EYFS Best Practice - All about… bereaved children
Tuesday, March 2, 2021
Talking about death with young children is necessary when there has been a bereavement. Anne O’Connor explains the best ways to tackle this difficult subject
It is difficult to find exact figures of how many children in the UK have been bereaved of a parent or close family member during the pandemic, but a 2019 report by Cambridge University highlighted that more than 41,000 children under 18 in the UK lose a parent every year. If deaths of siblings are included, that number rises to at least 45,000 every year (The Guardian, 2019).
If we look at the current numbers of deaths across the UK, we have to assume that a significant number of children must have been affected, not just within the family but also through the loss of friends, neighbours and even practitioners they have known in childcare or school settings.
Even if children have not been directly affected by a death, it is still likely that their significant adults will have had direct experience or been affected by increased anxiety about death and illness. Inevitably, this will have an impact on all our children.
UNDERSTANDING DEATH AND GRIEF
Our beliefs and cultural experiences often play a part in how we respond to death, and to children’s often tricky questions about it. However, none of us likes to think of children having to suffer from grief. As a result, we tend to try to protect them from the realities of death – and assume that they won’t remember or don’t grieve as deeply or for as long as adults.
As many adults who were bereaved as children can now attest, not only is this not true, but it is rarely helpful and can lead to long-term problems. ‘It is now widely accepted that the most helpful way for a child to manage the death of someone important to them is not to forget them but to find a healthy way to take the person with them into their adult life’ (Never Too Young To Grieve, Winston’s Wish).
While children may grieve as much as adults, they may well show that grief in different ways. It is generally accepted that children can seem to dip in and out of grief – sad one minute, then happy the next.
Many child bereavement support organisations refer to this as ‘puddle-jumping’, which is in stark contrast to the seemingly endless wave of grief so often experienced by adults. This can give the impression that children aren’t that affected, but it has been suggested that this is actually an inbuilt safety mechanism that protects the child from being overwhelmed by such powerful feelings.
The important thing to remember is that all babies and children will register a loss, and whether or not they can understand what has happened, they are able to grieve (see box, page 37).
Age can only be a very rough guide, however, as, like adults, children will respond differently to bereavement. This is particularly true of children with SEND who may not fit neatly into any one developmental stage. Knowing the child well helps us to find the most effective ways of communicating with them.
There is no right or wrong way to grieve. It is OK to cry and it is just as OK not to. We also need to be aware that children learn most about the process of grieving from watching the adults around them.
TALKING ABOUT DEATH
Having a sense of what children might be able to understand helps us decide what language to use and how much information to share with them. We don’t want to frighten them, but not talking about it is not helpful.
Most children will pick up when something is wrong and they are more likely to get confused and worried if a death isn’t spoken about. They quickly learn from us whether it is OK to talk and ask questions – and by asking questions they tell us if they have understood, or are still processing what they have been told and are not yet ready for more information. Ideally, we make the best decisions about what they are ready for when we know the child really well (for example, as a key person) or when we are able to work closely with the family.
The jigsaw approach
A useful approach suggested by Winston’s Wish is to think of it like a jigsaw (Never Too Young To Grieve). Start with one or two key pieces of information that fit and make sense for the child developmentally. Follow the child’s lead and gradually add more pieces of information as time passes and they grow and mature, particularly in response to new questions, which tell us they are ready for more information and to take on the ‘bigger picture’.
Be prepared for the same questions to resurface time and again as they process and consolidate information. Stick to the question they ask and pitch the detail to the child’s developmental awareness. Small triggers, some obvious (like an anniversary), some not so (maybe a sound or a smell), may cause them to revisit and ask different questions as they grow into adulthood and gain more understanding.
Knowing that they can openly ask questions and talk about how they feel – when they feel ready to – reassures children. Don’t assume that they know nothing – or indeed everything – about what happened. Talking sensitively with the family helps inform what we say to the child. Try not to shut down conversation even if it comes at an awkward time – or takes us out of our comfort zone.
