Kids and Grief: What Research Says About Supporting Children Through Loss

When a child loses someone they love, the first thing most parents hear is a version of the same advice: let them feel their feelings. Give them permission to be sad. Don’t rush them through it. That guidance isn’t wrong — but it’s incomplete in ways that matter. Research on childhood bereavement has identified specific factors that predict long-term adjustment, and most of them aren’t about emotional permission at all. They’re about structure, information, and the behavior of the surviving adults in a child’s life. If you have a grieving child — or you’re trying to prepare for an inevitable loss — the research offers something more actionable than “hold space.”

The Problem With General Grief Advice

The popular framing of childhood grief borrows heavily from adult models — particularly from Elisabeth Kübler-Ross’s five stages, which were originally developed to describe adults facing their own terminal diagnoses, not children experiencing the death of someone else. The stages model (denial, anger, bargaining, depression, acceptance) has been influential and heavily criticized. Its primary problem is that it implies a linear progression through discrete emotional states that research has consistently failed to confirm — in adults or children.

For children specifically, the five-stage model misses several critical features of how children actually grieve. Children do not move through grief in a sustained linear trajectory. They grieve in bursts, often returning to apparently normal play within minutes of expressing intense distress. They revisit losses at developmental milestones — a father who died when a child was 6 will be grieved again differently at 10, 13, 16, and 22, as the child’s cognitive and emotional capacity grows and the implications of the loss become more fully understood.

William Worden, a Harvard Medical School psychologist and one of the most cited researchers on childhood bereavement, documented this phenomenon extensively in his landmark 1992 Child Bereavement Study, conducted with Phyllis Silverman at Massachusetts General Hospital. Silverman and Worden followed 70 families for two years after a parental death and found that children’s grief was not a state to be moved through, but an ongoing relationship with the deceased that evolved over time. Children who were doing best were not the ones who had “resolved” their grief — they were the ones who had found ways to maintain a continuing bond with the person who died while adapting to their changed world.

This distinction between “resolving” grief and “adapting to” grief is not semantic. It changes what parents and caregivers should actually do.

What the Research Actually Says

The Tasks Model Outperforms the Stages Model

Worden’s 2018 fourth edition of “Grief Counseling and Grief Therapy” presents a tasks-based framework for understanding grief that has substantially more empirical support than stage models. Rather than describing emotions a bereaved person passes through, Worden describes four tasks that effective grief involves: accepting the reality of the loss, processing the pain of grief, adjusting to a world in which the deceased is absent, and finding an enduring connection with the deceased while embarking on a new life.

For children, the tasks model is more useful because it’s active rather than passive. Children don’t need to wait for stages to arrive and pass — they can work on tasks. Parents can support specific tasks. The question shifts from “how is she feeling?” to “is she able to talk about the person who died? Is she beginning to re-engage with school and friends? Is she building a way to keep this person in her life while moving forward?”

Bergman et al. (2017) studied school-age bereaved children and found that children who actively maintained connections with deceased parents — through photographs, stories, objects, memory rituals — showed significantly better adjustment over a five-year follow-up than children for whom the deceased was rarely or never discussed. The connection did not maintain grief; it transformed it into something the child could carry rather than be buried under.

Surviving Parent’s Functioning Is the Single Strongest Predictor

The Silverman and Worden (1992) Child Bereavement Study produced a finding that has been replicated across multiple studies and is consistently underemphasized in popular grief guidance: the mental health functioning of the surviving parent is the single strongest predictor of child outcomes after a parental death.

This is a profound responsibility and, for grieving parents, a difficult one. A parent who is severely depressed, withdrawn, or functionally impaired in the first year after a spouse’s death is significantly more likely to have a child with prolonged complicated grief, behavioral problems, and depression — independent of the child’s own relationship with the deceased parent.

The mechanism is straightforward. Children depend on their remaining caregiver to model that life continues, to maintain routines, to respond to their emotional signals, and to tolerate conversations about the person who died without becoming overwhelmed. When a parent’s own grief is incapacitating, these functions collapse, and the child loses not just one parent to death, but effective access to the other as well.

Schonfeld and Demaria (2016), writing in Pediatrics, specifically called this out in their American Academy of Pediatrics guidance on childhood grief: supporting bereaved parents is not secondary to supporting bereaved children — it is primary. The two are inseparable. Clinicians, school counselors, and family members who focus only on the child and neglect the surviving caregiver are missing the intervention that will have the most downstream impact on the child.

Long-Term Outcomes of Early Parental Loss

Luecken (2008) conducted a review of the long-term outcomes of childhood parental bereavement and found that the risks extend well beyond childhood. Adults who experienced parental loss in childhood show elevated rates of depression, anxiety disorders, complicated grief responses, and — notably — dysregulated physiological stress responses (elevated cortisol reactivity). The effects were moderated significantly by the quality of caregiving in the aftermath of the loss, not by the loss itself.

