Adults can help children cope with death by understanding how they process it

This article is the second in our Coping with Mortality series, which looks at our fear of death across the ages and how to cope with the dying process. You can read yesterday’s article on how death anxiety underlies most of our phobias here.

Our society is death-phobic, a particularly harmful trait when it comes to helping children process the death of someone close to them. Adults often feel uncomfortable discussing death with children. They might consciously or unconsciously inhibit tears or other emotions, assuming they are protecting those too young to understand the weighty concept.

But age-appropriate discussions about death allow children to share thoughts and feelings they inevitably have when someone they know dies. Helping them normalise these can best be done by understanding children’s perceptions of death at varying developmental stages.

Understanding death

As children develop, their understanding of death changes and expands. In 1948, psychologist Maria Nagy presented a pioneering study that found a relationship between age and a child’s comprehension of death. The study showed three distinct stages.

Children between the ages of three and five, she argued, tended to deny death as a final process but associated it with a journey from which someone would return.

In the second stage, between the ages of five and nine, children understood that death was final but kept the knowledge at a distance. They also thought if they were clever about it, they could trick death and avoid it.

The third and final stage was when children were nine and ten. At this point, they understood death was inevitable and affected everyone, including themselves.

Nagy’s study relates well to clinical psychologist Jean Piaget’s work, which is drawn on by many child psychologists and educators.

Piaget explained children’s understanding through the following developmental stages:

1. Sensorimotor (0-2 years): death is “out of sight, out of mind".

2. Preoperational (2-7 years): Magical thinking and egocentricity are predictable attributes of grief that predominate this stage, meaning children feel responsible for what happens to them and the world around them. When five-year-old Olivia screams at her sister Sophie, “I hate you! I wish you were dead!” and the next day Sophie is killed in a car crash, magical thinking can make Olivia feel she caused this death. She may then need an outlet for her overwhelming guilt.

3. Concrete Operations (7-12 years): This is an intermediate stage when children’s thinking matures, becoming more logical. This stage is characterised by curiosity, which could explain why children this age love reading books and watching films about zombies and skeletons.

4. Formal Operations (13 years and up): An adolescent perceives death as distant, at the far end of a long life. But when someone they know dies, they will seek support from peers.

Helping children process death

Research exploring how bereaved children maintained connection to their parents in the year following their death found that, out of 125 young people in the study, 92 (74%) believed their parents were in a place called heaven.

The findings underscored the importance of helping children put their relationship with the deceased in a new perspective, rather than encouraging them to separate from it. Supporting a child’s reconstruction of a dead parent includes strategies of connection such as locating the deceased, experiencing the deceased, reaching out to the deceased and using linking objects.

An example of maintaining this connection was a story 11-year-old Michelle wrote and a picture she drew about heaven after her mum died in a car crash. These made her feel comforted and safe as she was able to hold a positive image of where her mother was. Michelle’s vision was illustrated like this:

There are lots of castles where only the great live, like my mum … My mum loved to dance. I think she’s dancing in heaven.

Adults can follow a generic model to support bereaved children. First, they should tell children the truth about death, considering their developmental stage and understanding.

This could mean using phrases such as:

Usually people die when they are very very old or very very sick, or their bodies are so injured the doctors and hospitals can’t help, and a person’s body stops working.

When it comes to very young children, it is useful to use concrete language and images while avoiding cliches that can inhibit the grief process. If we tell little Johnny that grandpa went on a long journey, he might imagine grandpa coming back or ask why he didn’t say goodbye.

Second, we must let children be recognised mourners, attending funerals and memorials. Research shows attending funerals helps children acknowledge the death and honour their deceased parent.

It is helpful to become aware of common signs of grieving children, such as: wanting to appear normal, telling and retelling their story, speaking of the loved one in the present and worrying about their health or the health of others.

Adults can encourage kids to use rituals to work through grief. They can say a prayer, send off a balloon, sing a song, plant a flower, write a poem or bury a dog bone. Grieving children can express themselves through memory books, memory boxes, photos and even memory emails.

Girls and boys may have a restricted verbal ability for sharing feelings and a limited emotional capacity to tolerate the pain of loss, but they can communicate their feelings, wishes and fears through play. Play therapy can include using imagination and interacting with toy props. A toy telephone can stimulate a child’s dialogue with a loved one.

Childhood grief and loss cover the gamut of life issues but we can empower them by offering age-appropriate language and grief interventions that open safe exploration and communication of feelings.