Navigating Children’s Grief: How to Help Following a Death

Age	Concepts and Beliefs	Difficult Emotions	Possible Behaviors	How to Help	

Birth–2 years	
No understanding of death
Child does not have words for feelings
Aware of the absence of loved one
Notices changes in routine
Notices changes in family emotions	
Longing

Misses contact, sounds, smell and sight of loved one

Fears of being abandoned

Anxiety	
Crying
Sickliness
Indigestion
Thrashing
Rocking
Throwing
Sucking, biting
Sleeplessness	
Physical contact, cuddling and reassurance
Maintain routines
Meet immediate physical needs
Include the child in the mourning process when possible
Be gentle & patient	

3-5 years	
No understanding of permanence of death
To be dead is to be sleeping or on a trip
May wonder what deceased is doing
Can understand that biological processes have stopped, but sees this as temporary and reversible
May wonder what will happen if the other parent dies
Magical thinking and fantasies, often worse than realities	
Fear
Sadness
Insecurity
Confusion
Anger
Irritable
Agitated
Worried
Guilty	
Regressive behaviors
Repetitive questions
Withdrawn
Plays out scenes of death, change & feelings
Interested in dead things
Acts as if death never happened
Intense dreams
Physical complaints
Crying
Fighting	
Allow the child to regress
Give physical contact
Encourage children to play & have fun
Allow safe ways to express feeling
Give simple & truthful answers to questions
Maintain structure and routines
Answer repetitive questions
Let the child cry
Talk (reflective listening)
Include child in family rituals & mourning	

6-9 years	
Understands that death is final
Interested in the biology of death
Death associated with bodily harm, mutilation
& decay
His or her thoughts, actions or words caused the death
Death is punishment
Forming spiritual concepts
Who will care for me if my caregiver dies
Thinks about life’s milestones without the deceased (graduation, marriage, etc.)	
Sad
Anger
Lonely
Withdrawn
Worried
Anxious
Irritable
Confusion
Guilty
Fear	
Regressive behaviors
Specific questioning – looking for details
Acts as if the death never happened
Hides feelings
Withdrawal
Nightmares / sleep disturbances
Concentration difficulties
Declining or greatly improved grades
Aggressive acting out
Protective of surviving loved ones	
Allow need to regress
Give physical contact
Have intentional times together
Answer questions truthfully
Watch for confusion
Allow expression of feelings through verbal & physical outlets
Encourage drawing, reading, playing, art, music, dance, acting, sports
Let child choose how to be involved in the death & mourning
Find peer support for the child
Work with school to tailor workload	

Age	Concepts and Beliefs	Difficult Emotions	Behaviors	How to Help	

9-12 years	
Understands the finality of death
Denial
His/her words, thoughts or actions caused the death
Thinks about life’s milestones without the deceased (graduation, marriage, etc.)
High death awareness (death may happen again)
What if my caregiver dies?
Formulating spiritual concepts	
Emotional turmoil heightened by physical changes
Shock
Sad
Anger
Confused
Lonely
Vulnerable
Fear
Worried
Guilty
Isolated
Abandoned
Anxious	
Regressive behavior
& fluctuating moods
Hides feelings
Acts like death never happened
Aggressive acting out
Withdrawal
Nightmares & sleep disturbances
Concentration difficulties
Changes in grades
Talks about physical aspects of illness or death	
Allow regressive behavior & offer comfort
Expect & accept mood swings
Encourage expression of feelings through writing, art, music, sports, etc.
Find peer support groups
Be available to listen and talk
Answer questions truthfully
Offer physical contact
Give choices about involvement in death
& mourning	

12 years and up (teenagers)	
Understands the finality & universality of death
Denial
His/her words, thoughts or actions caused the death
Thinks about life’s milestones without the deceased (graduation, marriage, etc.)
High death awareness (death may happen again)
May sense own impending death
I need to be in control of feelings
If I show my feelings, I will be weak
Internal conflict about dependence & desiring independence
May utilize spiritual concepts to cope	
Highly self-conscious about being different due to grief
Shock
Sad
Anger
Confused
Lonely
Vulnerable
Fear
Worried
Guilty
Isolated
Abandoned
Anxious	
Occasional regressive behavior
Mood swings
Hides feelings
Acts like death never happened
Acts out role confusion
Aggressive acting out
Withdrawal
Nightmares & sleep disturbances
Concentration difficulties
Changes in grades
Impulsive & high risk behavior
Changes in peer groups
Fighting, screaming, arguing
Changes in eating patterns	
Allow regressive behavior & offer comfort
Expect & accept mood swings
Allow hidden feelings unless there is risk of harm
Encourage expression of feelings through writing, art, music, sports, etc.
Support relationships with understanding adults
Be available to listen and talk
Answer questions truthfully
Share your grief
Watch for high risk behavior
Find peer support groups
Offer physical contact
Allow choices about involvement in death
& mourning