Loss is a normal and inevitable part of the human experience, but when it comes to supporting children in their grief, it can be hard to know where to begin. This month, OHSU Doernbecher staff join bereavement professionals across the country in recognizing Children’s Grief Awareness Month to bring attention to the unique needs of grieving children.

While many children who are grieving report feeling isolated among their peers, current estimates project that in both Washington and Oregon, one in 16 children under the age of 18 are grieving the death of either a sibling or parent.

Although adults are well-intentioned in efforts to protect children from their grief, avoiding conversations about death and grief can make it even more difficult for children to navigate very difficult and confusing feelings. Caregivers can best support these children and adolescents by providing honest, direct and truthful communication – for example, bereavement experts recommend saying that someone died, rather than using euphemisms (e.g., loss, sleeping) that can be incredibly confusing.

Caring adults can begin by encouraging children to talk about the person who died and helping children find a way to express their feelings (for some children, this may be through play, physical activity, journaling, drawing or other art projects). In addition, because a child’s needs are heavily impacted by their developmental age and stage, it can be helpful to understand what might be commonly expected at different stages:

• Infants/toddlers: While often dismissed as being “too young to understand,” these young grievers are especially attuned to changes in their caregivers and routines, and might experience sleep disturbances, increased fussiness and regressions of milestones.
• Preschoolers: These children believe that death is reversible and temporary, and may continue to look for the person who died. These children need opportunities to express their emotions through play.
• School age children: It’s normal for school age children to believe that they have some control over the world around them, meaning they may often feel some responsibility for the death. It’s also normal for children in this age range to have some understanding that death is permanent; they may be especially interested in details about what happens to the person’s body after death, including funeral or cremation services.
• Early adolescents: As children grow, they have a better ability to understand more of the abstract concepts about death and dying, and may have more questions about cultural or religious aspects. Grieving children in this age range may often minimize their feelings, for fear of being either “babyish” or different from their peers.
• Teenagers: Teenagers are better able to consider how the death of someone they love will impact their future decisions, and may be more likely to seek support from peer groups.

Please know that there are a number of excellent resources to support grieving children, including The Dougy Center and The National Alliance for Children’s Grief. Their websites provide caregivers with information, toolkits and activity suggestions to support children before and after a death. Additionally, for families local to Portland, the Dougy Center offers excellent support groups, and their peer-model support groups serve as a model for similar organizations throughout the country.

Lindsay Wooster-Halberg, L.C.S.W.
Medical Social Worker
Bridges Program (Pediatric Palliative Care)
OHSU Doernbecher Children’s Hospital  

Laurel Barnes, L.C.S.W
Medical Social Worker
Pediatric Neuro-Oncology
OHSU Doernbecher Children’s Hospital