Concept of Death

During the middle years of childhood, children are just starting to understand that death is universal, and permanent. Oftentimes during the middle years, children believe their thoughts and feelings caused the death of another person/pet. For example, they may believe that because they were angry with someone and “wished they would die”, that this caused the death. They may believe that death is a form of punishment and worry that they will be punished similarly for their actions. Children may also connect events in distorted ways. They might believe they caused the death because they spoke with, or ate lunch with a loved one/pet on the day/week/month etc., they died, and that this caused the death.

Children on this age group often worry that the deceased person or pet is feeling sad, lonely, cold or afraid and in pain.

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Grief Response

This age group spans many years and there are many developmental differences across these years. In general though, this age group is starting to recognize that there is a difference between life and death; yet it is not unusual that some children may regress and believe that a deceased person or pet/other may return to life at some point or under certain conditions. They may search for them and ask when they will be returning despite having been told that the deceased will not be returning. They are likely to respond to the emotional reactions of trusted adults and caregivers as deeply as they respond to the loss itself. For example, if they observe adults crying, they are more likely to cry themselves.

This age group may show a fascination with death, or may believe their actions led to the death. They may spend time trying to figure out how they might have been able to prevent the death.

The most common grief responses are sadness, guilt, crying, confusion, anger and changes in eating and sleeping. They may worry that they will lose other people and/or pets whom they love.

When things change in the lives and routines of this age group, they feel afraid and insecure, and may be anxious to be apart from close trusted adults and siblings. They may present responses such as experiencing bad dreams, bedwetting, meltdowns and tantrums, thumb sucking and withdrawal. It is not unusual for these children to demonstrate changes in their behavior such as outbursts of anger, aggression, and an inability to focus on conversations and tasks at hand.

Other children in this age group might show no outward grief responses and act as though the death had not occurred. While they appear to be going about as usual, it is likely that they are in too much emotional pain to acknowledge, respond to, and process it.

Other expressions of grief include:

Being distracted in class, and having a hard time staying focused.
Regression to more childlike behaviors
Experiencing strong emotions of guilt, anger and fear.
Anxiety and depression
Physical symptoms including headaches, fatigue, gastrointestinal issues, aches.
Changes in sleeping and eating
Changes in behavior (defiance, aggression, withdrawal, clinginess)
Regression in academic performance
Apathy
Withdrawal
Interest in death

Ways to Support

Do not expect these children to be able to talk about their feelings. They may not have the vocabulary or self awareness
Be close, and avoid unnecessary separation if you see anxiety
Affirm that they are safe and will be looked after by (name of caregiver (s)).
Validate their feelings and grief responses
Talk with them openly and honestly about loss, grief, death, the afterlife (anything they want to talk about)
Let them ask questions and answer them honestly
Allow opportunities for creative play/art/acting about the death

Return to Grief in Preschool Children (2 - 4 yrs)

Proceed in Preadolescents (10 - 12 yrs)