In a single year, over 2 million children and adolescents in the United States experienced the death of a parent (Markowitz). The loss of a loved one is perhaps the most difficult experience a child or adolescent can endure. The affects on these young childrens social and emotional development can be profound. Although there has been a surplus of research studies conducted to measure the affect of death on adults there is only a minimal number of studies which examine the effects of death on children. This section of the newsletter utilizes various research studies which are focused on gaining an understanding of a childs grief response. It discusses the affect of losing a parent for children as they continue to mature throughout their lifetime. The number of factors that affect a grieving child is substantial and each individual factor has a large impact on the child. Some of these factors include the childs age and gender, the deceased parents gender, presence of siblings, parental communication patterns, cause of parents death as well as the childs experience at the funeral service. All of these factors can influence a childs post death experience in both positive and negative ways.
The importance of family, sibling, and outside support
Children of all ages respond separately and uniquely to the death of a parent. One of the most important factors for a grieving child is the presence of an adult support system. Children showed dramatically decreased levels of anxiety and depression when the parental communication patterns were well established (Raveis). Often times the surviving parent is too emotionally unstable and is unavailable to support their grieving children. In this type of situation the impact of another family member such as an aunt, uncle, or grandparent is crucial for the childs grieving period. A childs state anxiety measured much lower when the childs perception of communication with their surviving parent was well established (Raveis). It is critical that the child has someone to rely on to ask their questions to and receive reinforcement information concerning the tragic events in their life. An open family that communicates well will likely adapt in a healthier manner (Cohn). A child who is denied this communication tends to suffer from intense pathological mourning leading a child into denial (Black).
If there are going to be any changes to the childs lifestyle it is important that these changes be addressed with the child. Some examples of further traumatic changes for a child could include switching schools, moving into a new house, having a tighter economic lifestyle, re-marriage, etc. The ways in which children will respond to their loss will vary depending on their age, gender, relationship with their surviving and deceased parents, as well as numerous other factors. One particularly interesting result depends on the presence of siblings in a grieving family. In the study which measured childrens adjustment to parental death the influence of sibling interaction and communication proved to promote healthier grieving responses for children (Raveis).
Cause of the parents death
Childrens responses to parental death have also proven to depend on the cause of death. Children must deal with all different causes for the loss of their parent including: death as a result of an illness such as cancer, a sudden and unexpected death, suicide, an accident, a murder or violent act, as well as various other causes. A childs reaction will vary depending on the cause and will need to be dealt with individually.
A sudden death, for example, has been proven to be more problematic for children simply because there was no way for the child to prepare (Raveis). Even if the child was prepared the effects can still be monumental. A child who must watch their parent suffer or experience the loss of their presence in the home also will have a difficult time adjusting. Children have proven to show more depression, anxiety, and low self esteem symptoms during the parents illness than they do after the death (Siegel,(8)).
A violent death on the other hand is likely to cause traumatic stress responses such as posttraumatic stress disorder and complicated bereavement experiences for children. Usually children will fear their own safety, exhibit feelings of guilt, and develop new fears such as becoming afraid of the dark (Markowitz). Depending on the cause of the death there are specific support groups which are intended to help children grieve in a healthy way. These groups can be helpful for children to express their concerns and hear other childrens experiences which are similar to their own. The American Cancer Society and the American Heart Association are the two major support groups. These groups deal with children who all experienced the loss of a parent due to cancer or a heart attack. There are also thousands of smaller support groups which deal with all different causes of a childs loss. Regardless of which support group a child participates in it is very important that they are able to freely express their questions, concerns, and emotions.
Gender of the Child and Deceased Parent
Boys have proven to report lower levels of depressive symptomatology when compared with girls (Raveis). Older children also reported to have lower levels of state anxiety when compared to younger children (Raveis). One startling statistic confirms that childrens risk for developing emotional or behavioral problems doubles one year after the death of their parent (Siegel, (9)). This implies that directly after the loss of a loved one childrens risk levels measured lower.
There have been many debates over whether losing a mother is more traumatic for children when compared to losing a father. From one large study however this was proven incorrect. Children who lost a mother compared to a father did not have higher levels of depression or conduct disorder (Gersten). Childrens reaction to the loss of a mother and a father appeared to be the same which is very interesting.
Age of the Grieving Child
Children of different ages react in very different ways which inevitably effects their future social and emotional development. Generally children under the age of five or in early adolescence prove to have a more difficult time adjusting to the death of a parent (Markowitz). Children and adults cope with their loss in very unique and separate ways. From various measurements of their grief it has been proven that children and adolescent experience more intense grief reactions.
There are five distinct age brackets in which the children within the bracket respond in a similar manner. These age brackets have emerged as a result of thousands of studies. They include 3-5 yrs old, 6-8 yrs old, 9-11 yrs old, 12-14 yrs old, and 15-17 yrs old. Throughout various studies these brackets may vary by a year or two but they are relatively consistent. In one experiment, Kane explored the mental development of children ranging from 3-12 years old and categorized these children into three stages. For her the age brackets included three stages: stage one (3-6 yrs. Old), stage two (7-9 yrs. Old), and stage three (10-12 yrs. Old) (4). It is a childs level of cognitive development that helps to separate out these age brackets.
