Talking about death with children is one of the hardest challenges for any parent. Often, driven by the natural impulse to protect our children from pain, we tend to hide reality from them or use euphemisms that, far from helping, generate more confusion and anxiety. However, children do grieve, and they need adult support to move through grief in a healthy way.
As a licensed health psychologist specialized in child therapy, I have supported many families through grief. In this article, I offer a practical evidence-based guide to help your children cope with a loss.
How children understand death by age
How a child experiences and understands death depends directly on their level of cognitive and emotional development. Knowing these stages is essential to adapt our communication and support.
Ages 0 to 3
Babies and very young children do not understand the concept of death, but they do perceive the absence of a loved one and the emotional changes around them. They may show irritability, sleep and eating disturbances, regression in milestones already reached and a greater need for physical contact. The most important thing at this stage is to keep routines, provide constant affection and ensure the steady presence of a primary caregiver.
Ages 3 to 5
At this stage, thinking is still very concrete and magical. Children may believe that death is reversible (as in cartoons), that something they thought or did caused the death (magical guilt thinking), or that the deceased will return if they wish hard enough. They may ask repetitive questions about where the person is and when they will come back. It is essential to be honest and to repeat the explanation as many times as needed, with patience and warmth.
Ages 6 to 9
They begin to understand that death is irreversible and that all living beings die. However, they may struggle to accept that their parents or themselves could also die, which can generate anxiety. They often show curiosity about the physical aspects of death (what happens to the body). They may express grief through play, drawing or behavioral changes rather than through words.
Age 10 and older, and adolescents
Their understanding of death is similar to that of adults, but emotional management is still developing. Pre-teens and adolescents can feel overwhelmed by the intensity of their emotions, show abrupt mood swings, withdraw from peers, or display risk-taking behaviors. Some may try to appear "strong" so as not to worry the adults, suppressing their grief.
Signs of healthy grief in children
Childhood grief shows itself differently from adult grief. Some normal reactions include:
- Intermittent sadness alternating with moments of normal play (childhood grief comes and goes).
- Repetitive questions about the deceased and about death in general.
- Symbolic play related to death or loss (playing funerals, hospitals).
- Temporary regression in behavior (bedwetting, wanting to sleep with parents).
- Temporary changes in appetite or sleep.
- Fear that other loved ones will also die.
These reactions are normal and, in most cases, gradually resolve over time if the child receives appropriate support.
How to help your children move through grief
The role of adults is fundamental in the childhood grief process. Here are some evidence-based guidelines:
Be honest and direct: Use clear words such as "die" or "dead" instead of euphemisms. Explain what has happened with language adapted to the child's age.
Validate emotions: Let your child know that all the emotions they feel are normal and acceptable. "It is normal that you are sad. I am too. You can cry if you need to."
Allow play: Play is the natural language children use to process emotions. Do not be alarmed if your child plays with themes related to death; it is their way of processing the loss.
Maintain routines: Structure and predictability provide security at a time of emotional uncertainty.
Share your own grief: Showing your emotions in an appropriate way (without becoming overwhelmed in front of the child) teaches them that grief is a natural response and that emotions can be expressed.
Create memorial opportunities: Encourage the child to draw, write letters or create a memory album of the loved one.
EMDR for complicated childhood grief
When childhood grief becomes complicated — that is, when symptoms persist, intensify or impair the child's normal functioning over an extended period — specialized professional treatment may be needed.
Treatment with EMDR adapted for children has been shown to be very effective for complicated childhood grief. This therapy helps process the painful memories associated with the loss, reduces the emotional intensity of traumatic memories (such as having witnessed the death or having received the news in an upsetting way), and integrates the loss in a way that allows the child to continue their healthy emotional development.
In my child therapy practice, I work with children using techniques adapted to their age and developmental level, incorporating elements of play, drawing and storytelling that make the therapeutic process accessible and safe for them. Family involvement in treatment is an essential component of child therapy.
When to seek professional help
Although grief is a natural process, there are situations in which it is advisable to seek professional support:
- If grief symptoms persist or worsen after two or three months.
- If the child expresses the wish to die in order to be reunited with the loved one.
- If there is severe and persistent regression in behavior.
- If school performance drops significantly over a prolonged period.
- If the child becomes completely withdrawn from friends and activities.
- If the death was sudden, violent or traumatic.
If you need guidance on how to support your child through grief, contact me. I can help you both in person and through online therapy.