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Grief, Bereavement, and Coping With Loss (PDQ®): Supportive care - Patient Information [NCI] - Children and Grief

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Age 2-3 years

Children at this age often confuse death with sleep and may feel anxiety as early as age 3. They may stop talking and appear to feel overall distress.

Age 3-6 years

At this age children see death as a kind of sleep; the person is alive, but only in a limited way. The child cannot fully separate death from life. Children may think that the person is still living, even though he or she might have been buried. The child may ask questions about the deceased (for example, how does the deceased eat, go to the toilet, breathe, or play?). Young children know that death is physical, but think it is not final.

The child's understanding of death may involve "magical thinking". For example, the child may think that his or her thoughts can cause another person to become sick or die.

Grieving children under 5 may have trouble eating, sleeping, and controlling the bladder and bowel.

Age 6-9 years

Children at this age are often very curious about death, and may ask questions about what happens to the body when it dies. Death is thought of as a person or spirit separate from the person who was alive, such as a skeleton, ghost, angel, or bogeyman. They may see death as final and scary but as something that happens mostly to old people (and not to themselves).

Grieving children can become afraid of school, have learning problems, show antisocial or aggressive behavior, or become overly worried about their own health and complain of imaginary symptoms. Children this age may either withdraw from others or become too attached and clingy.

Boys often become more aggressive and destructive (for example, acting out in school), instead of showing their sadness openly.

When one parent dies, children may feel abandoned by both the deceased parent and the living parent, whose grief may make him or her unable to emotionally support the child.

Age 9 and older

Children aged 9 and older know that death cannot be avoided and do not see it as a punishment. By the time a child is 12 years old, death is seen as final and something that happens to everyone.

Grief and Developmental Stages

AgeUnderstanding of DeathExpressions of Grief
Infancy to 2 yearsIs not yet able to understand death.Quietness, crankiness, decreased activity, poor sleep, and weight loss.
Separation from mother causes changes.
2-6 yearsDeath is like sleeping.Asks many questions (How does she go to the bathroom? How does she eat?).
Problems in eating, sleeping, and bladder and bowel control.
Fear of being abandoned.
Tantrums.
Dead person continues to live and function in some ways."Magical thinking" (Did I think or do something that caused the death? Like when I said I hate you and I wish you would die?).
Death is not final.
Dead person can come back to life.
6-9 yearsDeath is thought of as a person or spirit (skeleton, ghost, bogeyman).Curious about death.
Asks specific questions.
May have fears about school.
Death is final and scary.May have aggressive behavior (especially boys).
Worries about imaginary illnesses.
Death happens to others, it won't happen to me.May feel abandoned.
9 and olderEveryone will die.Strong emotions, guilt, anger, shame.
Increased anxiety over own death.
Mood swings.
Death is final.Fear of rejection; not wanting to be different from peers.
Even I will die.Changes in eating habits.
Sleeping problems.
Regressive behavior (loss of interest in outside activities).
Impulsive behavior.
Feels guilty about being alive (especially related to death of a brother, sister, or peer).
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WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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