What Does Grief Look Like in Children and Teens?


How Young Children Grieve: Infancy through Elementary School

Often parents and adult family members believe that because their young children cannot understand death and grief on an adult level that young ones do not mourn the deaths of significant people in their lives. The truth is that if anyone is old to love, they are old enough to mourn. And with grief and the need to mourn in children of any age comes the need for security, reassurances that they are loved and will be taken care of, and freedom to express the grief emotions they are experiencing.

Talk with your children about the death and what they may be feeling in terms that are on their level of understanding. Use this information about grief in childhood and adolescence to provide a safe environment in which children feel supported and free to express their feelings without fear of judgment.

Infants and Toddlers (Birth to 2 year old)

  • Recognize absence of person despite inability to comprehend concept of death
  • Often experience insecurity, separation anxiety as result of loss and change
  • May protest by crying more than usual, becoming more irritable or demanding
  • May have changes in sleeping or eating patterns
  • Need more physical comforting, holding, rocking, nurturing
  • May show apathy, detachment, or withdrawal
  • May experience bladder or bowel disturbances
  • May experience temporary slowing of development or regression2 to 5 year olds
  • May initially seem unaffected by news of death (“Oh, can I go play now?”)
  • Perceive death as temporary and reversible
  • Use “magical thinking”; often create and believe magical explanations for death and fantasies about return of the deceased loved one
  • Need concrete explanations of death and its meaning (e.g. “the body stopped working”, “dead means never breathing, eating, talking, or moving again”)
  • Express confusion and emotion through art and play
  • May experience eating, sleeping, bladder, or bowel disturbances
  • May express somatic complaints (stomach aches, headaches, etc.)
  • Demonstrate “protest” in acting out behaviors (e.g. tantrums) or regression (return to bed-wetting, clinging, thumb-sucking, etc.)
  • Frequently have fears and separation anxiety following death
  • Take comfort in usual routines (meal time, play time, bedtime)
  • Deal with feelings in “approach-avoid” manner, demonstrating fleeting bouts of sadness, crying, anger, agitation
  • May openly talk about death, even to strangers
  • May talk about wanting to die to go visit deceased loved one6 to 9 year old
  • May use denial of death to cope
  • Still employ “magical thinking”, so may have difficulty understanding permanence of death at first
  • Often deal with feelings in “approach-avoid” manner, demonstrating fleeting bouts of sadness, crying, anger, agitation
  • Protest and anger shown in acting out behaviors and/or regression
  • May have difficulty expressing feelings or questions
  • Express emotion and confusion through art and play
  • Strongly attuned to grief/emotional responses of key adults in their lives; may reflect adult moods in their own moods
  • May experience intense fear of other attachment figures dying
  • School phobias and separation anxiety are not uncommon

How Older Children Grieve: Middle School through Adolescence

10 to 12 year olds

  • Better understanding of death intensifies shock and sadness responses
  • May experience school phobias and separation anxiety
  • May express somatic complaints (headaches, stomach aches)
  • May stop expressing grief to “protect” parents or siblings or to appear strong and “in control”
  • Need encouragement and opportunities to express feelings and memorialize
  • Tend to identify strongly with deceased loved one, adopting his/her habits, mannerisms, interests
  • Vulnerable to “parentification”, i.e. taking on adult roles to help grieving adult family members
  • Grief process complicated by early changes of puberty and associated developmental challenges

Adolescents

  • Grief complicated by intense challenges of adolescence (increased independence and responsibilities, physical changes, sexuality, identity development, etc.)
  • Abstract thinking skills allow more sophisticated understanding of death and spiritual issues
  • May experience fears about own mortality, or be in denial of this and try to prove immortality through reckless or risky behavior
  • May employ maladaptive behaviors to self-soothe and provide comfort (substance abuse, skipping school)
  • Commonly experience temporary decreases in school performance
  • May experience depression, guilt, and concerns about things said or left unsaid
  • Anger may manifest in tantrums, defiance, or withdrawal
  • Vulnerable to “parentification”, i.e. taking on adult roles to help grieving adult family members

    Signs of Complicated Grief in Children and Adolescents

The following signs may indicate that the grieving child or adolescent needs professional help:

  • Chronic or severe somatic symptoms (headaches, stomach aches, etc.)
  • Pronounced self-blame or guilt
  • Chronic or severe school problems, including skipping school
  • Ongoing Nightmares/sleep disturbances
  • Extreme regression (return to bedwetting, clinging, thumb-sucking, etc.)
  • Poor self-care
  • Excessive hopelessness
  • Extreme anger/hostility/violence or other extreme acting out/defiance
  • Social isolation/extreme withdrawal
  • Sudden change in friends/peer group
  • Intense separation anxieties or phobias
  • Apparent absence of grief or unwillingness to discuss the loss
  • Intense involvement in dating relationship to the exclusion of other friends or activities
  • Extreme negativity/gloom
  • Intense attraction to the topic of death, or fixation on the subject of death
  • Illegal activity/violating the rights of others
  • Substance abuse
  • Suicidal thoughts or plans

If your child or teen continues to be having difficulties in their grief, it may be time to seek help from  bereavement professionals in individual counseling or children’s support groups.

Posted by Larry M. Barber, LPC-S, CT author of the grief survival guide “Love Never Dies: Embracing Grief with Hope and Promise”  available online at Amazon (http://www.amazon.com/Love-Never-LPC-S-Larry-Barber/dp/1613796005 ), Barnes & Noble (http://www.barnesandnoble.com/w/love-never-dies-lpc-s-ct-larry-m-barber-ct-larry-m/1104364890?ean=9781613796016).

The grief survival guide is also available in Spanish as “El Amor Nunca Muere: Aceptando el Dolor con Esperanza y Promesa” 

Both English and Spanish versions are available for Kindle and Nook. Larry is the director of GriefWorks, a free grief support program for children and their families in Dallas TX  http://grief-works.org.

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About griefminister

Director, GriefWorks & CounselingWorks Licensed Professional Counselor Certified in Thanatology (Study of Death, Dying & Bereavement) by The Association of Death Education and Counseling Grief Therapist, Educator, Consultant Author-"Love Never Dies: Embracing Grief with Hope and Promise.'
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