This is the most counterintuitive finding in the literature for many parents: it’s not the death that primarily determines long-term outcomes. It’s what happens in the home after the death. Children who experienced warm, consistent, responsive caregiving after parental loss showed outcomes largely indistinguishable from non-bereaved children on most measures. Children who experienced disrupted, inconsistent, or emotionally unavailable caregiving after loss showed significantly elevated risk on nearly every outcome measured.

This finding recasts the goal of family support after a child’s bereavement. The loss itself cannot be undone. But the environment in which a child processes that loss is highly malleable — and it’s the primary target for meaningful intervention.

Age-Specific Grief Responses

Age Group	How They Understand Death	Common Grief Presentations	What Helps
Under 5	May not grasp permanence; may ask when person is “coming back”	Regression (bedwetting, clinginess), play disruption	Simple, honest language; consistent routine; close caregiver presence
5–8	Beginning to understand permanence; magical thinking possible	Worry about own death and surviving parent’s death, focus on physical details	Factual explanation; permission to ask questions; school continuity
9–12	Understands death intellectually; may suppress emotion to protect adults	Physical complaints, irritability, academic drops, peer withdrawal	Explicit permission to grieve; non-intrusive check-ins; journal/art outlets
13–17	Understands fully; identity implications of loss	Risk behavior, social withdrawal or intensification, depression, identity disruption	Peer support; non-judgmental adult availability; psychoeducation
All ages	Grief recurs at milestones	Anniversaries, graduations, holidays trigger reactivation	Normalize recurrence; plan for milestone moments; maintain memory rituals

What to Actually Do

Tell the Truth, in Age-Appropriate Language

Euphemisms — “passed away,” “went to sleep,” “we lost him” — are well-intentioned and harmful. Research consistently finds that children who receive clear, honest, concrete information about a death adapt better than children given vague or misleading explanations. “We lost him” confuses young children who take language literally. “Went to sleep” can create bedtime anxiety. “Passed away” means nothing to a five-year-old.

Schonfeld and Demaria (2016) recommend language like: “Grandpa died. That means his body stopped working completely and he won’t be alive anymore. His heart stopped beating, and he can’t breathe, and he can’t feel anything anymore.” This sounds blunt, and it is — deliberately. Clear language prevents the distorted understandings that children construct when adults are unclear, and it signals that this topic can be talked about.

Maintain Routines While Tolerating Disruption

The research on routines in bereaved families is consistent: predictable daily structure is one of the primary environmental factors associated with better child adjustment. School attendance, mealtimes, bedtime rituals — these matter not as performance of normalcy but as genuine contributors to regulation and safety.

This doesn’t mean forcing a child back to school two days after a death. It means that when the acute phase passes, gradually returning to structure is not “rushing through grief” — it’s evidence-based care. Bergman et al. (2017) found that school-based connection was specifically protective for school-age bereaved children, particularly for those who had positive teacher relationships.

Build a Continuing Bond, Not Closure

One of the most evidence-supported and least-practiced interventions in childhood grief is deliberate maintenance of connection with the deceased. This can take many forms, but the research is specific: it helps.

Practical strategies include keeping photographs visible and talking about them, telling stories about the person who died (including funny ones — children benefit from permission to laugh), celebrating the deceased’s birthday annually, maintaining a small collection of objects that belonged to them, writing letters to the person who died, and creating family traditions that reference them. The goal is not to prevent the child from moving forward but to give them something to carry that doesn’t require standing still.

Watch for Complicated Grief — It Requires Professional Support

Normal grief and complicated grief (also called prolonged grief disorder) look different. Red flags that warrant professional evaluation include: grief that is intensifying rather than gradually decreasing at three months or more post-loss; complete inability to discuss or reference the deceased; significant functional impairment (school refusal, inability to eat, social shutdown) persisting beyond four to six weeks; persistent belief that the deceased is still alive in a non-developmental way; explicit statements about wanting to die to be with the deceased.

The neuropsychological assessment framework is a useful reference for parents trying to determine when a child’s functioning has crossed from normal stress response into territory requiring professional support. Complicated grief in children is treatable — but it requires trained clinicians, not just time.

Take Care of Your Own Grief — Visibly

Bereaved parents often suppress their grief to protect their children. The research says this backfires. Children who observe a surviving parent expressing grief — crying, saying “I miss Dad today too,” acknowledging sadness — adjust better than children whose surviving parent appears to have no emotional response to the loss.

The mechanism, according to Worden (2018), is modeling. Children learn how to grieve by watching adults grieve. A parent who names their sadness, tolerates it without being overwhelmed, and continues to function shows the child that grief is survivable. A parent who acts as though nothing happened leaves the child without a script.

The important qualifier: modeling healthy grief is different from being overwhelmed in front of a child. Brief, acknowledged expressions of sadness are adaptive. Extended emotional collapse in a child’s presence is not. The goal is authentic, regulated grief expression — which, for parents in acute bereavement, often requires their own support.

Use School as a Resource

Teachers, school counselors, and coaches often have more daily contact with a bereaved child than any mental health professional. Schonfeld and Demaria (2016) specifically recommended that parents notify a child’s school of any significant death in the family, provide teachers with information about how the child is doing, and ask for a point of contact for concerns.

