Bereavement Reactions Of Children & Young People By Age Group

Key points about bereavement reactions in children and young people

Waiho i te toipoto, kaua i te toitoa. Let us keep close together not far apart (Māori Proverb).

• how any child or young person grieves when someone they love has died will depend on many things
• bereaved children and teenagers will need ongoing attention, reassurance and support 

How does a child or young person grieve?

How any child or young person grieves when someone they love has died will depend on many things, such as their:

• age
• gender
• developmental stage
• personality
• ways they usually react to stress and emotion
• relationship with the person who has died
• earlier experiences of loss or death
• family circumstances
• how others around them are grieving
• amount of support around them

Babies, children and teenagers may often seem unconcerned, playing or doing their usual activities, so adults can assume they are not properly aware of the death, or affected by it. They are, but in their own ways. Babies, children and teenagers tend to grieve in bursts, and at other times will look for reassurance and comfort in their normal routines and activities.

Bereaved children and teenagers will need ongoing attention, reassurance and support. 

How do babies and toddlers (0 to 2 years) grieve?

Babies and toddlers don't understand the concept of death. They can respond to a change in their environment. They will experience feelings of loss, abandonment and insecurity if a significant person is missing. They don't have the language to express how they are feeling and will pick up on the distress that is around them. 

It is common for extended family or friends to offer to look after children following bereavements. Babies, toddlers and young children benefit from staying as close as possible to their ususal caregivers. 

Common reactions

• increased crying and irritability
• being clingy - needing to be held more
• looking for the person who has died
• being anxious around strangers
• possible withdrawal - less interest in play or food (possible weight loss)
• regression in previously reached milestones

Ways to support

• hold and cuddle more - keep them close
• keep to routines if possible
• be calm around them and speak calmly to them
• provide comforters, favourite teddies or blankets etc

How do preschoolers (3 to 4 years) grieve?

Preschoolers find it hard to understand that death is permanent. They often develop an interest in the death of birds and animals are are developing an understanding that being dead is different from being alive. This age group has rich 'magical thinking' where they may think the person can become alive again or that they did something to make the person die.

Preschoolers have a very literal understanding and think in a very concrete way. It is important to use real words such as 'dead'. Euphemisms such as 'lost' or 'passed away' may cause misunderstanding and confusion.

Preschoolers can feel insecure and frightened when things change. They will need lots of reassurance that they will be kept safe and be looked after.

Common reactions

• crying more, clinging and being fearful
• looking or calling out for the person who has died
• tantrums, being irritable or stubborn
• withdrawal or showing a lack of response
• changes in eating or sleeping habits, less ability to play
• temporary regression (such as bedwetting, returning to crawling, wanting a bottle)
• having a sense of the presence of the person who has died)

Ways to support

• provide information (you can do this over time) and honest answers to questions
• keep routines
• talk about who is looking after them and keeping them safe
• support them with touch - hugs, encouragement, holding their hand etc
• keep close to familiar adults (you may notice anxiety even when being left with familiar adults)
• honestly explain death as a part of life using what they can see (use plats or insects as examples of death in nature)
• read children's books together about death and grief
• use words that describe feelings
• encourage creative play and exercise as an outlet for thoughts and feelings
• include them in doing something for the funeral (such as drawing a picture to put in the casket or on the service sheet)
• create a memory box together

How do school-aged children (5 to 12 years) grieve?

School-aged children gradually begin to develop an understanding that death is permanent and irreversible. Some children may still think that death is temporary or that the person who has died will feel things and be cold, lonely or hungry. Children increasingly become aware that death is an inevitable part of life and can become anxious about their own health and safety. They may be concerned that someone else they love may die.

Children may be interested in what has happened to the person after they have died, where they are now. They may ask blunt questions about what has happened to the person's body.

It is important to answer questions honestly and provide enough information so that children are not left with gaps in their knowledge. The risk of not enough information is that a child may fill this space with inaccurate information.

Children’s imagination and 'magical thinking' can mean a child may feel that their thoughts, words or actions caused a death. They may feel guilty.

Continuing to answer questions and explain death to this age group is important. Their understanding will be developed over time and they may need to revisit what has happened and ask the same questions many times to make sense of their experience.

Ongoing reassurance, love and affection is helpful.

