School-Aged Children

Loss and Bereavement in Childhood
During childhood (ages 6-10), children mourn differently than adults.Like younger children, they are unable to endure long periods of crying and mourning and therefore alternate between sadness and routine.Children this age are also much less verbal than adults and may have difficulty expressing their feelings in a conversation. Thus, it is especially important to pay attention to non verbal behavior, especially play.

Children, at this chronological age begin to understand the meaning of death, and can experience deep grief. At this stage children begin to understand the fact that death means a final separation. This is usually a very difficult realization for them. At this time they may also remember a previous experience and suddenly mourn a loss they suffered at an earlier age in addition to the current loss. This occurs because it is only now that they understand, that death and separation are final and irreversible.

Death has a profound impact on a child's sense of security, especially if the deceased was someone who was close to the child, such as a parent. In such cases the child may develop an intense fear of suddenly losing the other parent or of dying himself. The mysteriousness of death in the eyes of a child only intensifies the unexpectedness and incomprehensibility of it. Children this age will come up with all sorts of questions, many of which may seem to adults, very insensitive. It is important to allow the child to ask any questions he wishes, and to receive answers even if they may be in the form of, "I don't know," or "I need to think about it."

On the other hand, children may pretend that the death never happened or they may regress to behavior typical of younger children, such as bedwetting, clinging to a parent, or thumb sucking. All of these forms of behavior are normal and reflect the child's way of coping as best he can, in this most difficult of situations.

Common Characteristics of Bereavement
While each child reacts to death in his own unique manner there are a number of typical behaviors common to children this age who are coping with death: 

• Fears
  Children see death as something external that catches up with people and gets them. The causes of death are not always clear to them, nor can they distinguish between non-fatal illness and fatal illness. This confusion may contribute to the sense that death is unexpected and can happen to anyone, at any time, including themselves. 
• Asking the same questions over an over again
  At this age children are preoccupied with the idea that maybe they or another loved one will suddenly die without warning. As part of processing the fact that a loved one has died, and beginning to understand the loss, they may ask the same questions over and over again, even if they have previously been given full explanations. They tend to focus on specifics: "Exactly how did he die?" "From what disease and what was different about the disease and other illnesses?" It is important to be patient and answer the child every time he asks. This is the child's way of processing this difficult experience, and beginning to adjust to the new reality of life without the loved one. 
• Anger
  The child may be angry at the deceased who left him and at the unfairness of it all. In other cases, the child may display anger towards the remaining parent and others around him who are alive. The anger the child expresses may evolve from the helplessness he feels in the face of death. 
• Blame
  The child may feel at times that the death was his fault because of something he did or said. She may try to improve her behavior in order to bring the person back or she may express a wish to die too, to atone for what she did and in order to rejoin the departed. It is essential to explain to the child the true reason for death and to convey to the child that it was not her fault, and that she is not to blame. 
• Mood Swings
  Children may experience mood swings similar to those of adults, ranging from withdrawal into one's self, occasional crying, or angry outbursts. Children may also experience difficulty in concentrating or social problems in school. 
• Physical Disturbances
  Children this age may report difficulty falling asleep or sleep that is disturbed by nightmares. The child may also experience loss of appetite or refuse to eat. These are symptoms that occur usually in the immediate aftermath of loss, and generally recede within a short period of time. 
• Regressive Behavior
  Many children will revert to earlier forms of behavior following the death of a loved one, such as bedwetting or thumb sucking. Added to the distress caused by the loss of the loved one, is the shame of these forms of behavior, especially if they happen in social situations, such as at school.

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