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Questions and Answers about Children’s Grief ....PARENT & TEACHER SHEET
What is grief?
Grief is the normal, but difficult, response to a loss. Grieving occurs as a child comprehends
and accepts the finality of a death, and adapts to the consequences of the loss.
While the death of a family member or fri end usually causes the most in tense grief, children
may grieve other types of losses. Some of these include their parents’ divorce or separation, a
move or relocation, the ending of a friendship or important relationship, the death of a pet, or
experiences of illness or disability. School-age children’s coping with loss can be influenced by
the responses of their peer group and adults in their educational setting. As a teacher, being
informed about children’s grief is an important step in support ing them (Shear & Sha ir, 2005;
Zisook & Shear, 2009).
Are there certain tasks grieving children must do to work through their grief ?
Everyone grieves differently, and there is not one “best” way to grieve. There are some specific
challenges, however, that chil dren will need to manage as they gradually accept and adjust to a
loss (Goldman, 2000; Baker, Sedney & Gross, 1992). Adults can help them with these challenges.Understanding
Children must understand what has happened, to the exten t allowed by their developmental
stage. Children’s understanding of death is also influenced by the reactions of family members,
family spiritual and cultural beliefs, and history of loss. Even when death is explained in
simple language, young children will often repeat the same questions many times as they try to
understand. Children of all ages will need many opportunities to ask quest ions.
Grieving
Children need the chance to feel and express the emotions that accompany a loss. These may
include sadness, anger, worry, guilt, relief and many others. Sometimes children will protect
their parents from their feelings until they sense that the adult s can handle them. Sometimes
children are afraid to experience intense feelings and work hard to keep those feelings at arm’s
length. It i s important that chil dren have safe out lets to express their feelings and can gri eve
freely, but i t’s also essential that they don’t fee l pressured to express or focus on fee lings that
may be overwhelming.
Adjusting to Changes
Children have to adjust to living without the deceased. This is particularly hard when a child
loses a family member or close friend because day-to-day life will certainly change. Children
may need help in developing new routines, finding new people to provide the things that the
deceased did in the past, or under standing the r eactions of other people affected by the loss.
Commemorating
Children need ways to continue to remember and feel connected to someone who has died.
Privately, a child may find a way to talk to the deceased, or imagine them in a part icular
location, or carry f orward values that were important to the deceased.
©2011 LIVESTRONG is a registered trademark of the Lance Armstrong
Foundation. The Lance Armstrong Foundation is a 501(c)(3) under federal
tax guidelines.
Participation in public ceremonies and ri tuals can al so be benef icial to children as they grieve.
Rituals can provide children with comfort, a sense of belonging to a larger, caring community,
and a way to see how different people express feelings about a loss.
It is often helpful for children to attend funerals, if certain conditions are met in advance.
Children should be prepared for what they will see and hear, know that the y can express
themselves and how others are likely to do so, have a safe adult to talk and sit with, and have a
plan for how to exit early if they feel overwhelmed. Other opportuni ties to memorialize someone
include participating in a r emembrance service, planting a tr ee, writing a letter, telling a story,
creating a memory box, or s imply visiting a special spot that reminds the child of the deceased.
Going On
An important part of grieving is going on wi th day-to-day living. Adjustment to a loss involves
alternating between paying attention to sadness and how much a person is missed, and paying
attention to things that ar e pleasurable and satisfying. It he lps to remind children that it is good
for them to play, laugh and love again, and that i t’s what the deceased would have hoped for.
What does grief in children look l i k e ?
Children definitely experience grief when they are faced with the recent death of a loved one.
Yet their grief may be overlooked or misunderstood because it can appear so different from
an adult’s gri ef. Grieving children have many of the same feelings as adult s, such as sadness,
anger, worry and guilt, and at times, their feelings may be as intense. However, children’s
strong negative feelings do not tend to last as long at any given time. Their distress may come
out in reaction to small frustr ations, like trouble doing homework, rather than to a reminder of
the death. Children may also feel strong positive emotions more quickly after a loss than many
adults. As a result, they may appear unconcerned or even callous to people who see them when
they are focused on an engag ing activity or having fun.
The child’s developmental stage, temperament and relationship with the deceased are some
of the most significant things that can affect how a loss is felt and expr essed. Other factors
include how the child learned of the death, whether there were opportunities to say goodbye,
the child’s experience at a funer al or o ther ritual, history of loss, mental health st atus, and
other stressors. Children of all ages may worry that since one person has di ed perhaps others
will die too.
