Keeping Kids Healthy
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 brother, sister or parent is the unavailability of other family members who may 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 may also help the child understand the situation.

Once children accept death, they are likely to display their feelings of sadness on and off over a period of time, and 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, and anger is a natural reaction.

The anger may 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 may demand more attention, cuddling and talk “baby talk.”

Younger children may believe they are the cause of what happened around them. A young child may think a parent, grandparent, brother or sister 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 person;
  • Withdrawal from friends; and
  • Sharp drop in school performance or refusal to attend school.

These warning signs indicate that professional may be needed. A child and adolescent psychiatrist can help the youngster accept the death.

How to help. Here are a few titles parents may want to check out:

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

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

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

High school
“A Matter of Time,” by R. Schotter

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.