Developmental Stages of Understanding Death

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Developmental Stages of Understanding Death

Age	Concept of Death	Grief Response	Signs of Distress	Possible Interventions
0-2	May not understand death Will sense changes in the home	Irritability Will respond/react to emotions of adults	Regression Change in sleeping or eating patterns	Reestablishment of routine Comforting, holding
2-4	May see death as abandonment or punishment Death is reversible, not permanent May connect unrelated events to death	Very present oriented Aware of change	Regression Change in sleeping or eating patterns Bedwetting Insecurity Separation anxiety	Reestablishment of routine Comforting, holding Drawing Playing
4-7	Death is reversible, not permanent May feel responsible for the death “Magical thinking” May see death as contagious	Repetitive questioning May reenact death or the funeral during play Asks about loved one’s return	Regression Nightmares Change in sleeping or eating patterns Violent play Tries to take on the role of the person who died	Symbolic play Art and drawing Allow/encourage expression of feelings
7-11	Death as punishment Fears of bodily harm for themselves or others Starting to understand the finality of death	Questions about specific details Concerns about normalcy in the grieving process Some understanding of mourning Fears loss of other loved ones	Regression Problems in school Withdrawal from friends Change in sleeping or eating patterns Suicidal thoughts Concern with bodily harm	Answer questions honestly. Encourage expression of feelings Allow some alone time, but be available Symbolic play Talking
11-18	Death is universal, final and irreversible Understands possibility of own death	May try to care for others Depression Denial May want to talk to friends, rather than family.	Regression Intense anger or guilt Acting out Poor school performance Opposition/defiance	Encourage verbalization Encourage self-motivation Listen and be available Do not attempt to “fix” child.