How children’s grief feels and looks also depends on the recency of the loss. In the beginning,
a loss may be extremely painful. As time passes, a child usually feels less pain and does not
think about the loss as much. This doesn’t mean that the chil d has st opped caring about the
loved one. Instead it shows the child’s resiliency and means he or she is coming t o terms wi th
the fact that the loved one is gone and cannot return. The child is finding a way to adapt to the
changes that r esult from the loss. As children mature, they become capable of understanding
loss in different ways. They must also manage the new w ays the loss impacts their everchanging
lives. They may have to repeat the process of adapting to and coming to terms with
the loss again and again. Thus, grief is not something that i s ever really “completed.”
©2011 LIVESTRONG is a registered trademark of the Lance Armstrong
Foundation. The Lance Armstrong Foundation is a 501(c)(3) under federal
tax guidelines.
How do children at different developmental stages deal with death? How dop they grieve?
Children are old enough to grieve a loss if they are old enough to experience attachment.
Preschool
Very young children are beginning to understand the world outside of themselves, but their
cognitive, emotional and language skills are still developing. They think in concrete ways and can
be confused by some common explanations of death. For example, a five-year-old who was told
that his father had gone “to live in Heaven, up in the sky ,” expressed his wish to become a pilot
so that he coul d visit him. Another preschool-age child was told that “just the body” gets buried
in a cemetery because the spirit goes to Heaven. She asked later, “What happens t o the heads?”
Preschoolers’ belief that the ir own wishes and thoughts can make things happen in the world
may cause them t o worry that a death is their fault. Adults need to listen for those kinds of
worries and reassure children that no one’s thoughts caused the death. Young children may also
struggle to understand the idea of someone being gone “forever” and may ask when the deceased
will come back. They may ask the same quest ions over again as they seek to understand what
has happened. Simple and repeated explanations are what they need t o hear. Preschoolers may
also have trouble sustaining their newest accomplishments, like using the toilet, separating
easily from a parent in the morning, or using words, not hands, to deal wi th conflicts.
Elementary School
Children in elementary school tend to think about things in concrete, literal ways, and it can
be difficult for them to understand abstract concepts or euphemi sms such as “taken by the
angels,” or “moved on.” They, too, are helped by hearing simple explanations of what happened
and why, and by being given the chance to ask whatever questions they want. Sometimes
questions from this age group sound insensitive, even gory; for example, children may wonder
about what happens to a body after death. Usually these questions show that they are trying
to make sense of what happened by “getting the story straight.” Even at thi s age, children
sometimes worry that they did something to cause a death so it is helpful for adults to check in
and ask them, “What do you think happened?”
Elementary school-age children may feel a wide range of emotions, including sadness, worry
about other loved ones, anger that the loss feels so unfair, and sometimes relief and guilt.
Like all grieving children, they will need extra support and love as well as a sense that life
is returning to normal as much as possible. Staying busy is one of the most common ways
elementary-age children manage their difficult feelings so giving them a lot of opportunities
for physical and cr eative activities is helpful. Adults can also help children find comfortable
settings in which to express their feelings and reassure them that their feelings will get easier
with time. Peer groups, like a “lunch bunch,” can be he lpful as can identifying a safe adult
at school that the child can go to for support. Because chil dren often experience feelings
physically—like getting frequent headaches or st omachaches—the school nurse is an important
member of the support team.
©2011 LIVESTRONG is a registered trademark of the Lance Armstrong
Foundation. The Lance Armstrong Foundation is a 501(c)(3) under federal
tax guidelines.
Middle School (Early Adolescence)
Middle school is a time of great emotional, cognitive, spiritual and physical growth for
children. Typically they are quite mature in some areas but immature in others. Since children
develop at such different rates, there can be a l ot of variation in how gri ef is expressed in early
adolescence. Middle school children understand that death is final and may fee l overwhelmed
by strong and often conflicting emotional reactions. They may be fearful about showing str ong
emotions in front of peers and of being treated differently after a l oss. Because children at this
age want to feel more independent, the natural dependence that gri ef reactions can precipitate
can be hard to handle. Although they may want support from adults, they may worry about
being seen as “childish.” At school, they should be ab le to seek adult s for support in a private
and confidential way.
Middle school-age children are well-known for being influenced by—and wanting to fit in with—
their peers. They may feel isolated from non-grieving peers, or worry that the ir way of grieving
is “wrong.” Participating in a support gr oup with other grieving middle school children can be
very helpful.
High School (Adolescence)
Adolescents in high school may struggle with many of the same concerns as middle school
students, but wi th increased pressure to appear independent and in con trol. Their responses
can sometimes look like those of a mi ddle-schooler, and other times seem very adult. Under
stress, teenagers may be able to sound mature (i.e. “t alk the t alk”) but behave in ways that are
selfish or insensitive (i.e. not “walk the walk”). Adolescents’ growing ability to consider abstract
ideas may allow them to grapple for the first time with questions about justice, spirituality,
the meaning of suffering and the purpose o life. They may struggle to handle the intense and
powerful emotions associated with grief and may have more difficulty distracting themselves
from these feelings than younger children do. Extreme feelings of sadness, loneliness and anger
are common reactions for this age group. Adults can help by talking honestly about their own
grief responses and what works to manage them.
