Child Grief and Loss: Developmental Effects Across Ages

Introduction: Understanding Child Grief

Grief is a natural and inevitable part of human existence, and most people experience some kind of loss during their lifetimes. Historically, the majority of research literature regarding grief has focused on this phenomenon in adults, with very little attention paid to the depth of suffering children experience in response to loss (Bonanno et al., 2007). Until recently, the complexity and breadth of impact that loss events have on children have been understood primarily through the lens of adults' experiences rather than through concern for the children's own experiences and needs (Melhem et al., 2008).

The purpose of this paper is to critically review current literature for a deeper understanding of the potential short-term and long-term deleterious effects of grief on child development across social, physical, cognitive, and emotional domains. Using a hypothetical case of a six-year-old girl named Emma who is affected by the death of her father, this review will describe and evaluate current findings and challenges in child grief research from the perspectives of developmental psychology. The paper will investigate the possible impacts of grief and loss in relation to children's developmental conceptions and reactions to death. By examining relevant studies concerning these issues, this review will identify a number of steps to ameliorate potential negative effects of grief related to death for children like Emma.

Short-Term and Long-Term Effects of Child Grief on Development

In normal circumstances, children achieve different developmental tasks linked to psychological maturity primarily within the framework of their association with adults. Loss of a single parent or both parents owing to death constitutes a significant effect on a child's mental development and potentially on cognitive and physical growth as well. Although the impacts of parental loss will differ from child to child and from family to family, the negative impacts caused by this loss can be reduced only if the child is able to dwell in a surrounding that is accommodating to the mourning process and can provide clarification and understanding of life proceedings (Hensley et al., 2009). Unfortunately, many children who have experienced this shock have not obtained adequate assistance in coming to terms with the loss and often remain psychologically affected at the level of functioning they had at the time of the parent's death.

In a study conducted by Brent et al. (2009) on child bereavement, the researchers found that the degree of depression and anxiety remained high in bereaved children, who demonstrated larger functional impairments. A history of depression prior to the loss predicted depressive illness in bereaved youth. Brent also found that self-blame and blaming others for the loss, typically associated with complicated mourning, was a risk factor for depression in the following year. Brent et al. suggest that their results advocate for treatment of depression and complicated mourning in the first nine months following the death, as this may prevent longer-term harm.

The short-term effects for a child who has lost a parent during the first year include deterioration in meeting basic reliance and care needs. The child may not seek or respond to basic necessities in the way they did before experiencing the loss. Additionally, the child's sense of security and confidence will be affected by the reality that adults may not be readily available. Another short-term effect is disruption in the attainment of sequencing and understanding cause-and-effect relationships, resulting from changes in daily routines and caregivers. To lessen these short-term effects, the surviving parent should always be available "on demand" for the child and should cater to earlier developmental basic needs once more. All interactions with the child should be evaluated by asking, "What will help this child develop the belief that a grown-up person will be available?" Additionally, it is critical for the mother to maintain a consistent routine (O'Connor et al., 2008).

Death During the Initial Year of Life

The possible long-term impacts include the risk that if the child's dependency needs are not met, she will mature believing that she is owed by life. Additionally, she is likely to have difficulties in meeting the dependency needs of others. Trust in others will be severely damaged. Furthermore, learning difficulties secondary to problems with cause-and-effect reasoning are likely to occur, and may not become obvious until later years (Simon et al., 2007).

At this stage, short-term impacts include disruption of the balance between age-appropriate dependency and interdependency. Interference with identity development, stemming from changes in family structure, will disrupt the child's personality growth. The child's awareness of both internal and external stimuli can be diminished, and there is a possibility of deterioration in recently acquired skills. Additionally, the normal acquisition of language can be temporarily interfered with by parental death, especially if the deceased parent was the child's primary language model.

Death During Ages One to Three (Infancy Years)

It is important to note that careful attention should be paid to meeting the child's dependency needs while simultaneously helping them feel increasingly sufficient and capable of some interdependence on their own terms. If the child is permitted to return to former levels of functioning, they will generally regain skills within a few months. However, if excessive pressure is exerted on the child to maintain peak functioning or achieve new skills without adequate time for adjustment, long-term difficulties are most likely to occur.

The long-term impacts include the possibility that the child will permanently assume the role of the deceased in the future. Interference in personality development, with an increased incidence of borderline ego disturbances, could be a severe effect. Inadequacy in self-awareness may be ongoing. There could be long-term subtle language difficulties. Once they become adults, these individuals may be rigid, inflexible, and unable to manage aggressive impulses effectively (Shear et al., 2007).

Death During Ages Three to Six

This is the age bracket in which Emma's case falls. At these ages, Emma's egocentric and magical reasoning may prevent her from understanding the cause of her parent's death. It is very important that Emma's mother identify Emma's personal magical reasoning concerning the death—for example, is Emma thinking that she caused the death, or that she can do something to undo it? Another short-term effect is that Emma may display indiscriminate attachment to adults. She is also likely to experience contradictory feelings regarding what is good and bad in herself and others.

These short-term effects can be reduced significantly by identifying, clarifying, and validating magical reasoning—acknowledging that Emma may feel responsible is crucial. Another approach involves giving the child age-appropriate explanations for the loss and repeatedly reassuring Emma about her position in the family. Additionally, sufficient opportunities for play must be offered at this age, as each psychological issue, including mourning, should be worked through primarily through play.

The probable long-term impacts of the loss include the risk that, given the magical thinking pattern of good versus bad, Emma may believe that she is bad and responsible for the loss. Emma may also think that her father's death was connected to her wanting her mother to herself, which could have long-range implications for her sexual development and increase the risk of sexual exploitation. The magical reasoning and the good-versus-bad struggle may cause Emma to relate her father's death to her being too big or too little in her family.

Death During Ages Seven to Twelve

The short-term effects include the reality that children at this age bracket attend school, and if a parent dies, little energy is available for normal duties. Additionally, children become aware of differences between themselves and peers, which could lead to withdrawn or difficult behavior with age mates. To reduce the impacts of loss, children should be provided with opportunities to focus on mourning so that they can later concentrate on tasks at hand. Second, children should be assisted in developing more sophisticated reasoning and realistic understanding of death. Third, children should receive permission to leave behind old lifestyles and develop new ones. An example of a long-term effect includes difficulties with the internalization of conscience.

At this developmental stage, teenagers require the presence of parent figures to complete their psychological tasks of developing autonomy while still having authority figures available. Parent loss will interrupt these critical developmental tasks. Additionally, control issues will continually affect the teenager's behavior, particularly if they feel that major decisions about their life are beyond their control.

Loss at Teenage Years

To reduce short-term effects, teenagers need to feel that they have increasing control over their own lives. Adults should provide them with as many opportunities as possible to exercise control over various aspects of their lives and to participate meaningfully in decision-making about their future. Teenagers also require assistance in determining how much of their history to disclose to friends and peers. The possible long-term effect is that if the teenager believes they have lost all control over their own life, they may experience severe psychological consequences including suicidal ideation (Zisook et al., 2007).