Children's Grief and Developmental Stages
Children at different stages of development have different understandings of death and the events near death.
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, quiet, unresponsive to smiling or cooing, undergo physical changes (for example, weight loss), be less active, and sleep less.
Age 2-3 years
Children at this age often confuse death with sleep and may experience 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 she might have been buried, and ask questions about the deceased (for example, how does the deceased eat, go to the toilet, breathe, or play?). Young children know that death occurs physically, but think it is temporary, reversible, and not final. The child's concept 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 bladder and bowel functions.
Age 6-9 years
Children at this age are commonly curious about death, and may ask questions about what happens to one's 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 of death, or bogeyman. They may see death as final and frightening but as something that happens mostly to old people (and not to themselves). Grieving children can become afraid of school, have learning problems, develop antisocial or aggressive behaviors, become overly concerned about their own health (for example, developing symptoms of imaginary illness), or withdraw from others. Or, children this age can become too attached and clinging. Boys usually become more aggressive and destructive (for example, acting out in school), instead of openly showing their sadness. When a parent dies, children may feel abandoned by both their deceased parent and their surviving parent because the surviving parent is grieving and is unable to emotionally support the child.
Ages 9 and older
By the time a child is 9 years old, death is known to be unavoidable and is not seen as a punishment. By the time a child is 12 years old, death is seen as final and something that happens to everyone.
A child's grieving process may be made easier by being open and honest with the child about death. Not talking about death indicates that the subject is taboo and does not help a child to cope with loss. Use clear, direct language. Explanations should be simple and straightforward. Euphemisms such as "She passed away" or "We lost him" are best avoided, as they can confuse and alarm children. Each child should be told the truth, using as much detail as he or she is able to understand. Listen to any questions the child may have and try to answer them as fully as possible. Children often need to be reassured about their own security (they often worry that they, or a surviving parent, will also die).
If you are planning a memorial ceremony, try to include the child in the arrangements and in the ceremony itself. These events help children (and adults) remember loved ones. Children should not be forced to be involved in funerals or memorials, but they should be encouraged to take part in those portions of the events with which they feel most comfortable. If the child wants to attend the funeral, wake or memorial service, she should be given a full explanation of what to expect in advance. Try to encourage them to express their feelings. The surviving parent may be too incapacitated by his own grief to give the child full attention. Therefore, support from a familiar adult or family member can be extremely helpful.