Teens in this age group continue to be self-conscious and concerned about how their peers
view them. They can be vehement about not wanting to be pitied. They may withdraw from
their family members as they seek support from people outside of the family. A positive peer
group should be respected, bolstered and supported. Adolescent grief groups are ideal for those
willing to attend, as the young person may also feel isolated from non-grieving peers. Since
a loss can impact how adolescents weigh upcoming life decisions—such as going away to
college—it is important for adults to be open to talking frankly about the practical effects of a
loss without making the adolescent feel selfish for wondering.
Teens sometimes engage in risky or dangerous behavior as they struggle with the developmentally
incongruent reality that death can occur to those they love. Risky behavior may be a way to
seek help without having to ask directly for it and shoul d be addressed quickly.
©2011 LIVESTRONG is a registered trademark of the Lance Armstrong
Foundation. The Lance Armstrong Foundation is a 501(c)(3) under federal
tax guidelines.
What are some grief reactions in children and adolescents ?
Behavioral Emotional Physical Cognitive Spiritual
Crying Sadness Weight gain/loss Shock/disbelief
Questioning God or spiritual faith
Changes in sleep patterns
Anger Headaches
Hypervigilance
Searching for meaning of life
Loss of appetite/ change in appetite
Guilt Stomachaches Nightmares Anger at organized religion/God
Change in school performance
Anxiety, fear, panic
Fatigue, exhaustion
Difficulty concentrating
Feeling loss of purpose
Withdrawal Sense of responsibility
Gastrointestinal symptoms
Loss of focus/short attention span
Fear of religion/ God
Risky behaviors Loneliness Chest pains Confusion Re-purposing life
Avoiding reminders of the person or the loss event
Feeling abandoned
Shortness of breath
Preoccupation Depression
Irritability/ agitation
Feeling shut down
Changes in blood pressure
Worry
Clinginess Numbness Dizziness/fainting/ light-headedness
Obsessive
thoughts about the deceased or dying
Relief Numbness Heightened/ lowered alertness
Dramatic emotional swings
Unexplained pains/aches
Disorientation
Nausea Daydreams
Sense of visitations/ conversations with the deceased
Trouble withmemory
©2011 LIVESTRONG is a registered trademark of the Lance Armstrong
Foundation. The Lance Armstrong Foundation is a 501(c)(3) under federal
tax guidelines.
What are signs that my child may need additional aupport?
Although extremely painful at the beg inning, grief usually gets easier with time. Grief does not
automatically lead to depression. If there is concern that a child is depressed, it is important to
seek help for the child and not simply assume that t ime will make things be tter. Similarly, grief
may contribute to whatever problems a child exhibits, but may not be the only, or even primary,
cause. Teachers can help children by continuing to think broadly about what may affect their
functioning—for example, considering the possibility of an undiagnosed learning disability in
regards to a chil d’s classroom performance.
Red flags indicating a child may need more support include:
• A persistent change or difficulties in the child’s functioning in two or more arenas (home,
school or wi th peers)
• Any self-harm, increased risk-taking or substance abuse
• Any symptoms that in terfere significantly with the child’s usual funct ioning for more than a
few weeks
What can I s ay t o a gr i e v i ng ch i l d ?
• “I am so sorry that y our father died.”
• “I will be ri ght here to listen no matter what y ou are feeling.”
• “Tell me what we can do to help you feel supported in class.”
• “Who can you talk to about thi s?” (Ask about bo th adults and o ther children.)
• “I really care about you.”
• “Would you like to talk to other kids who have gone through a loss?”
• “It’s really hard to believe right now, but this won’t always feel so, so har d.”
How can I support a grieving child?
• Acknowledge their loss honestly.
• Provide unconditional love and support.
• Maintain normal routines as much as poss ible.
• Identify non-death l osses as well as death l osses.
• Allow ample time for grief responses.
• Accept that chil dren may not want to talk about gri ef.
• Anticipate anniversary reactions and long-term expressions of grief.
• Ask children what they would like to do on holidays like Christmas, Mother’s Day, and
Father’s Day.
• Reflect feelings without judgment.
• Allow them to express their feelings, including the ones that may be har der to understand
such as gu ilt, relief and anger.
• Stay present with the chil d for an extended peri od of time.
• Create opportunities for peer support whil e recognizing some chil dren’s wish for privacy.
• Assess for signs of depression, suicide, post-traumatic stress, or di fficulty coping.
• Seek out p lay therapy, art therapy, and/or expr essive therapies.
• Recommend counseling and support ive services, including children’s grief groups.
• Consider the chil d’s overall web of support: family, friends, teachers, clergy, coaches and
professionals.
