Supporting Grief And Loss In Young Children

BY KK WOMEN'S AND CHILDREN'S HOSPITAL

4 July 2022  |   8 min read

Grief and loss are natural life experiences everyone goes through, with children being no exception to this. While children are sometimes thought to be unaffected by feelings of grief as they may be too young to understand the concept of loss, they actually do experience losses and may react to them in different ways. This Quick Byte edition describes how young children (under 7 years of age) may experience grief and loss, and how adults can help to support them.

What constitutes a loss for children?

Children of different ages experience loss differently, because of developmental changes in their understanding as they grow up. In addition, similar to adults, each child may assign different meanings to their experiences even if they are of the same age. As such, what counts as a loss to each child can be unique to them.

Nonetheless, feelings of loss generally arise in children from transitions or disruptions in their lives, even seemingly minor ones. Children may perceive losses relating to changes in important relationships, environments, objects, abilities, aspects of self or relations to others (e.g. trust, support, safety, control). Here are some examples of events that young children may view as losses:

  • Life-changing events: death of a loved one/person they are close to, parental divorce, loss of daily function (e.g. becoming disabled after an accident), loss of caregiver relationship or functions (e.g. due to separation, physical/mental illness or incarceration), moving to an out-of-home placement (e.g. foster care)
  • Major transitions: moving house, going to preschool, parent returning to work after being at home, changing school or classes (which may also include changing teachers and friendship networks), a pet’s death, changes to daily routines resulting from COVID restrictions and measures
  • Minor transitions: moving from a small bed to a big one, changing toys
  • “Non-events” (i.e. something not occurring as expected): not being able to join school events or play activities due to illness or injury, not being able to do what other same-aged peers do (e.g. run, learn similar material) due to physical disability or developmental delay

As children can perceive events differently from adults, it is possible for children to experience grief and loss for an event that an adult may otherwise expect their child to feel happy or excited by. For example, a child may feel a loss of closeness with their parents at the birth of a new sibling. Conversely, it is also possible for children not to experience grief and loss for an event that one would typically expect them to. For example, in events involving death, a child may not experience feelings of grief, and may instead be more curious about what happens to a body after death.

Feelings of loss generally arise in children from transitions or disruptions in their lives, even seemingly minor ones.

How do young children express grief?

Children may learn how to respond to losses based on how they see others respond to it (e.g. if adults respond to death with fear or stoicism, children may also learn similarly). Additionally, how young children express their grief also depends on their developmental stage. For example, babies or toddlers (below age 3) may not understand that a loved one has died, but may perceive the absence of a familiar person and be distressed by that. Preschoolers may think that death is reversible, and ask questions about it in order to try and understand their world.

Also, many young children may not yet have the words to express how they feel, and may instead present with these behaviours:

  • Cry or appear anxious
  • Be more irritable with more tantrums
  • Become more clingy
  • Have physical complaints (e.g. headaches, stomachaches)
  • May have disturbances in their sleep (including nightmares)
  • May also show regressive behaviours (e.g. bedwetting, needing help with tasks learnt before)
  • Re-enactments – may have violent play or attempts to take on role of person who passed away

These behaviours can be difficult to manage, but are common reactions which typically become less frequent, and less intense with time. However, if these reactions become more severe, or appear to be prolonged, professional help should be considered to better support the child.

How do young children express grief?

Grief is often a personal process and takes as long as needed, particularly for major losses (e.g. death of a loved one). Adults can support young children experiencing grief or loss by expressing care and understanding for the child’s feelings. Healthy mourning includes allowing the child to experience the difficult feelings around the loss but also affirming and remembering the loss. Some ways to do so may include:

1) Normalising grief and talking about feelings

  • Provide simple but truthful answers to the child’s questions
    • For death in particular, refrain from using euphemisms (e.g. “Your uncle has gone to sleep”) as young children between ages 2 to 7 may have the view that death is still “reversible”
  • Acknowledge that the loss the child has experienced can feel scary, sad, or make them feel upset and angry
  • Explain how it is common for us to cycle through the ‘big’ feelings of grief (i.e. feelings may come on some days, but go away on others)
  • If appropriate, share your own feelings about the event (e.g. “I miss your mummy too and some days I also feel sad”) and/or as a group (e.g. family/class)
  • Be patient with the child’s grief reactions
  • Remind the child that they are loved (through physical and emotional gestures e.g. hugs, kind words, being present by the child’s side)
  • Be mindful that your responses to the loss might influence how the child also reacts to the loss (e.g. if an adult reacts adversely to or refuses to talk about the loss, the child may learn to react in similar ways as well)
  • Be curious and culturally sensitive about how the child’s culture and family discuss the loss

2) Keep memories alive

  • Do small activities with the child to remember the lost person / item / place / time (e.g. keep a scrapbook or memory box, write a letter, do art together, create a song)
  • Invite the child to talk about the lost person / item / place / time whenever they want to (e.g. “You can tell me about your best friend any time you want”)

3) Establish new routines and maintain old ones

  • Identify or create moments that the child can still enjoy, and new things they can look forward to (e.g. what the child can look forward to when shifting to a class)
  • Establish structure in routines (e.g. going to school, brushing teeth etc.) but give choices where possible to increase the child’s sense of control and predictability
  • Set limits to the child’s behaviours (e.g. consequences for misbehaviour should still be in place) but be flexible when needed

Additional Helpful Resources

References

Cronin, P., & Munson, L. (2010) Loss and Grief in Young Children. Young Exceptional Children, 13(2), p86-99. Fiorini, J. & Mullen, J. (2006) Understanding Grief and Loss in Children. VISTAS Trauma, Grief, Disaster, and Crisis Counselling. Accessed on 14 March 2022 at https://www.counselling.org/knowledge-center/vistas/by-subject2/vistas-crisis/docs/default-source/vistas/understanding-grief-and-loss-in-children

This article is contributed by KK Women’s and Children’s Hospital. This article was first published on Trauma Network for Children’s Quick Bytes Newsletter and is republished with permission.

The Stay Prepared – Trauma Network for Children (TNC) programme is a joint collaboration between KK Women’s and Children’s Hospital (KKH) and Temasek Foundation. It aims to enhance the psychosocial capability of the Singapore community to support children and youth after crises or traumatic events. For more resources, visit the Trauma Network for Children Website at www.childtraumanetwork.sg.