People of all ages experience losses. One of the many things children must learn, is how to cope with loss. Losses may be relatively minor and require only a brief adjustment process or they may be more significant, causing major changes in life, either temporarily or permanently. One kind of loss that young children may experience is death or loss of access to parents or other significant adults through divorce, relocation, hospitalization or institutionalization, or incarceration. Another is the loss of home because of eviction or natural disaster.
Usual reactions to loss include feelings of sadness and regret. Fear is another common early childhood response to loss and grief. Young children do not express these feelings like adults do, and they express them differently at different ages. At different ages, children adjust to loss differently, depending on their intellectual and emotional development and social supports.
WHAT TO EXPECT AND DO
Adults must not let children's reactions get lost in the turmoil that accompanies loss. Caregivers should expect that children of all ages may show eating or sleep disturbances, irritability, regression to earlier behavior patterns, or changes in desire for comfort and contact. Children who are coping with loss need familiar routines and structure, individual attention, reassurance, and consistency. It is important to talk to children of all ages in the face of loss, using words and ideas that are accurate and understandable to them. Caregivers should be aware of the age-specific signs of coping with loss and should use appropriate strategies related to the child's developmental stage.
Infants and toddlers may not understand what has happened; they will react to the emotions of others around them, as well as to changes in routines, stimulation, and environments. Children this age may react to loss with irritability, disruption in eating or sleeping, clinging, or regressions to earlier behavior patterns.
To help infants and toddlers cope with loss, caregivers should maintain routines insofar as possible. Pay attention to the child by responding to his/her needs, cuddling, hugging, and interacting with the child frequently. Remember, family members may be so emotionally distraught, worried, and preoccupied, that they are unable to provide young children with their usual love, care, and attention. Caregivers may fill the gap at a crucial time.
Children who are 3 or 4 understand far more language than they can use to express themselves. However, children of this age do not understand some important concepts, like the permanence of death. They may respond with common reactions as mentioned above as well as act out aggressively, have tantrums, withdraw, stop toileting themselves reliably, and even think they are responsible for the loss itself. Such thoughts can lead to destructive feelings of guilt.
Caregivers can help 3-4 year olds cope with loss in some of the same basic ways already identified. In addition, help the child express feelings both through play opportunities and by naming feelings. A simple explanation by adults and reassurance that they are safe and cared for will also help toddlers and preschoolers cope better. If regression or acting out persist long after the loss, suggest that the family consider consulting a professional.
Younger school aged children (5-7 years old) may or may not understand the real meanings of loss. Even if children this age grasp what has happened, they are unlikely to understand all the implications of major life-changing loss. They may exhibit the same regression, neediness, or withdrawal that younger children do as well as increased social or school problems. Five to 7 year olds are likely to ask questions, often repeatedly.
To help 5-7 year olds cope with loss, caregivers should make sure that someone explains what has happened very simply and concretely, as many times as needed. Prepare them for unusual events by telling them what to expect. With support, children this age can participate in grieving rituals and other responses to loss.
Older school age children who are grieving or coping with significant loss may be particularly vulnerable to peer influence and poor judgement during that time. Caregivers should be alert to school performance issues, behavior problems, withdrawal, and major changes in peer interactions. Some adverse reaction is normal, but it should be temporay. If it lasts more than a few months or seems to be jeopardizing the child's well being, alert the child's family to your concerns. Remember, parents may be preoccupied with grieving and coping too, and may be paying less attention to their children than usual.
It is important to keep parents informed. Let them know what you observe of their child's initial reactions to the loss, and his or her adjustment, coping, and grieving over time. Be as specific as possible. Discuss strategies for helping the child and be prepared to suggest additional sources of help if necessary. Every child care provider should know of at least one community mental health professional who is skilled in working with children and their families.
STAFF TRAINING
Most of the staff have probably suffered enough of a loss to have had to cope and grieve. Inservice training that helps staff understand their own coping styles as well as provides information and understanding of normal child responses to loss may be helpful. If the losses that children are coping with are the result of a community tragedy rather than a personal one, it is particularly important to support staff's own response and adjustment. They can then help children cope with loss through classroom activities, art, stories, and play.