typical grief responses by age.  Again, every child is different and we can't quantify all the unique and individual qualities of your child in this list. Childhood grief is complicated, just like adult grief, so if your child reacts in a way that concerns you then it might be a good idea to talk things over with an expert like a pediatrician, school counselor, or child psychologist.

Childhood Grief Reactions by Age:

o-1:

• They have no ability to conceptualize death
• Their memory capacity for specific relationships is undeveloped.  Unless the person who died was a close caregiver, they may  have very little response.
• They may be aware that something is different or missing.

1-2:

• They do not understand the finality of death
• They are concrete thinkers.  It may feel callous to explain death in a straightforward way, but metaphors and euphemisms will be confusing.  Provide simple and clear explanations.
• If they are old enough to ask, they may inquire where the person is or when they will be back.
• They probably won't understand there are factors beyond our control and won't understand why the person chose to leave, particularly if the person who died was an adult.  Make sure to explain that death and leaving were not things their loved one chose.
• They are not too young to sense the stress and emotion felt by grownups in their lives.
• Sticking to their normal routine may provide a sense of security, normalcy, and comfort.
• Give them attention and provide them with reassurance.

Signs of Distress may include increased irritability and crying, changes in eating and sleeping patterns, and/or withdrawing.  If these or any other behaviors concern you, you may want to discuss them with their pediatrician or seek outside counseling from a child psychologist.

2-4:

• They still don't understand the finality of death and still might see it as abandonment.
• They see death as reversible or not permanent.  Dead people are simply sick or asleep and can get better or wake up.
• They may ask the same questions over and over; be patient and stick with the same straightforward explanation.
• They may not have the words to explain how they are feeling.  You are likely to see expressions of childhood grief through behavior and through play with toys and/or drawing.
• They may experience separation anxiety.  When you must leave the child, it might be helpful to prepare them in advance that you will be leaving and provide them with reassurance about when you will return.
• They may feel the person's absence in an intense way one moment and be back to happily playing the next.
• They will be aware of changes in patterns and routine.  Provide them with a lot of reassurance, nurturing, and consistency.

Signs of Distress may include regressive behaviors in the areas of sleep, potty training, and/or eating.  They may become clingy.  They may appear irritable, confused or suffer from nightmares.  If these or any other behaviors concern you, you may want to discuss them with their pediatrician or seek outside counseling from a child psychologist.

4-9:

• They are starting to develop the ability to feel guilt.  Guilt can be confusing for them and they may feel guilty for odd things.
• "Magical Thinking" is seen around 4 years old.  This is when children believe their thoughts and wishes can cause things to happen.  For this reason children may irrationally feel responsible for the death because of thoughts or wishes they had prior to the death.  (Example:  I'm responsible for the death because I told my mom I hated her and wished she would go away).
• They may be interested in the process of dying and ask 'how' or 'why' things have happened.  Their questioning may be repetitive.
• They have begun to understand that death is not reversible or temporary, but still may believe that death only happens to some people and will not happen to them.
• Death is often personified as things like ghosts and monsters.
• At this age, children lack the words to express their emotions.  They may have strong feelings of grief and loss but can't express this verbally. Instead, they may express feelings through anger and frustration.
• Symbolic play using drawings and stories can be helpful.
• They may need permission and encouragement to grieve.  Encourage expression of feelings through talk, play, or physical outlets.

Signs of Distress may include regression, nightmares, sleep disturbances, and/or changes in eating.  They may engage in violent play.  They may try to take on the role of the deceased.  If these or any other behaviors concern you, you may want to discuss them with the school counselor or pediatrician or seek outside counseling from a child psychologist.

9-12:

• They understand the finality of death and that everyone eventually dies, however they still may engage in denial that it will happen to them (don't we all?)
• They are curious about the physical aspects of death - what does the body look like?  what does it feel like? etc.  Provide straightforward explanations.
• They know how to express their feelings and emotions, but they may choose not to.  Encourage them to express the range of feelings they are having.
• They may be concerned with how others are reacting to the death.  What is the right way to react?  How should they react?
• Involve them. Allow them to give input and make choices regarding funerals, memorials, belongings, etc.

Signs of Distress may include having problems at school, withdrawing from friends, acting out, disturbances in sleeping and eating, an overwhelming concern with the body, and/or role confusion. If these or any other behaviors concern you, you may want to discuss them with the school counselor or pediatrician or seek outside counseling from a child psychologist.

12-20(ish): Don't miss our post on helping teens cope with grief. 

• They are capable of having a more adult perspective of death.
• Involve them. Allow them to give input and make choices regarding funerals, memorials, belongings, etc.
• They are able to think abstractly about death and related concepts such as afterlife.
• They may try to make sense of things, philosophize, and/or search for meaning.
• Their mourning may be more traditional - extreme sadness, anger, denial.  Even though they are capable of expressing grief they may chose not to.
• They may work to give the appearance they are coping well when they are not.
• They may feel forced to act as a consoler and comforter for younger children or adults.
• Be available, listen, and encourage them to talk about it.  Do not attempt to minimize what they are feeling.
• Set a good example by speaking about your own feelings surrounding the death (without putting them in the role of the comforter).
• They may be more willing to talk about grief with people outside of the family.  Grief camps and support groups may be helpful.
• They may act out or engage in dangerous behavior such as risk taking, drugs, alcohol, etc.

Signs of Distress may include having problems at school, depression, anger, suicidal thoughts, rule breaking, role confusion, and/or acting out.  If these or any other behaviors concern you, you may want to discuss them with the school counselor or pediatrician or seek outside counseling from a psychologist.

For more information about childhood grief and bereavement, check out the following articles:

• Understanding Grief in Children
• Talking to Kids About Death and Grief: 10 Comprehensive Tips
• Should I discuss deceased loved ones with my child?
• Exploring the Mixed-Up Emotions of Grief: Art Activities for Kids
• WYG Talks to Kids About Death: Kids and Euphemism Take Two

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