The first group includes 3-5 year olds. This aged child would typically ask When is my Daddy coming home? and is unable to understand the permanency of death (Markowitz). They are in an early preoperational thinking stage. This child will likely demand a replacement because they want to have a Mommy and a Daddy like their classmates in preschool. Sometimes you will see a child regress in their behavior for example they may lose their potty training skills.
The second age bracket includes 6-8 year olds who may say I think I killed her ( Markowitz). This child is in the late preoperational stage and understands that death is universal. They are able to realize that their mother or father will not return. They may worry that a thought they had caused the death of their parent and it is extremely important to explain to the child it is not their fault. This is also the age bracket of children who fear going back to school because they are now different. In an extreme case this child may express their desire to kill themselves so they can be with their dead parent.
The third age bracket includes 9-11 year olds who want to know the facts about their loss (Markowitz). They are in a concrete operational stage and can understand cause and effect. This child may feel obligated to take over their parents role and will often reminisce about the good times they shared.
Adolescents compose the last age bracket; early adolescents between 12- 14 years old and late adolescents between 15-17 years old (Markowitz). Early adolescents are going though puberty and the loss of a parent can be devastating and traumatic at this age. They will likely withdraw from their emotional relationship with the surviving parent and rely on their friends. Late adolescent children use their formal operational thinking skills. They are highly likely to experience depressive symptoms and may turn to drugs and alcohol as an outlet for their problems.
Effects on Infants and Toddlers
Infants and toddlers ranging in age from 0-36 months must not be forgotten when a parent has died. Although the methods are extremely different just like adults, infants and toddlers must learn to cope with their grief and loss. Even though they are unable to comprehend the idea that their parent died they can sense the emotions of the people surrounding and caring for them. Though touch, facial expressions, and tone of voice infants and toddlers will sense that something is wrong. Infants are found to cry more than usual, sleep more or less than usual, alter their eating and elimination patterns, exhibit their inability to trust, and even develop non organic failure to thrive as a result of the death of a parent (Hames). Toddlers are especially seen to show regressive behaviors and exhibit anger more frequently. The younger the bereaved child the more likely they will be to have a negative outcome (Hames). The importance of attachment and bonding during infancy is disrupted and the most important thing for an infant is to find a caregiver who will give them unconditional love and affection when they need it the most. They will have a fear of abandonment thus it is beneficial to only have one new main caregiver instead of multiple.
A childs experience during the funeral services of their deceased parent has proven to play a significant role in a childs post death grief response. Factors including the preparation the child receives for the service, their participation in planning and attending and whether or not they view the body drastically affects the child later in life. Often times the surviving parent attempts to protect their child by not allowing them to attend the funeral this however tends to have a negative affect on children as they grow up (Worden). Attending a funeral will provide the child with some sense of closure as well as inclusion in the families grieving activities. It is important for the child to understand what is going on and to express their questions, emotions, and goodbyes. In general the importance of a childs participation and attendance of the funeral has proven to be beneficial for children. In another study of the children who attended the funeral experienced 50% less psychological symptoms than those who did not (Weller).
Effects on children later in life
A childs experience with the death of a parent is a risk factor for major depression later in life (Gersten). These bereaved children are also more likely to develop schizophrenia or bipolar disorder as adults. It was determined that 20% of grieving children would benefit from support groups or professional health. This may even decrease their chances of developing disorders as adults.
In a measured population of children who lost a parent their risk factor for major depression was high. The rate of male to female death in the prime parenting years between 25 and 50 years old has doubled since 1980. This is important because researchers can try to further explore the debate over whether the deceased parents gender affects children. Depression has been found to be the leading negative health outcome for children who lost a parent (Gersten). Children between the ages of 8 and 15 who lost a parent had a 7.5 times greater risk for developing major depressive symptoms compared to children not exposed to the death of their parent (Markowitz). A childs depression tends to increase as they grow and mature. The same research study also proved the common stereotype that children who lost a parent have a high risk factor for developing conduct disorder to be incorrect. The three most important tasks for a child to practice for healthy healing process include: engaging in the process of morning the dead, changing their relationship with both the surviving parent and the deceased parent, and overcome obstacles in order to continue developing (Worden, (11)).
Returning to School
Most children have a fear of being different and may exhibit school refusal after their loss. They are afraid that their friends will not want to play with them because they no longer have a mother or father and may be sad at times.
Studies have been performed to determine the correlation between the death of a parent and the childs academic performance. Although the childs grade point averages did decrease it was not by a significantly large number. Some positive results confirm that schools can and do support bereaved children with an encouraging and open environment (Wetzel).
Other important issues the affect children
Families with higher incomes proved to exhibit fewer problems when compared to lower income families. Some of the problems measured included sleep disturbances, difficulty with concentration, and learning difficulties (Worden, (10)). A familys religion and culture also plays a large role in how a family will cope with their loss.
Reading books with your children about death has also proven to dramatically help young children to understand their emotions (Guy). Informative books will enable children to gain a realistic conception of death. In one study a researcher noted that every child is exposed to death at least once a day via television, books, the newspaper, the news, playing outside (seeing dead insects and bugs), etc.(Guy). This should help parents gain confidence in being able to discuss such a difficult topic with their child. By discussing death with a child the child will feel more comfortable asking questions when they arise throughout their childhood.