Children’s Developmental Stages: Concepts of Death and Responses to Grief
Each child is unique in his or her understanding of death and response to grief. This understanding is largely influenced by the child’s developmental level and chronological age. But remember that there can be tremendous overlap among age groups because children move from one developmental level to another at very different rates.
Infancy to Age 2
Concept of Death
Babies do not have the cognitive capability to understand an abstract concept like death. They function very much in the present. When someone significant dies, babies are more acutely aware of loss and separation. They react to the emotions and behaviors of significant adults in their environment and to any disruptions in their nurturing routine and schedule. If there is a sudden change, they feel tremendous discomfort.
Babies may search for the deceased and become anxious as a result of the separation. Common reactions include: irritability and protest, constant crying, a change in sleeping and eating habits, decreased activity and weight loss.
Preschool Age (2-4)
Concept of Death
“When will my mommy be home?”
“How does (the deceased) eat or breathe?”
Preschool children do not comprehend the concept of “forever.” For this age group, death is seen as temporary and reversible. Even when a preschooler is told that Mommy is not coming back, for example, he or she may ask an hour later where mommy is.
They do not usually visualize death as separate from life, nor as something that can happen to them. Preschool children love to play “peek-a-boo” games where adults in their life disappear and then reappear again. It is through these games that they slowly begin to understand the concept of “gone for good.”
Because preschoolers tend to be present-oriented, their grief reactions are brief but can be very intense. This is the developmental stage where children are learning to trust and form basic attachments, so when a significant adult in their life dies, they become very concerned about separation and altered patterns of care. Children this age typically have a heightened sense of anxiety concerning separations and rejections because they don’t yet have the capacity to use fantasy to gain control over what is happening. [i]
They also respond to the emotional reactions of adults in their life. If they sense their parents are worried or sad, they may cry or have a tantrum, either because they are concerned or as a way to distract their parents from difficult emotions. Typical grief responses of the preschool child include confusion, frightening dreams and night agitation, and regressive behaviors such as clinging, bed wetting, thumb sucking, inconsolable crying, temper tantrums and even withdrawal from others. They may search intensely for the deceased despite assurance that that person will not return. They may exhibit anxiety toward strangers.
Early Childhood (4-7)
Concept of Death
“It’s my fault. I was mad at my mother once and I told her I wish she would die and then she died.”
“The roadrunner in the cartoon always comes back to life, so I know Daddy will too.”
As with preschoolers, this group views death as temporary and reversible. They sometimes feel responsible for the death because they believe that negative thoughts or feelings they have had about the deceased caused his/her demise. This “magical thinking” stems from the belief that everything in their environment revolves around them and that they can control what happens. Even when children at this age are exposed to death through the media or at school, they still may believe that if you are careful enough you can avoid death.
Children at this age may also connect occurrences that do not have anything to do with each other. If a child bought a certain toy the day that her sister died, she may attribute the toy to causing the sister’s death, especially if the real cause of the death is not fully explained to her.
As with preschoolers, this age group may repeatedly search for the deceased or ask where he/she is. Repetitive questioning about the death process is also common. “What happens when you die?” “How do dead people eat?” They will often express their grief feelings through play instead of verbally. Themes of family loss and death may surface as they play with dolls or action figures. They may play act the death itself or the funeral.[ii]
Sometimes children at this age appear unaffected by the death and act as if nothing happened, but this doesn’t mean that they are oblivious OR that they have accepted the death. It may signify their inability in the moment to acknowledge very painful reality. They may model their grief reaction after adults in their lives who are feeling uncertain how to express grief feelings. Other typical responses include anger, sadness, confusion and difficulty eating and sleeping.
As with preschoolers, this age group may regress as a way to receive more nurturance and attention during this difficult time. Children who have experienced a loss at this age tend to be fearful that other loved ones will leave them as well. Sometimes they form attachments to people who resemble the deceased in some way.
Middle Years (7-10)
Concept of Death
“Do your fingernails and hair keep growing when you die?”
“If I smoked cigarettes, would I die?”
This age group may want to see death as reversible, but they begin to see it as both final and universal. Children in this age group sometimes visualize death in the form of a tangible being such as a ghost or boogeyman.[iii] They are very curious about the details of death, cremation and burial and may ask candid questions.
Even though they know death can happen to anyone and that there are many things that cause death, they still do not typically think of death as something that can happen to them or their family members, but instead to only old or very sick people. They may believe that they can escape from death through their own efforts. They also might view death as a punishment, particularly before age nine. Sometimes they are unable to comprehend how the death will affect their life, which can become a source of anxiety.
Children in the middle years often become concerned with how others are responding to the death as they become less focused on themselves and more on others. They may fear that other loved ones will die as well. Sometimes they may become overly concerned about their own health and may fear bodily harm and death.
Some children in this age group may act out their anger and sadness and experience difficulties in school due to a lack of concentration. On the other hand, they may have a jocular attitude about the death, appearing indifferent, or they may withdraw and hide their feelings. Other typical responses include shock, denial, depression, changes in eating and sleeping patterns, and regression to an earlier developmental stage.
This age group tends to have more coping strategies available than younger children and may fantasize how they would prevent the death from happening again as a way to gain control over the situation. Death is also play acted in children at this age, for example, through war games, especially for those children who have difficulty expressing feelings verbally.
Children in this age group may assume the role or the mannerisms of the deceased. They may also take on tasks or chores normally performed by the deceased, such as care for their siblings. They may idealize the deceased as a way of maintaining a bond with them.
Concept of Death
“None of my friends could ever relate to what it’s like losing their dad.”
“I know that Grandma is not coming back and I will miss her. I don’t understand why my mom is so upset about it.”
Pre-adolescents conceive of death in much the same way as children in the middle years, with a few additions. Pre-adolescents are in the process of establishing their own identity, increasing their independence from their parents and other adults and increasing their dependence on their peer group. In understanding death, pre-adolescents attempt to understand both the biological AND emotional process of death. They are, however, more able to understand the facts surrounding the death of someone than they are the feelings surrounding the death.[iv]
It is common for pre-adolescents to want to cover up their feelings about their loss so as not to appear “different” from their peer group. They fear that expressing sad feelings may be seen as a sign of weakness (particularly for boys). For this reason, they may seem removed and indifferent.
They also may express their grief feelings in uncharacteristic ways such as through anger outbursts, irritability and bullying behavior. Feelings may also be exhibited through physical complaints, moodiness, changes in sleeping and eating patterns, indifference toward schoolwork, or isolation from their peers.
They may show concern for practical issues after the death, such as how the household will survive without the deceased or how they personally will be taken care of. They also might have questions regarding religious and cultural beliefs related to death.
[i] Atle Dyregrov, Grief in Children: A Handbook for Adults (London: Jessica Kingsley Publishers, 1990), p.43.
[ii] Wiliam C. Kroen. Ph.D., LMHC, Helping Children Cope with the Loss of a Loved One (Minneapolis: Free Spirit Publishing Inc.), p.41.
[iii] Helen Fitzgerald, The Grieving Child (New York: Simon & Schuster, 1992), p.56.
[iv] Theresa Huntley, Helping Children Grieve (Augsburg: Augsburg Fortress, 1991), p. 17