By Drs. Sally Robinson and Keith Bly

When a family member dies, children react differently from adults.

Preschool children usually see death as temporary and reversible — a belief reinforced by cartoon characters who die and come to life again.

Children between 5 and 9 begin to think more like adults about death, yet they still believe it will never happen to them or anyone they know.

Adding to a child’s shock and confusion at the death of a sibling or parent is the unavailability of other family members who might be so shaken by grief that they are not able to cope with the normal responsibility of child care.

Parents should be aware of normal childhood responses to death in the family as well as danger signals.

According to child and adolescent psychiatrists, it is normal during the weeks following the death for some children to feel immediate grief or persist in the belief that the family member is still alive.

But long-tern denial of the death or avoidance of grief is unhealthy and can later surface in more severe problems.

A child who is frightened about attending a funeral should not be forced to go. However, some service or observance is recommended, such as lighting a candle, saying a prayer or visiting a grave site.

Books on death, grief and mourning also might help the child understand the situation. Here are a few titles parents might want to check out:

Preschool and early elementary school children:

“Last week my Brother Anthony Died,” by M.W. Hickman
“Why did Grandpa Die?,” By B. Shook-Hazen

Elementary school children:

“The Accident,” by C. Carrick
“Dusty was My Friend,” by A.F. Claudy

Middle school children:

“Tiger Eyes,” by Judy Blume
“Beat the Turtle Drum,” by C. Greene

High school students:

“A matter of Time,” by R. Schotter

Once children accept death, they are likely to display their feelings of sadness on and off over a period of time — often at unexpected moments. The surviving relatives should spend as much time as possible with the youngster, encouraging the child to express his or her feelings openly or freely.

The person who has died was essential to the stability of the child’s world. Anger is a natural reaction.

The anger might be revealed in boisterous play, nightmares, irritability or a variety of other behaviors. Often, the youngster will show anger toward the surviving family members.

After a parent dies, many children will act younger than they are. The child might demand more attention, cuddling and talking baby talk.

Younger children might believe they are the cause of what happened around them. A young child might think a parent, grandparent or sibling died because he or she had wished the person dead.

The child feels guilty because the wish came true.

Some additional danger signals to watch for are:

  • An extended period of depression in which the child loses interest in daily activities and events;
  • Inability to sleep, loss of appetite, prolonged fear of being alone;
  • Acting much younger for an extended period;
  • Excessively imitating the dead person;
  • Repeated statements of wanting to join the dead people;
  • Withdrawal from friends; and
  • Sharp drop in school performance or refusal to attend school.
  • These warning signs indicate professional help might be needed. A child and adolescent psychiatrist can help the youngster accept the death.

Keeping Kids Healthy

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital, and Keith Bly is an associate professor of pediatrics and director of the UTMB Pediatric Urgent Care Clinics. This column isn’t intended to replace the advice of your child’s physician.