Q: My 8-year old son was very close to his grandmother who just passed away. My wife and I aren’t sure if his reactions are appropriate or if we should be concerned.

A: It is never easy to lose a loved one regardless of age. While there are five stages that are commonly referred to in the grief process: denial, anger, bargaining, depression, and acceptance, it is important to keep in mind it is not a linear process. In other words, individuals may go through the stages in a different order, return to some stages, and may even spend more time in specific stages. Depending on a child’s age, they will demonstrate their progression through the stages in different ways. It is also common for grief to resurface later when there are birthdays, anniversaries, holidays, family reunions, etc.

Before jumping into common ways children grieve based on their age, it is worth acknowledging other variables beyond age that can play a role in the bereavement process. Some of these factors include:

• Gender
• Development
• Culture
• Personality
• Ways your child typically reacts to change and stressors
• Relationship with the person who passed away
• Cause of death (e.g., traumatic accident, illness, etc.)
• Understanding of death
• Earlier experiences with death and/or loss
• Amount of support available to them
• How others are modeling their ability to cope with the loss

While babies and toddlers do not understand death and do not have the ability to communicate with language how they are feeling, they still can demonstrate loss in other ways. Some common behaviors that are exhibited for this age group include: looking for the person who has died; experiencing possible weight loss; crying more than usual; displaying irritability; wanting to be held more; not engaging in typical activities; and being distressed, anxious, and on edge. If they are typically more responsive or expressive, they might be noticeably quieter and more reserved. While there are similarities between how babies/toddlers and preschoolers respond to death, preschoolers may also experience the following: dreams or sensing the presence of the person who died; changes in eating and sleeping habits; bed wetting/soiling; and a regression in progress (e.g., crawling again even though they are able to walk).

Children of primary school age will experience some of the reactions mentioned above, but in addition may also blame themselves for the death; be easily distracted and/or forgetful; experience anxiety or increased fears; not want to go to school; feel embarrassed or different from others to the extent they may try to conceal their loss; and exhibit defiant behaviors. The next age group includes older children, ages 10-12. All the above noted for primary school aged children applies with the possibility of the following: anxiety about the safety of loved ones and themselves; strong emotional reactions (e.g., anger, guilt); and an increase focus on what happened (e.g., “How did grandma die? What did the doctor say? Could we have done something else?”) They may also experience a desire to please adults and not worry them, which in turn takes away from their ability to grieve (i.e., their attention and energy is re focused from grieving to pleasing).

In addition to reactions discussed above, teenagers commonly display forgetfulness, are easily distracted, and have a hard time concentrating at school. They may not want to go to school; be overwhelmed by intense reactions (e.g., anger, guilt); have difficulty expressing themselves; experience an increase in anxiety/fears; worry about the safety of others and themselves; and have questions about death. They may engage in risk-taking behaviors (e.g., substance use); make jokes to mask their true feelings; act as if they do not care; have strained interpersonal relationships; experience isolation and a decrease in self-esteem, and express physical complaints (e.g., headaches, tummy aches). While teenagers may want to be around loved ones more, they may also at times withdraw and express a desire to be alone.

While the above mentioned highlights common reactions for different age groups, it is important to keep in mind that the various variables can result in other reactions that could still be deemed
appropriate. If there is concern related to the duration and/or intensity of symptoms, it could be helpful to meet with a child psychologist for assistance.