Understanding how emotional regulation develops in children can help parents interpret what they see at school — a child who holds it together all day and collapses at home is not doing fine; they’re depleting their regulation resources in one environment and running out in another. This is normal but worth monitoring.

What to Watch for Over the Next 3 Months

The first three months after a significant loss are the period of highest risk for the development of complicated grief. Normal acute grief looks like emotional waves — periods of intense sadness alternating with apparent normality, behavioral regression, sleep disruption, and difficulty concentrating. This should gradually, unevenly, decrease over the first two to three months.

Concerning patterns to watch for include: no apparent grief response (sometimes children shut down entirely, which is not resilience but suppression); intensifying behavioral problems that aren’t subsiding; persistent school refusal or academic collapse; increasing somatic complaints (headaches, stomachaches) with no medical explanation; significant withdrawal from previously enjoyed activities or friendships; explicit statements about death or not wanting to be alive.

Anniversaries — including the one-month, three-month, and one-year marks — often trigger grief reactivation. This is expected and normal. Naming it in advance (“The anniversary of grandma’s death is coming up — we might both feel extra sad this week, and that’s okay”) reduces the confusion and distress when it happens. Planning a small acknowledgment of the date — visiting a meaningful place, cooking a favorite meal, looking at photographs together — can transform an acutely painful anniversary into a meaningful ritual.

Frequently Asked Questions

Should I take my child to the funeral?

The AAP and Worden (2018) both recommend including children in funeral and memorial services, with preparation and a trusted adult available to accompany them if needed. Excluding children from these rituals to “protect” them often backfires — it communicates that death is too frightening to witness and removes the child from the community of grievers. Children who attend funerals with appropriate preparation report feeling included in an important family experience, not traumatized by it. Preparation means explaining in concrete terms what they will see, hear, and experience before they arrive.

How do I explain death to a young child who keeps asking when the person is coming back?

Repeat the truth patiently and consistently. Young children under five often don’t fully grasp permanence and may ask repeatedly. Answer the same way each time: “She’s not coming back. When someone dies, their body stops working forever, and they can’t come back. It’s okay to miss her.” Each repetition is the child processing, not failing to understand. The consistency of your response is itself reassuring.

My child seems fine — should I be worried?

Not necessarily. Children grieve in bursts and often appear fine between episodes. If a child shows brief sadness followed by apparently normal play, this is typical. The signal to watch for is complete absence of any grief expression over time combined with behavioral changes — increased irritability, sleep disruption, somatic complaints. “Fine” that is actually suppression often shows up in body and behavior before it shows up in explicit emotion.

When should we see a professional?

Seek professional support if grief symptoms are intensifying rather than gradually decreasing at three months post-loss; if the child is significantly impaired at school or socially; if there are any statements about wanting to die; or if the surviving parent’s own grief is significantly impairing their functioning. A pediatrician is a good first contact and can make referrals to grief-specialized therapists.

How do I talk about the person who died without making my child sad?

This framing reverses the goal. The aim is not to talk about the deceased without triggering sadness — it’s to talk about them in ways that gradually make the sadness more bearable. Mention the person naturally in conversation: “Your dad would have loved this.” Share memories and stories. Laugh about funny things they did. Sadness that arises from these conversations is healthy; it means the child is processing the loss. Avoiding the deceased to keep a child from feeling sad teaches the child that their grief is dangerous.

Does grief affect school performance?

Yes. Bergman et al. (2017) documented academic disruption as one of the most common school-age bereavement presentations. Concentration, memory, and motivation are all affected by grief, and teachers should know about significant losses. Accommodations (extended deadlines, permission to step out when overwhelmed, a trusted adult to check in with) during the first several months are appropriate and helpful — not coddling.

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About the author

Ricky Flores is the founder of HiWave Makers and an electrical engineer with 15+ years of experience building consumer technology at Apple, Samsung, and Texas Instruments. He writes about how kids learn to build, think, and create in a tech-saturated world. Read more at hiwavemakers.com.

Sources

• Worden, J. W. (2018). Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner (4th ed.). Springer Publishing.
• Silverman, P. R., & Worden, J. W. (1992). Children’s reactions in the early months after the death of a parent. American Journal of Orthopsychiatry, 62(1), 93–104.
• Luecken, L. J. (2008). Long-term consequences of parental death in childhood: Psychological and physiological manifestations. In M. S. Stroebe et al. (Eds.), Handbook of Bereavement Research and Practice. American Psychological Association.
• Bergman, A. S., Axberg, U., & Hanson, E. (2017). When a parent dies – a systematic review of the effects of support programs for parentally bereaved children and their caregivers. BMC Palliative Care, 16, 39.
• Schonfeld, D. J., & Demaria, T. (2016). Supporting the grieving child and family. Pediatrics, 138(3), e20162147.
• American Academy of Pediatrics. (2016). Helping children cope with loss. AAP Policy.