February 2021

R U AWARE?

YOUR MONTHLY DOSE OF TRAUMA-INFORMED KNOWLEDGE

Supporting Grieving Children

 By: Melissa Donadio, M.A.

Children between the ages of two and six-years-old are in the Preoperational developmental stage (Piaget, 1971), during which they are likely to view death as temporary. They believe that the person is coming back and may spend time wondering about what the dead do or engage in fantasy thinking (APA, n.d.). It is important to explain to children in this age range that death of the physical body is permanent, which can be done by avoiding euphemisms like “went to sleep” or “passed away” as these can cause additional confusion. Children in this age range are likely to feel sadness, but these emotions are displayed in between periods of normal playing behavior (Good Grief, n.d.). They may also experience nightmares, fears of separation, and may begin to display earlier behaviors such as thumb sucking or bed wetting (Good Grief, n.d.). It is common for children in the Preoperational developmental stage to ask when a loved one is coming back. Caregivers can assist the child by answering questions in a calm manner and repeating information as often as necessary (APA, n.d.). Further, caregivers should provide a structured daily routine and offer reassurance in a loving manner.

Between the ages of six and ten-years-old, children are in the Concrete Operational stage of development (Piaget, 1971). Children in this stage may display an avid interest in death, which is often demonstrated in their behaviors (APA, n.d.). For example, children may be pre-occupied with ghosts, cemeteries, or other cultural images related to death (Schonfeld, 1993). They may also display aggression, possessiveness over a caregiver, exaggerated fears, or a phobia of attending school (Good Grief, n.d.). In this stage, children also begin to understand that death of the physical body is permanent, which can be a distressing experience. Children may develop a fear of death or others dying, or they may blame themselves for a death and experience feelings of guilt (Good Grief, n.d.). To best support these children, caregivers can reassure the child that they had nothing to do with the death they are mourning, validate feelings of love, and assist them in expressing feelings in appropriate ways such as drawing or writing (Good Grief, n.d.).

Moreover, children in adolescence are in the Formal Operational stage of development (Piaget, 1971), during which they can understand adult concepts related to death, such as religious or cultural components and existential issues (Schonfeld, 1993). They recognize that life inevitably ends, which can lead to fears or worries about their own death, and they may question religious and philosophical beliefs (Good Grief, n.d.). Additionally, adolescents may tend to take a protective role over other loved ones and may avoid discussing a death to not upset them (APA, n.d.). It is also common for adolescents to wish to fit in with their peers, so they may act as if they are not grieving. Other common responses to adolescent grief include anger, aggression, somatic complaints, increased risk taking, or defiant behaviors (Good Grief, n.d.). To support adolescents who experienced a death of a loved one, caregivers should be as open as possible, allow opportunities to grieve in a safe space, and assist in learning to manage feelings in a healthy manner.
Regardless of which developmental stage a child is in, there are a few main concepts that all caregivers can utilize to assist children coping with the loss of a loved one. First, it is important to remember that grief is normal and expressed differently in all people, so caregivers should modify their expectations to meet the needs of each individual child (Good Grief, n.d.). Additionally, caregivers should acknowledge that children of all ages can feel alone during the grieving process, so it is beneficial to maintain routines and consistency, which provide a sense of security. Caregivers should also be direct and answer questions honestly to avoid confusion and promote openness in their relationships (Ehmke, n.d.). Moreover, caregivers should pay attention to their own emotions, which can model appropriate expressions of grief for children. Lastly, caregivers should consult with a doctor or mental health clinician if they notice a child is not recovering from loss in a healthy manner (Ehmke, n.d.).

Resources

• National Alliance for Grieving Children: https://childrengrieve.org/
• The Dougy Center, The National Center for Grieving Children and Families: https://www.dougy.org/grief-resources/
• Child Mind Institute: https://childmind.org/guide/helping-children-cope-grief/
• Good Grief: http://good-grief.org

References

 American Academy of Pediatrics, (n.d.). Resilience in the face of grief and loss: A curriculum for pediatric learners. Retrieved from: https://www.aap.org/enus/Documents/Understanding%20Grief%20and%20Loss%20in%20Children%20Discussion%20Guide.pdf

Ehmke, R. (n.d.). Helping children deal with grief. Child Mind Institute. Retrieved from: https://childmind.org/article/helping-children-deal-grief/

Good Grief. (n.d.) Grief in Developmental Stages. Retrieved from: https://good-grief.org/wp-content/uploads/2017/04/Grief-in-Developmental-Stages.pdf

Good Grief. (n.d.). Tips for Supporting Grieving Kids. Retrieved from: https://good-grief.org/wp-content/uploads/2017/04/10-Tips-for-Supporting-Grieving-Kids.pdf

Piaget, J. (1971). The theory of stages in cognitive development. In D. R. Green, M. P. Ford, & G. B. Flamer, Measurement and Piaget. McGraw-Hill.

Schonfeld, D. J. (1993). Talking with children about death. Journal of Pediatric Healthcare, 7(6), 269-274. doi: 10.1016/S0891-5245(06)80008-8