If we follow children’s lead, we can also judge when they want to be distracted from their thoughts and so are prepared to engage in other things that interest them. Accept their feelings and avoid telling them what you think they should feel or that they don’t need to feel that way.
Let them know their feelings are OK, even the bad ones that they may not have words for – remember our feelings about people who have died are not always straightforwardly loving or affectionate.
‘What does “dead” mean?’
Death is an abstract and difficult concept to explain, but it is also a topic of conversation that has relevance to all children and at random times, regardless of whether or not they have experienced a bereavement.
- Use simple words that are matched to the child’s development, but avoid words like ‘lost’ and ‘asleep’. They can seem kinder, but are also likely to confuse. Adults may find it hard to use the word ‘died’, but it is easier for children to understand. They will value your honesty and a trusting relationship will allow them to talk openly to you in the future.
- Use new words linked to bereavement and death consistently and accurately. A child may not initially understand what ‘dead’ or ‘died’ means, but they will know it is different from ‘gone’ and ‘lost’, and their understanding will develop over time (Never Too Young To Grieve).
- Think about the descriptions that will make most sense to children – for example, ‘When we are dead we do not breathe, our hearts stop beating and we can’t play anymore’ (Grimmer). See also www.childbereavementuk.org/telling-a-child-that-someone-has-died.
- Remember also that children may be curious about the way adults use words associated with death for commonplace things – for example, ‘I nearly died laughing’ or ‘My phone battery is dead!’
‘Where did they go?’
How we answer questions about what happens after death will depend a lot on our own spiritual beliefs and our knowledge of the child’s family and community. Work as closely as possible with a bereaved family (and members of their religious community, if appropriate). Listen carefully to a child’s questions and keep your answers simple and to the point. Try to answer as soon as they ask and be prepared for repeated short conversations rather than long answers.
Remember it’s OK to share your uncertainty, and acknowledge that different people think and believe differently about these difficult questions. Many of the bereavement support organisations have advice and suggestions for how you might respond. For example, ‘Grown-ups find that difficult too … what do you think?’, or ‘Nobody knows for certain, and people think different things, but I believe
Don’t worry too much if you think you didn’t answer perfectly – for the child, the fact that you paid attention is important.
‘Did I do it?’
Some young children may believe that something they did, or even thought, might have caused the death, and a lack of appropriate information might lead them to ‘fill in the gaps’ with these scary thoughts. They might also believe they can influence or reverse a death – for example, keeping someone alive by being extra good.
Simple, reassuring, developmentally appropriate explanations can help children see that the responsibility is not for them to carry.
Bereaved children may not have words for how they feel, and may need help to express the intensity of their emotions. This is particularly true for young pre-verbal children, those with communication difficulties or those who communicate non-verbally. They will need our help to learn that these feelings won’t always stay exactly the same or feel so intense.
Paying attention to behaviour helps us to understand the child and to guide them in understanding their strong emotions and how to find healthy ways of expressing them.
Behaviours are likely to include separation anxiety, withdrawal, aggression and lack of concentration, as well as over-compliance and regression (see box).
A child may try extra hard to be ‘good’ to avoid distressing or angering a stressed parent. Regression might include toileting or feeding issues, acting younger than their age, or wanting a long-forgotten blanket or dummy.
Such behaviours are normal in the context of grief and not an accurate reflection of a child’s true level of development. They are also not out of the norm for any child at any age dealing with regular stresses, so not all behaviours may link directly to grief.
Most behaviours will gradually disappear, but please seek guidance if they persist or become more severe.
Useful responses include:
- Patience and reassurance as you validate the child’s feelings and support them through the emotions.
- Familiar routines and sensory comforts – smells, textures, songs, games, etc.
- Loving attention and comfort from familiar people.
- Reassurance that they are loved and cared for.
- Simple explanations and concrete terms matched to their developmental stage.
- Attentive responses to questions as well as behaviours, and body language.
- Recognising, acknowledging and honouring the emotions and feelings behind behaviours.
