Every parent has stood in that moment — the one they hoped would never arrive. A grandparent has died. A pet is gone. A family has fractured. And the child before them is carrying something so large and so formless that neither of you quite knows what to do with it. You want to help. You want to say the right thing. And in the particular silence that grief creates you are wishing someone had told you what the right thing actually is.
There is no single right thing. But there is a body of knowledge — clinical, developmental, and deeply practical — that can help any adult who loves a grieving child understand what that child is experiencing, what they need at each stage of development, and what kinds of support are most likely to reach them.
Helping children with grief is not a single skill. It is a different task at every age — shaped by the child’s current understanding of death, their cognitive and emotional developmental stage, and the particular quality of the relationship they have lost. Grief reactions in children are influenced by ongoing developmental processes and manifest differently depending on the child’s age and developmental stage — and these grief-related processes unfold within the caregiving context, as children and adolescents rely heavily on the adults in their environment to navigate and cope with the death of a loved one. A three-year-old and a twelve-year-old can lose the same person and grieve in ways that barely resemble each other.
What Children Understand About Death — and When
Before exploring what helping children with grief looks like in practice, it is worth establishing something that the research makes consistently clear: a child’s understanding of death is not simply a smaller version of an adult’s. It is a qualitatively different understanding, shaped by the cognitive frameworks available at each particular stage of development, and changing significantly across the childhood years in ways that directly determine how grief is experienced and expressed.
Grief in children and adolescents is a complex and often misunderstood process, distinct from adult mourning in both its expression and developmental impact. Young people may struggle to articulate their emotions, leading to behavioural changes that are frequently misread as anxiety, oppositional behaviour, or stress related to developmental transitions.
Up to approximately age three, children have very little conceptual understanding of death. All objects are experienced as alive — a perspective developmental psychologists call animism — and the permanence of death is entirely beyond the child’s cognitive reach. What the very young child registers is not death as a concept but absence as a felt experience: something important is missing, the environment feels different, and the people around them are behaving in unfamiliar ways.
Between three and five years, children begin to move away from universal animism but do not yet grasp the permanence of death. As Sarah Behm, PPS, MBA notes in her developmental framework for childhood grief, this age group may believe the person is simply asleep and will wake up — a phenomenon known as magical thinking that is entirely normative for this stage and should never be corrected with impatience or alarm. The preschool child’s belief that the deceased will return is not denial in the clinical adult sense. It is developmental reality.
Between five and eleven years, children gradually develop an understanding that death is permanent — and around age nine, most children reach the significant milestone of understanding that death is both personal and universal: that they themselves will one day die, and that all living things are subject to the same inevitability. This understanding, while developmentally appropriate, can generate significant anxiety alongside the grief of the immediate loss.
Adolescence is an important life transition. Mixing grief in with that can be complex — some adolescents may become more anxious and hypervigilant about protecting themselves and others, while others might engage in risk-taking behaviours to test the boundaries of life and death.
How Grief Appears at Each Stage
Understanding what grief looks like at each developmental stage is as important as understanding what the child conceptually understands about death — because grief in children rarely looks like adult grief, and the failure to recognise it for what it is can leave a child’s experience unacknowledged and unsupported for longer than it should be.
Infants and toddlers — ages 0 to 3
The grieving infant or toddler does not cry for the person who has died in the way an older child or adult does. What appears instead is a cluster of behavioural, emotional, and physical signals that reflect the disruption of the regulatory environment the child depends on: reduced affection toward caregivers, rejection of the environment, slow or hyperactive movement, prolonged sadness, anxiousness and difficulty being soothed, loss of appetite, sleep disturbances, and what Behm describes as fragmented memory — the sense that something is missing without the cognitive framework to understand what or why.
Most infants, children, and adolescents experience normative changes in their emotional, behavioural, and social functioning following the loss of a parent or other caregiver. For the very youngest, this response is, at its root, an attachment response: the nervous system registers the absence of a regulatory presence and responds accordingly.
