To be sure, for most children before the age of five, death is still not a terrible force to reckon with. When they see a flattened cartoon character on TV get up and walk away, death remains reversible—and anyway, it’s something that does not necessarily happen to everyone.

A dramatic turning point, however, usually takes place between five and six. Now children begin to realize that when someone dies, there is no coming back; but they don’t believe it is supposed to happen until one is very old. Only after about age nine do youngsters understand death to be part of an inevitable biological process that anyone, not just the elderly, can go through at any time.

A child’s response to loss, whether of a pet, friend or family member, likely will be a function of age. The child’s emotional maturity, prior experience with death, and the quality of the relationship with the deceased are also important factors. While the best approach to take with a bereaved child should depend on the developmental level and life circumstances of that child, there are general principles that can be used as a guideline:

1.      Share, Don’t Hide Your Sadness. Parents and other relatives often try to hide their own sense of sadness and loss in order to protect children. But adults who attempt to cover up grief “for the sake of the child” perform no favor. Children can see when others are upset. Words cannot mask what lies in the heart, and when the two are dissonant, the signals can increase the mystery and fears surrounding death. It is comforting for children to know that the feelings they have are in line with those of the rest of the family. Sharing emotions can help children feel connected to other members of the household.

2.      Anticipate Children’s Reactions. Many children respond to death, especially of a parent or sibling, with a lacerating sense of guilt. Although this reaction seems strange, they may feel responsible for the death. They recall angry feelings they sometimes harbored toward the deceased, and can become convinced that their earlier hostile wishes have become reality—as if the wishes were equal to the deed. To help ease their feelings of self-blame, you can offer children down-to-earth information about the condition that caused the death. The information need not be clinically detailed, but without it, children may feel the self-blame. Sadness and fear in the face of death often can be expressed indirectly. Some children become angry. Others develop psychosomatic complaints and hypochondria. Still others may begin to show their anxiety through compulsive behavior and ritualistic acts, hoping that there is some way to return the deceased to life. Understand and accept these turbulent reactions for what they are—a predictable backlash to unspeakable grief.

3.      Foster a Sense of Continuity. The U.S. Institute of Medicine has reported that with the death of someone close, for many youngsters, “The belief that the world is a safe, predictable place may be destroyed, resulting in a disruption of a child’s capacity for basic trust.” When a parent dies, children need to feel that their own survival remains unthreatened. Assure them, in caring acts as well as words, that they will not be abandoned. In addition to receiving overt reassurances, children need to feel a continuing sense of order and routine in their day-to-day lives. Their psychological well-being often depends on the presence of familiar motifs such as getting up and going to school the usual way, playing in the Sunday soccer games, or having a friend sleep over on Friday nights. Such events testify in tangible terms that the world will continue to turn.

4.      Watch for Problem Symptoms. Like many bereaved adults, some children are rendered vulnerable by the death of a loved one. Their hitherto smooth course of development becomes rocky, and they seem unable to view the future with hope. For some youngsters the losses sustained in childhood can resound over the years, increasing their vulnerability to episodes of depression decades later. Some bereaved children display a number of disquieting patterns of behavior, such as:

a.      Anxiety about further loss

b.     Preoccupation with dying

c.      Desire for a reunion so strong that the child expresses the wish to die

d.     Strong resistance to forming new attachments

e.      Apathy and depression

f.       Drop in self-esteem

g.      Proneness to accidents

h.     Exaggerated clinging

i.       Absorption in daydreaming and inability to function in school

j.       New patterns of hyperactive, aggressive, or destructive behavior, and

k.      Stealing or other antisocial behavior that succeeds in gaining attention.

It is not unusual for grieving children to exhibit one or another of these reactions, which are not necessarily cause for alarm. It is when they form a pattern, are intense, and interfere with day-to-day functioning, that intervention by a professional therapist is necessary.

It is important to show confidence in children’s internal resources. In the long run, children often are more resilient than we give them credit for. While death is indeed part of the child’s kingdom, so is the capacity to adapt.

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This article first appeared in The Brown University Child and Adolescent Behavior Letter. Permission to copy was granted by Manisses Communications Group, Inc. P.O. Box 3357 Providence RI 02960