- Voicing emotions for them where appropriate.
- Understanding that regression is probably temporary while gradually rebuilding their confidence in their skills.
- Giving them space and time to be themselves, to play and be distracted, as well as to withdraw when they need to.
- Showing them you are available when they want to talk and ask questions.
- Listening to their stories and helping them to remember special and significant events and aspects of the person or people who have died – and continuing to do this as time passes.
Making sense of the world
Children play to make sense of the world as they see it. Acting out pretend scenarios allows them to express concerns, ask questions (of themselves as well as others) and ‘reshape a narrative’, so that they can drive the plot and, crucially, ‘change the outcome of a scary situation or try out different solutions to a problem’ (Kate Cray, The Atlantic, 2020).
Parents and practitioners all over the world are commenting on how the pandemic is appearing in children’s play activity. This kind of play shows us what children are fearful of and how they are working it through, as well as how their awareness and understanding is developing.
It also needs observing in just the same way we observe all other play and behaviour. Watch out for children who seem anxious or overwhelmed by the play scenarios or seem ‘stuck’ – compulsively repeating the same scenarios without being able to change the outcome. Careful ‘playmating’ with (or alongside) the child can sometimes help, but do seek guidance if you are concerned.
Creative and physical activity
Creative and physical activities can play an essential role in the grieving process, helping a child find ways of expressing themselves, as well as giving outlet to physical feelings and opportunities to soothe distress.
Arts and crafts activities, as well as movement and dance, can provide a child with concrete ways of exploring abstract feelings and thoughts, especially when non-verbal actions feel safer, or more accessible, than words.
Feeling free to move to music, to stamp and march about, to sing loudly or use paints or crayons with no expectation of an outcome can help release tension and bottled-up emotions, while manipulating clay or constructing can provide a sense of control when all around feels in chaos.
Tidying up and sorting can also be soothing, even for very young children, and sweeping and other methodical, rhythmic, large motor movements such as swinging and swaying can be very comforting and help ease anxiety. This is true for grown-ups too, so make the most of opportunities to join in or initiate activities.
Lifecycles and lifetimes
Death and decay is a fact of everyday life, and children are often fascinated by it, providing us with natural and relaxed opportunities to explore the concept of death, and how it differs from life – for example, through the changing seasons and lifecycles of plants and animals.
The questions children ask tell us what information they need to consolidate, as well as what they are ready to know about next. Remember, young children are also capable of exploring bigger philosophical ideas about life, death, humanity and the way we treat animal and plant life. See Philosophy for Children resources at www.p4c.com.
Telling our stories
We all have our stories about how it was for us when somebody died. Children will also need to tell their stories, and listening helps us both to appreciate how they are feeling and to learn what they have understood, and perhaps misunderstood.
Although there are many picturebooks exploring bereavement, remember to make the most of stories that explore other aspects of loss – what it feels like to miss someone, as well as getting through adversity.
Be aware that some children might be grieving people lost to them in ways other than death (for example, refugee and asylum families and looked-after and adopted children). Also think about how you might adapt a favourite story to reflect current times and experiences in ways the children will recognise.
Held in mind
Feeling held in mind – and holding others in our minds – is an important aspect of emotional health, but becomes particularly important for children who have experienced loss. Children will need extra reassurance that they are loved unconditionally by the people who are important to them.
When a death is anticipated (for example, a very elderly or terminally ill family member), we can sometimes help to create special memories, often just with regular one-on-one time, quietly talking, reading or playing together, as well as special memorable events.
Unfortunately, this isn’t always possible with Covid deaths and when access to hospices and care homes has been restricted, so video- and phone-calling have become more important. Photo books and memory boxes are also special ways of holding people in mind.
SUPPORTING OUR FAMILIES AND OURSELVES
Parents and children’s family members will be grieving too and using their own coping mechanisms. The better we know the family, the more able we are to tune into their needs, highlighting the special relationship key people have with their families.