Preschool — ages 3 to 5
The preschool child’s grief manifests through behaviour — clinginess, stubbornness, impulsivity, regression to earlier developmental behaviours such as bed-wetting or thumb-sucking — and through the magical thinking that is characteristic of this stage. Constant questioning is common: the preschool child may ask where the person has gone repeatedly, not because the answer has not been given but because the permanence it implies is not yet cognitively available to them.
One of the most clinically important features of preschool grief is the child’s tendency toward what Behm identifies as toxic shame or excessive guilt — the belief that they caused the death. The preschool child’s egocentric cognitive framework makes this conclusion feel entirely logical. This belief must be addressed directly, warmly, and without alarm.
Elementary school — ages 5 to 11
The elementary school child’s grief tends to be more visible in its behavioural expression: irritability, tantrums, aggressive outbursts, social withdrawal, difficulty in school. The body often carries what the mind cannot yet process: frequent stomachaches and headaches, sleep difficulties, changes in appetite. A child’s distress may not manifest as sadness — it may appear through stomach pain, school refusal, irritability, or unexpected changes in behaviour that are frequently interpreted as anxiety, oppositional behaviour, or stress related to developmental transitions.
Cognitively, the elementary school child may become preoccupied with the details of the death and with death and dying more generally. The fear that characterises this stage is worth noting: the child who understands that death is personal and universal may become acutely anxious about the safety of the surviving people in their life — and particularly about the safety of their remaining primary caregivers.
Middle school — ages 11 to 13
Although adolescents are typically better able to process death compared to younger children, they will often be avoidant of their feelings and may suppress them in attempts to please or avoid upsetting others. The pre-teen’s grief is often masked — this age group is considerably better at hiding their feelings than younger children, and the social pressures of early adolescence create additional incentive to appear unaffected. What shows through the mask is often risk-taking, acting out, experimentation with substances or unsafe behaviours.
Survivors’ guilt — the painful conviction that they should have died rather than the person who did — is more common in this age group than in younger children. Research has found that after the death of a loved one, children may have prolonged or noticeable experiences with maladaptive grief, and caregiver behaviours play a central role in facilitating or inhibiting healthy grief responses in children and adolescents.
High school — ages 13 to 18
The adolescent’s grief combines adult cognitive complexity with the emotional intensity and regulatory challenges of a nervous system still under active development. Risk-taking escalates. Academic functioning deteriorates. The existential dimension of the loss — questions about meaning, about mortality, about the purpose of a life that can end without warning — becomes central in a way that it does not for younger children.
The adolescent grieving child deserves particular clinical attention because the presentations that can accompany their grief — depression, anxiety, suicidal ideation, self-harm, substance use — are both more common and more serious than at earlier developmental stages. Prolonged Grief Disorder was added as a new diagnosis to the DSM-5-TR, reflecting the field’s increasing recognition that for some children and adolescents, grief reactions can persist and significantly impair functioning in ways that warrant clinical intervention.
Prolonged Grief — When to Seek Professional Support
Most children move through grief in a way that, while painful and sometimes disruptive, does not permanently impair their development or functioning. But for some children, grief becomes complicated — prolonged, intensifying rather than gradually easing, or accompanied by clinical presentations that exceed the capacity of even the most loving and present adult support network.
Bondy and Scott’s 2025 systematic review of interventions for Prolonged Grief Disorder in children and adolescents highlights that while evidence-based interventions exist and are effective, access to trained providers across sectors — paediatrics, social work, behavioural health, and schools — remains a critical gap.
Signs that professional support may be needed include: grief that is intensifying rather than gradually easing after several months; significant and persistent deterioration in school functioning, peer relationships, or daily living; the emergence of depression, anxiety, suicidal ideation, or self-harm; risk-taking behaviour that puts the child in danger; and the child’s complete inability to speak about or acknowledge the loss across an extended period.
Seeking professional support is not an indication that the adult has failed the child. It is an indication that the child’s grief has reached a level of complexity that deserves specialist care — and that the adult recognises this with the same clear-eyed attentiveness that brought them to the question of helping children with grief in the first place.
Grief Activities for Kids: What Play Therapy Offers
The research on grief and childhood consistently identifies creative, expressive, and play-based activities as among the most effective therapeutic tools available for grieving children — not as supplements to real therapeutic work but as the primary medium through which children at most developmental stages are best able to process the experience of loss.
