Developmental Stage/Task: Egocentric. Believe world centers around them. Narcissistic. Lack cognitive understanding of death and related concepts. Limited language skills.
Concept of Death: Death seen as reversible, as abandonment, not permanent. Common statements: “Did you know my mom died? When will she be home?”
Grief Response: Intensive response but brief. Very present oriented. Most aware of changes in patterns of care. Asking questions repeatedly.
Signs of Distress: Regression: changes in eating and sleeping patterns, bed wetting, general irritability and confusion.
Possible Interventions: Short, honest answers, frequent repetition, lots of reassurance and nurturing. Consistent routine.Play is their outlet for grief.
Developmental State/Task: Gaining a sense of autonomy. Exploring the world outside of self. Gaining language. Fantasy wishing and thinking. Initiative phase seeing self as the initiator. Concerns of guilt.
Concept of Death: Death still seen as reversible. Personification of death. Feeling of responsibility because of wishes and thoughts. Common statements: “It’s my fault. I was mad and wished she’d die.
Grief Response:More verbalization. Great concern with process. How? Why? Repetitive questioning. May act as though nothing has happened. General distress and confusion.
Signs of Distress: Regression: nightmares, sleeping and eating disturbed. Possible violent play. Attempts to take on role of person who died.
Positive Interventions: Symbolic play using drawings and stories. Allow and encourage expression of energy and feelings through physical outlets. Talk about it.
Developmental Stage/ Task: Concrete thinking. Self-confidence develops. Beginning of socialization. Development of cognitive ability. Beginning of logical thinking.
Concept of Death: Death seen as punishment. Fear of bodily harm and mutilation. This is a difficult transition period, still wanting to see death as reversib
le but beginning to see it as final.
Grief Response: Specific questions. Desire for complete detail. Concerned with how others are responding. What is the right way to respond? Starting to have ability to mourn and understand mourning.
Signs of Distress: Regression: school problems, withdrawal from friends. Acting out. Sleeping and eating disturbed. Overwhelming concern with body. Death thoughts (desire to join one who died). Role confusion.
Possible Interventions: Answer questions. Encourage expression of range of feelings. Explain options and allow for choices. Be available but allow alone time. Symbolic plays. Allow for physical outlets. Listen andallow for talk about the death.
Developmental Stage/Task: Formal operational problem solving. Abstract thinking. Integration of one’s own personality.
Concept of Death: A more “ADULT” approach. Ability to abstract. Beginning to conceptualize death. Work at making sense of teachings.
Grief Response: Extreme sadness. Denial. Regression. More often willing to talk to people outside of family and peer support. Risk taking. Traditional mourning.
Signs of Distress: Depression. Anger often towards parents. Suicidal thoughts. Non-compliance. Rejection of former teaching. Role confusion. Acting out.
*Dr. Donna Schuurman has been the Executive Director of The Dougy Center since 1991, and is an internationally recognized authority on grief and bereaved children, teens and families. Donna is the author of Never the Same: Coming to Terms with the Death of a Parent, and has written extensively on topics related to bereaved children. Her articles and other contributions have been published in scholarly journals and textbooks, and she has been interviewed as an expert on the subject by Redbook, The New York Times, SmartMoney, The Wall Street Journal, USA Today, NPR’s ‘Talk of the Nation’, and many other consumer publications.