Helping Children Cope with Loss, Death, and Grief

Children react to death in a variety of ways.

All children are unique in their understanding of death and dying.  When discussing death with children, adults must be sensitive to children’s capacity to understand the situation. The range of reactions that children display in response to the death of people important to them may include:

• Emotional shock (apparent lack of feelings), which serves to help the child detach from the pain of the moment.
   
• Regressive (immature) behaviors, such as needing to be rocked or held, difficulty separating from parents or significant others, needing to sleep in parent’s bed or an apparent difficulty completing tasks well within the child’s ability level.
   
• Explosive emotions (acting out behavior), which reflect the child’s internal feelings of anger, terror, frustration and helplessness. Acting out may reflect insecurity and an effort to seek control over a situation in which they have little or no control.
   
• Asking the same questions over and over, not because they do not understand the facts, but rather because the information is so hard to believe or accept. Repeated questions can help listeners determine if the child is responding to misinformation or the real trauma of the event.

Children’s developmental level impacts their reactions to a death.

Children’s understanding of death is influenced by their developmental level, cognitive skills, personality characteristics, religious or spiritual beliefs, teachings by parents and significant others, input from the media, and previous experiences with death.  Even though each child is an individual, a general understanding of the impact of developmental level on how children understand death can help adults plan their discussions.

• Infants and Toddlers: The youngest children may perceive that adults are sad, but have no real understanding of the meaning or significance of death.
   
• Preschoolers: Young children may deny death as a formal event and may see death as reversible. They may interpret death as a separation, not a permanent condition. Preschool and even early elementary children may link certain events and magical thinking with the causes of death.
   
• Early Elementary School: Children at this age start to comprehend the finality of death. They begin to understand that certain circumstances may result in death. At this age, death is perceived as something that happens to others, not to oneself or one’s family.
   
• Middle School: Children at this level have the cognitive understanding to comprehend death as a final event that results in the cessation of all bodily functions.
   
• High School: Most teens fully grasp the meaning of death in circumstances such as an automobile accident and illness. They may seek out friends and family for comfort or they may withdraw to deal with their grief. Teens (as well as some younger children) with a history of depression, suicidal behavior and drug and alcohol use are at particular risk for prolonged and serious grief reactions and may need more careful attention from home and school during these difficult times.

Helping children cope with death and grief

• Let your child teach you about his/her experience of grief. Give children the opportunity to tell their story and be a good listener. Become attuned to and respond to the child's own pace for revealing feelings. Offer opportunities for comfort by being available whenever the child/teen is ready or is experiencing some strong emotion.
   
• Don’t assume that every child understands death in the same way or with the same feelings: All children are different and their view of the world is unique and shaped by different experiences.
   
• Remember that grieving is a process, not an event: Give your child adequate time to grieve in the manner that works for that child. Pressing children to resume “normal” activities without the chance to deal with their emotional pain may lead to additional problems or negative reactions.
   
• Don’t lie or tell half-truths to children about the tragic event: Children are bright and sensitive. They see through false information and start to wonder why you do not trust them with the truth. Lies do not help the child through the healing process or help develop effective coping strategies for life’s future tragedies or losses. However, you should also avoid giving your child unnecessary information.
   
• Help all children, regardless of age, to understand loss and death: Give your child information at the level that he/she can understand. Allow your child to guide you as to the need for more information or clarification of the information presented. Loss and death are both part of the cycle of life that children need to understand.
   
• Have more than one conversation. A child's familiarity, interest, and questions about difficult situations change over time. Be available and look for teachable moments or opportunities for further exploration.
   
• Be simple and direct in talking with your child. Use correct words and language. Although this may be difficult for adults, saying someone has died is preferable to potentially confusing euphemisms such as "he went to sleep," "he passed on," and "we've lost him."
   
• Encourage children to ask questions about loss and death. Don’t worry about not knowing all the answers. Treat questions with respect and a willingness to help the child find his or her own answers. If you do not know the answer to a question a child asks, it is all right to say, “I don’t know.” It helps children to see adults model how to cope in a situation where they do not know all the answers.
   
• Don’t expect your child will grieve in an orderly or predictable way. Everyone grieves in different ways. There is no one “correct” way for adults or children to move through the grieving process. Make sure your child understands this also.
   
• Let your child know that you really want to understand his/her feelings and needs. Sometimes children are upset but they cannot tell you what will be helpful. Giving them the time and encouragement to share their feelings with you may enable them to sort out their feelings.
   
• Your child may need long-lasting support: The more losses a child suffers, the more difficult it will be to recover. Try to develop multiple supports if your child has suffered suffer significant losses.
   
• Pay attention to all parts of your child’s life. Provide understanding, support, and extra guidance or assistance with school assignments, social obligations, and home chores as necessary over time. Talk to and enlist the support of other adults (such as teachers and coaches) who are in contact with the children.
   
• Keep in mind that grief work can be hard and complicated for both children and adults. Sudden and/or violent deaths can especially complicate the grieving process.

Pay attention to your own feelings and to how they impact your child.

• Be aware of your own need to grieve. Focusing on your children is important, but not at the expense of your own emotional needs. Adults who are grieving will be far more able to help children work through their grief if they pay attention to their own feelings and needs.
   
• Do not hide your feelings. Explain them as a way to help children understand their own, but keep expression of strong, dramatic feelings for private times with other adults.
   
• Be sensitive to how your feelings affect your child.  Children are aware of how their parents and other important adults feel, and these adult feelings affect the way children interpret and react to information about death and tragedy. 

Children may need guidance in what to do after a death.

• Children (and many adults) need help in communicating condolence or comfort messages. Provide children with age-appropriate guidance. Help them decide what to say and how to say it.
   
• Help children anticipate some changes in others’ behavior. It is important that children understand that some people they know may act differently, may withdraw from their friends for a while, might seem angry or very sad, etc., but that this does not mean a lasting change in their relationship.
   
• Children need to have some options for providing support. Having something concrete to do helps them deal with their fears and concerns. Suggest making cards, drawings, helping with chores or homework, etc. Older teens might offer to help with some shopping, cleaning, errands, etc., or with babysitting for younger children.
   
• Encourage children who are worried about a friend to talk to a caring adult. This can help alleviate their own concern or potential sense of responsibility for making other people feel better. Children may also share important information about a friend who is at risk of more serious grief reactions.

Sometimes more help is needed

Following the death of someone close to them, many children and teens adjust emotionally and return to healthy functioning at school, home and with friends after a year has passed. However, some children develop more serious problems that warrant the attention of a mental health professional. Some problems may emerge even two or more years later as different developmental tasks or life challenges are confronted.

You may wish to consider seeking out professional help if your child develops persistent difficulties with sleep, appetite, weight change and/or disturbance or shows extended periods of sadness, excessive grief, and loss of interest in activities. Other behaviors of concern include inability to respond to comfort, purposeful withdrawal from friends, prolonged physical complaints, acting younger, and destructive or angry outbursts. Refusal to go to school and marked decline in school performance are also important to note.

Minneapolis Public Schools has social workers and psychologists assigned to every school. If you need to discuss your child’s reaction to a loss or would like some help in locating community support, please call the office at your child’s school and ask to be connected with one of these support professionals.

The material in this document was adapted by Martha J. Rosen, Ph.D., Manager of Psychological Services, Minneapolis Public Schools from the National Association of School Psychologists (http://www.nasponline.org/resources/crisis_safety/griefwar.pdf) and the New York University Child Study Center (http://www.aboutourkids.org/articles/children_grief_what_they_know_how_they_feel_how_help).