Common reactions 

• blaming themselves for the persons death
• looking for or sensing the person's presence
• being distracted and forgetful
• having increased anxiety for their safety and the safety of people they care about
• not wanting to be separated from caregivers
• not wanting to go to school
• having physical complaints (such as tummy pain, headaches)
• may try to suppress their emotions to protect the adults around them
• withdrawal from usual activities
• being quiet or not showing a response to the death
• feeling strong emotional reactions such as anger, guilt or a sense of rejection
• behavioural issues (such as aggression, tantrums, defiance, getting into trouble at school)
• may try to please adults and take on adult responsibilities
• change in eating and sleeping habits
• temporary regression
• embarrassment around being different

Ways to support

• reassure your child they are safe and say who is looking after them (they may want to know who will look after them if you die)
• keep routine and normal boundaries around expected behaviour
• tell them that you know they are sad, use words to describe feelings
• keep separation from loved adults and caregivers to a minimum
• make time to listen to their thoughts and questions and answer honestly
• talk about death being a part of life, observe changes in nature and read books about death and dying together
• include them in planning for a tangi/funeral and talk about whether they would like to do something as part of the honouring of the person who has died
• make a memory box, scrap book, photo album together
• encourage play - this is a natural form of communication and an opportunity to process what has happened
• encourage exercise

How do teenagers (13+ years) grieve?

Teenagers understand that death is part of life.

Developmentally, they are in a time of big physical and emotional changes and may flip back and forth between younger age group type reactions and more adult reactions. Grief can have an impact on the developmental task of moving from dependence to independence, where young people move from family ties to increasing reliance on their peers. 

It can be difficult to ask for support while asserting independence. 

Teenagers may want to be with friends more than family for support. In some instances, teenagers will gravitate to their online gaming community for support and connectedness. This behaviour is a normal reaction! Having meal times at the family table may give you opportunities to 'check in' with your grieving teen. 

Keep in mind they may find the intensity of emotion overwhelming and may not be able to express what they are feeling.
Young people don't like to feel different and a bereaved teenager may feel socially isolated. They may want to feel and look as though they are coping while trying to manage or deny difficult internal emotions and feelings. To escape this level of discomfort some teens may use risk taking behaviour.

Common reactions

• difficulty concentrating, being easily distracted
• withdrawal, needing more personal space
• taking on adult responsibilities and become 'the carer' for those around them
• 'act out'
• isolation
• trying hard to please
• being overwhelmed by intense reactions such as guilt, anger or fear
• having difficulty expressing their emotions
• fearing for their own and others' safety
• having questions about mortality, death, dying and spirituality
• using jokes and humour to mask their feelings
• feeling embarrassed, hiding or minimising their loss
• wanting to be close to friends and family
• having physical symptoms (such as feeling sick, headaches, stomach aches)
• dreaming about or sensing the presence of the person who has died
• getting into trouble, being defiant, irritable
• eating or sleeping more or less than usual
• risk taking behaviour to escape, find comfort or to prove they are alive and strong
• temporary regressing (for example, losing self-confidence, bed wetting)
• having strained relationships
• having a change in self-image, lower self-esteem, confidence
• sadness may move to depression
• may have suicidal thoughts

Ways to support

• include them, be honest about what is happening
• talk about the death together
• be willing to listen and give regular opportunities to be available to answer questions
• acknowledge and share your feelings and let your teenager know that you understand it is hard for them
• if they don't want to talk to you, leave helpful information around the house
• talk about grief, what is normal and how everyone grieves differently
• ask for support from extended family, friends, teachers, GP - ask other adults to be available and check in with your teenager
• keep routines, where possible
• avoid expectations of adult behaviour
• praise and encourage them
• seek professional help if you are concerned

What do bereaved children and teenagers need?

Bereaved children and teenagers will need ongoing attention, reassurance and support. It is not unusual for grief to resurface later on, even well after the death. This can happen as they move through different life milestones, and develop as individuals.

It's important to remember that grief takes as long as it takes. Navigating though grief is not only a personal process but a family one as well. Create meaningful events and anniversaries with your family that will help children continue to process and make sense of their loss as they continue to grow.   

What should I do if I'm worried about my grieving child?

If you are concerned about any extreme reactions, or if you think your child or teenager may have become depressed, contact your doctor or other trained adviser, such as a counsellor, senior staff member from their school, social worker, community or youth worker or a local family support agency.

You can also read more information about supporting children, parents and whānau experiencing grief

See the KidsHealth's section on emotional and mental wellbeing