©2011 LIVESTRONG is a registered trademark of the Lance Armstrong
Foundation. The Lance Armstrong Foundation is a 501(c)(3) under federal
tax guidelines.
What can schools do to help the grieving child?
• Identify safe adult s such as schoo l social workers/counselors who have training in chil dren’s
grief that chil dren/adolescents can t alk with. Be very specific about who these adult s are, and
create socially safe ways for children to access the counse lor. For example, the soc ial worker
could meet with every child once, or wi th everyone in a gr oup, not just the chil dren who are
“identified.” This reduces the st igma of grief.
• Start a chil dren’s grief group in the schoo l for children who have experienced any loss.
Sometimes a l ocal non-profit agency or hosp ice will l end staff to run such a gr oup if the
school does no t have adequate personnel.
• Teach about l oss/illness as a normal part o f life through the use o f books that di scuss loss,
during teaching about sc ience and the li fe cycle, and in the st ories that ar e used in the
classroom to illustrate other skills. However, be sens itive to the ways such discussions are
affecting any children who have experienced a l oss.
• Prepare classmates for the return of an ill or bereaved classmate by letting them ask questions
of a professional—either a teacher, nurse or soc ial worker—before the chil d returns to the
class. Also try t o learn about and r espect the bereaved child’s wishes regarding how much,
and when to talk about the s ituation.
• Talk about death/dying whene ver the opportuni ty arises.
• Have an emergency crisis plan for small and l arge incidents that everyone in the schoo l
understands. Sometimes this requires enlisting support from other professionals in the
community if the schoo l personnel are also grieving.
• Allow school personnel to model normal grieving responses by showing the ir emotions and
naming them.
• Create educational opportunities for personnel to learn about chil dhood grief at the beg inning
of the schoo l year and during educat ional development days.
• Use art/creative writing to allow children to express loss reactions. Children can make
memory boxes, write letters to family members of the deceased, and cr eate pictures/memories
of their friend, classmate or family member.
• Allow children to write letters, cards, etc., to a grieving classmate or family.
• Create memorial awards or scho larships in honor o f deceased.
• Enlist children’s ideas of ways to remember and honor the deceased, indiv idually and as a
school.
• Train personnel to identify signs of depression and suicide.
• Help the chil d cope wi th the r esurgence of pain, particularly likely around anniversaries and
his or her de velopmental milestones.
©2011 LIVESTRONG is a registered trademark of the Lance Armstrong
Foundation. The Lance Armstrong Foundation is a 501(c)(3) under federal
tax guidelines.
What can a teacher do to help a grieving child i n the classroom?
• Work with the parent, child and school counselor to identify a safe p lace the child can go
to when feeling overwhelmed in class (i.e. the counse lor’s office, library, another favorite
teacher). Many children develop a s ignal with their teacher to notify him or her when the y
need to go t o their safe p lace. This may be a no te or subt le gesture.
• Be aware of the chil d’s level of comfort in sharing inf ormation with the c lass. Many children
feel very supported by class cards while others are extremely uncomfortable with everyone
knowing about their loss or wi th it being brought up t o the en tire class in front of them. Also
understand that a chil d’s preference for this may change.
• Take note if the chil d is struggling to answer questions that peer s may ask about the l oss.
Reassure him or her that i t is okay to tell friends, “I don’t w ant to talk about i t today,” and
remind the chil d of who they can t alk to if they need t o.
• Maintain classroom routines and expect ations. Many bereaved children feel further
stigmatized when they are not held to the same expect ations as the ir peers in turning in
assignments and f inishing projects. Some may need the extr a time or support but st ill need
limits and deadlines.
• Realize that some chil dren may not acknowledge the l oss at all whil e they are at schoo l,
making it their safe p lace of routine and r egularity. Share these observations with the parent
or school counselor.
• Create ritual within the c lassroom for all kinds o f losses: This could look like a c lass worry
jar that the chil dren add to when they need t o get rid of a worry at the beg inning of class;
a paper tr ee with paper leaves where children could write down major changes in the ir lives
when they occur, just as the l eaves change in natur e; a r ock garden where children could
write things that the y miss on the r ocks; or a pr oblem-solving time when the gr oup could
help identify good things t o do when fee ling sad or mad lik e journaling, exercising, talking,
playing, etc.
Additional Resource s
http://www.dougy.org/
http://www.nationalallianceforgrievingchildren.org/
http://www.nationalallianceforgrievingchildren.org/classroom-activities-time-crisis
http://www.education.com/reference/article/cultural-approaches-support-grief/
http://www.rainbowhospice.org/bereavement/school.asp
http://www.childrensgrief.net/
http://www.ojp.usdoj.gov/nij/journals/262/critical-incidents-in-schools.htm
http://aacap.org/page.ww?name=Children+and+Grief§ion=Facts+for+Families
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