We may need to signpost them to services, as well as providing emotional support. For example, Cruse provides a comprehensive list of services, while The Little Book of Bereavement for Schools aims to help schools support children and their families. Winston’s Wish and other grief support organisations also offer specific information and a range of helpful publications (see References and resources).
The weight of responsibility
The added weight of physical and emotional responsibility that early years practitioners have experienced during the pandemic makes it even more important that we look after ourselves and our colleagues. Taking time to acknowledge our losses in the past – as well as more recently – will help when we have to be present with children and their grief.
Long before the current situation, childhood bereavement was highlighted as a ‘huge social issue’ with potentially long-term consequences for the individual – and wider society – and there was pressure for a Government-led national bereavement policy for schools. Although it may be hard to think of more policy writing at a time like this, perhaps now is exactly the time to be thinking of a ‘planned holistic bereavement response’ that supports everyone in settings with this difficult but crucial aspect of daily life. A policy template to adapt to your setting’s specific needs is at: www.winstonswish.org/supporting-you/support-for-schools.
HOW CHILDREN GRIEVE
Winston’s Wish suggests the following rough guide to children’s understanding of death and how they might express their grief:
Babies: Birth to 12 months
This age group will experience the absence of someone who cared for them, may have strong emotions and may respond to others’ emotions, but they will not understand why.
A child will experience a loss of security, which might affect their eating or sleeping. They may cry more and appear less settled, more irritable, maybe even inconsolable and become more clingy.
Toddlers: 1-3 years
This age group will be aware someone is missing, but will not fully understand why or the finality of death, so they might expect the person to come back. They will notice the changes in their life due to the bereavement, particularly to routines. And they will react to others’ emotions, without understanding why.
A child may ask and search for the person. They may become angry (tantrums, etc.), cry more or become withdrawn. Their usual eating, sleeping and toileting patterns may become disrupted, and they may use body language to express their emotions.
This age group will still struggle to understand what dead means and might expect the person to return. While they might start to understand some of the physical reasons for death, they still find them difficult to grasp. They will also miss the person who has died and may be able to recognise some feelings but are unlikely to link them with grief.
A child may:
- listen to explanations but take these literally
- learn to use, but not always understand, words about death
- need to ask the same questions over and over
- think they did something to cause the death
- show their feelings in their behaviour and play, including increased anger, and fears and worries about other things
- experience separation anxiety
- have difficulty paying attention
- be withdrawn and appear not to react much at all at first
- find it hard to relax
- regress in their eating, sleeping and toileting routines
- have physical symptoms, such as tummy aches
- need reassurance that others aren’t going to die. (NTYTG, pp10-11)
From the ages of five to ten years, understanding grows, and by seven, most children understand that death is permanent – and inevitable. This can lead to increased worry about death for themselves and others, but equally a fascination with the facts.
Children are increasingly able to show compassion for others who are bereaved and may try to hide or control their feelings if they think their sadness will upset others. However, they may also display behaviours such as withdrawal, anger, poor concentration and regression, which may not always be interpreted as expressions of grief.
References and resources
- ‘Bereaved children missing out on vital support in UK schools, study finds’, www.cam.ac.uk
- ‘Schools “need support of government to help grieving children”’, www.theguardian.com
- Winston’s Wish booklets include:Never Too Young to Grieve: Supporting children under 5 after the death of a parent; A Child’s Grief: Supporting a child when someone in their family has died; and As Big as it Gets: Supporting a child when a parent is seriously ill, www.winstonswish.org
- ‘How children and young people grieve’, www.childbereavementuk.org
- ‘How to support young children in relation to death and bereavement’ by Tamsin Grimmer, www.lindenearlyyears.org
- ‘Supporting a child who’s grieving’, www.mariecurie.org
- ‘What should you tell children about death?’, www.dyingmatters.org
- ‘How the Coronavirus Is Influencing Children’s Play’ by Kate Cray, 1 April 2020, www.theatlantic.com
- Signposting pack, www.cruse.org.uk
- The Little Book of Bereavement for Schools, www.crownhouse.co.uk