The death of a close family member, especially a parent or sibling, places a tremendous stress on a child—an incomparable loss with bewildering experiences and feelings that begins a process of bereavement and adaptation. Similar feelings may be evoked by other serious losses such as divorce. Six percent of children younger than 10 years old have lost at least one parent; countless others mourn the loss of siblings, other relatives, and friends. These life crises place children at a significant risk for emotional, behavioral, and physical problems. The pediatrician is in a unique position to provide support and anticipatory guidance for these children and their families, to monitor carefully the progression of the mourning process, and to prescribe early intervention for apparent disturbances.
Children have many of the same feelings of grief experienced by adults. Yet, a child's grieving has unique characteristics. Children have varied behavioral manifestations and they may express them differently than adults in mourning. Some children show no outward signs of grief. Many seem to have a short, acute sadness and then seem to resume normal activities. Others manifest symptoms over a period of years. Because of these variations, each child should be considered individually to understand the personal meaning of the loss and the child's unique process of mourning.
For children who lose a loved one, the bereavement process consists of a three-step process: understanding and coming to terms with the reality and circumstances of the death, mourning, and resuming the normal course of living. Initial management requires careful attention to the child's developmental level, temperament, previous behavioral and developmental history, the relationship with the deceased, the circumstances of the death, and any significant changes in the child's life-style and caretaking.
- Copyright © 1992 by the American Academy of Pediatrics