Play therapy is a highly adaptable treatment method that can be modified according to children’s ages, circumstances, and the settings in which counselling occurs — and can be used in schools, community settings, and homes to help children following the death of a significant other.
For children aged 3 to 12 years, play therapy is an effective treatment modality — and applying cognitive-behavioural approaches in the context of play can be beneficial across the developmental range. This is not surprising from a developmental perspective. Language — the adult’s primary medium for processing grief — is the tool least available to children in the most intense moments of emotional experience. Play, drawing, storytelling, movement, and creative making are the tools most available — the languages through which children have always processed what is too large and too complex for words.
The Play Therapy Toolbox: 123 Simple Play Therapy Activities and Therapeutic Games Supporting Every Stage of Child Development from Age 3 to 12 contains dedicated activities for grief and loss across every developmental stage — each one grounded in the same developmental understanding that informs this article, and each one designed to meet the grieving child where they actually are rather than where we wish they were.
The activities draw on sandtray, expressive arts, narrative therapy, somatic approaches, and attachment-based play — because grief in children does not have a single therapeutic route through it. It has as many routes as there are children grieving. And a resource built around that understanding is one that can actually be used.
A note I feel strongly about: before attempting any self-help grief practices at home, I would sincerely recommend consulting a qualified mental health professional. Even when a child’s grief appears normative, a single assessment session with an experienced clinician can provide invaluable guidance on what that specific child needs — and peace of mind for the adults around them.
Three Things Worth Knowing
Grief in children does not look like grief in adults.
The child who is playing happily twenty minutes after being told someone has died is not in denial and is not unaffected. They are processing the news in the way children process overwhelming emotional content — in doses, through the activities that regulate their nervous system, in the intermittent way that is the developmentally appropriate rhythm of childhood grief. The adult who expects sustained visible sadness will miss most of what the child is actually experiencing.
The language of death matters more than most adults realise.
The clinical literature consistently recommends using the words dead and died rather than euphemisms such as gone, passed on, or no longer with us — because euphemisms introduce ambiguity that a child’s developing understanding of death cannot easily resolve. A child told that someone has gone will, entirely logically within their developmental framework, expect them to come back.
This does not mean delivering the news without care or preparation. It means that the words chosen should be honest — embedded in a conversation that is warm, unhurried, age-appropriate, and held within a relationship the child feels safe in. The goal is not clinical directness for its own sake. It is the kind of honest, gentle truth that gives a child something real to grieve — rather than an ambiguity that leaves them waiting for something that will never arrive.
How the conversation begins, where it happens, who is present, and how much time is given to the child’s response all matter as much as the words themselves. The truth, offered carefully and with love, is not unkind. It is the most respectful thing an adult can offer a grieving child.
You do not have to have all the answers.
The most important thing any adult can offer a grieving child is not the right words. It is presence — warm, regulated, honest. The adult who sits beside a grieving child and says I don’t know, but we will figure it out together is offering something more valuable than any explanation: the experience of not being alone with something that is too large to carry alone.
Disclaimer: This article is intended as an educational and supportive resource for parents, caregivers, educators, and mental health professionals. It is not intended to diagnose, treat, or replace professional therapeutic or medical care. If a child is experiencing significant emotional, behavioural, or developmental difficulties, please seek guidance from a qualified mental health professional.
Rostislava Buhleva-Simeonova is a psychologist, art therapist, and gamificator. She has worked with children, adults, and the elderly within various therapeutic programmes over the past eight years, all the while providing the much-needed playful twist that art and gamified experiences can bring to this sometimes uneasy setting. But it wasn’t until the birth of her daughter, Aurora, that this work took on an even deeper personal meaning. With her academic and real-life experience, honed through numerous trainings and sessions, she is currently authoring books and articles in the field of child psychology and development, offering expertise in art and play therapy to guide parents and caregivers, as well as professionals in the fields of social work and mental health, throughout various pivotal moments in children’s lives. Last but not least, all of her books have been “peer-reviewed” by her daughter, who testifies to the efficiency of these methods.
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