Children’s understanding of death and grief evolves as they grow. Preschool children (ages 2-4) often do not grasp the permanence of death and may believe that the deceased person or pet could return at some point. They may show grief responses by imitating the emotional reactions of adults around them, such as crying or withdrawing. Behavioral signs of distress, like tantrums, bedwetting, or separation anxiety, are also common (American Academy of Pediatrics [AAP], 2017). Providing reassurance, maintaining routines, and using clear, simple language to explain death is essential at this stage. Engaging in supportive activities like art, storytelling, or being involved in memorial rituals can help them process their feelings (AAP, 2017).

In middle childhood (ages 5-10), children begin to recognize death as permanent and universal, though they may still struggle with feelings of guilt, believing they caused the death through their thoughts or actions. Emotional responses in this age group can include sadness, confusion, anxiety, and physical complaints such as stomachaches or headaches (National Institute of Mental Health [NIMH], 2020). They may also experience behavioral regression, like thumb-sucking or withdrawal. It’s important to offer clear, truthful explanations and validate their feelings without minimizing their experience. Encouraging creative outlets like drawing or role-play can help children express and process their grief (NIMH, 2020).

Preadolescents (ages 10-12) have a more developed understanding of death but may still have trouble expressing their emotions, particularly if societal or gender norms prevent them from doing so. They may exhibit grief responses like withdrawal, irritability, or aggression, along with difficulty concentrating at school (AAP, 2017). Anxiety about their own safety or the safety of other loved ones is common. It’s important to allow preadolescents the space to grieve while reassuring them that their feelings are normal. Open, honest conversations about death, grief, and the afterlife, as well as opportunities for them to engage in peer support, can help them navigate their grief (NIMH, 2020).

By the time adolescents (ages 12-18) reach this stage, they understand that death is inevitable and permanent. However, the tumultuous nature of adolescence, marked by physical, emotional, and social changes, can complicate their grief response (American Psychological Association [APA], 2014). Teenagers may alternate between seeking peer support and withdrawing, often concealing their grief to avoid social stigma. Common grief responses include depression, anxiety, changes in sleep and appetite, and even risky behaviors (APA, 2014). To support adolescents, it is crucial to affirm their grief, provide them with a safe space for self-expression, and maintain an open dialogue about their emotions, acknowledging their complex needs during this stage of development.

References
American Academy of Pediatrics (AAP). (2017). Death and bereavement in children and adolescents. https://pediatrics.aappublications.org/content/early/2017/10/16/peds.2017-3385

American Psychological Association (APA). (2014). Adolescent development. https://www.apa.org/topics/adolescence

National Institute of Mental Health (NIMH). (2020). Childhood grief. https://www.nimh.nih.gov/health/topics/childhood-grief