Working with Loss and Grief in children

The death of a loved one is always difficult. For children, the death of a loved one can affect their sense of security. Like adults, children express loss by grieving and yet children may not demonstrate their grief openly as adults. Grief may affect their behaviour, the way in which they take in information, and their need for support.

This will depend on the child, their age, and their emotional maturity. It will also depend on who the child has lost to death. A child’s experience of grief varies depending on the type of loss and the developmental stage of the child. For example, moving to a new town may precipitate a grief response that is mild and transient, while grief from the loss of a parent most likely threaten the foundation of the child’s world. Young children express grief in vastly different ways from teens and adults.

Like any person, children express their grief by their behaviour, thoughts, emotions and physical reactions. The initial expressions of grief in children range from regression, temper tantrums, and exaggerated fears in younger children to physical symptoms, lack of concentration, and mood swings in older children. Grieving children may not dwell on the person who died and may continue to carry on with activities (for example: they may be sad one minute and be playful the next).

A child’s grieving period may be shortened because they will tend not to think through their own thoughts and feelings like adults (ruminate) and also the child may have trouble putting their thoughts into words compared to adults, due to their limited vocabulary. As a consequence, children will tend to favour their behaviour as a primary means through which to portray their grief.

Children’s Grief and Developmental Stages

2 -3 years: Children at this age tend to have no understanding of death and are more likely to react to separation from the significant person and changes in their world. Toddlers are generally curious at this stage about where things go and gain delight in disappearance and reappearance. The distress associated with changes in their environment due to the death of a loved one may result in the following reactions:

• Crying
• Searching
• Change in sleep
• Change in eating habits

How parents/carers can help children cope at this age: What we do is far more important that what we say to a child this age. Generally, a grieving infant needs large doses of tender, loving care… holding, cuddling and stroking.

3-6 years: With language and learning comes an interest in the world. Children at this age tend to be full of questions, often repeated. Children at this age tend to see death as a kind of sleep. They cannot fully separate death from life. Being dead may mean for a child at this age, to be living under different circumstances. For example, the child may continue to think that the deceased is still living despite witnessing the burial.

As a result the child may continue to ask questions about the deceased and wondering over such things like why the deceased is not getting hungry or how can the deceased eat when they are underground. Children at this age may equate death with punishment. They will tend to communicate their feelings and emotions through:

• Separation fears
• Tantrums
• Crying
• Fighting

How parents/carers can help children cope at this age: When talking about death to the child, it should be explained simply to avoid confusion. Role playing with animals, toys and puppets can help the child gain an understanding of the loss.

6-9 years: Children at this age have the mental capacity to comprehend simple concepts like germs and disease. So they have a better capacity to understand the basic causes of death than younger children. However, their emotional understanding can be incongruent whereby there is less sophistication in their beliefs and thoughts about how bad things happen.

So they may tend to fabricate their basic comprehension of the cause of death with other less realistic phenomena. Feelings of insecurity resulting from the death may be expressed in the reluctance to separate from surviving caregivers. Children at this age will tend to personify death and are likely to display the following:

• Anger
• Denial
• Irritability
• Withdrawal

How parents/carers can help children cope at this age: Children’s artwork can speak louder than words and free expression can be encouraged by taking this approach.

9-12 years: Children at this age will tend to have acquired a mature understanding of death. They will usually understand that death is final and have a better comprehension of the reality of cause. It is more along the lines of an adult understanding of death and will therefore often be accompanied by adult like behaviours such as feeling a sense of responsibility. They may have a strong need to control their feelings and may have difficulty doing so. The most common reactions are:

• Withdrawal
• Crying
• Isolation
• Sleep disturbance
• Longing
• Aggression

How parents/carers can help children cope at this age: Children of this age not only need support and comfort but can also be a source of comfort for others. Opportunities to be helpful to others during the crisis can actually help children deal with their own feelings.