How much do toddlers understand when someone they know dies? Do infants grieve? Can toddlers be protected from grief when the death is in their extended family? Most people, parents included, have trouble resolving their own grief and perhaps cannot consider the effects of the death of a loved one on children. Adults' discomfort with dying and the grief process affects young children's understanding of death. The younger the child, the more complicated and uncertain attempts at interpretation may become.
Social workers already working with a family when an unexpected death occurs can offer aid and comfort during the crisis. Sometimes a very young child is referred for therapy following a tragic family loss. Clinicians must realize that children three and younger are also affected by loss and that their grief is often underestimated. What suggestions can a clinician offer to parents who must tell a young child that a loved one has died? How does one acknowledge a child's grief?. How can the death of a pet become a preparatory life experience for a toddler?
This article attempts to answer these questions by reviewing the developmental theories that allow an understanding of infants' and toddlers' experiences of death and their reactions to grief. We present some common parental interventions that shape very young children's grief reactions to death. Often these interventions lead to toddlers' misconceptions of death and impede their healing. Potentially helpful and effective interventions are described for families and professionals helping children three and younger cope with their questions and anxieties about death.
Developmental Theory and Grief Work
In the 1940s two developmental theorists observed and documented the effects of the distress caused children by the loss of their mothers. Burlingham and Freud (1942) observed infants from birth to age four in the Hampstead Nurseries after they were separated from their mothers. Spitz (1946) conducted observations in New York on institutionalized infants from birth to age 18 months who had been separated from their incarcerated mothers for three months or longer. As the first serious studies of their kind, the works emphasized the profound effect the loss of the primary caretaker had on infants and concluded that the depth of infants' despair and grief can be life threatening.
Some years later other theorists described in greater detail the emotional experience and psychological processes that these early researchers had observed. Mahler (1961) considered the grief process an integral part of ego development. She conceived of grief as a "basic ego reaction," explaining that "as the ego emerges from the undifferentiated phase, the mimetic, gestural, and physiological signs of grief do appear, albeit in rudimentary form". If infants experience grief from their earliest days, then what does this process look like?
Bowlby (1960) analyzed normal infant attachment behaviors and what happens when this attachment is disrupted by a severe loss such as the long-term separation (by death, incarceration, foster care, and so forth) from close family members, particularly the primary caretaker. He emphasized that separation anxiety has an immediate relation to grief and mourning and described a three-step sequence of grieving behaviors through which infants process such a loss: (1) protest--the outrage and anguish over the loss, (2) despair--the realization of no hope, and (3) detachment--the separation from people in general. Because infants are not yet capable of reasoning through such a trauma, they may develop an inability to trust or bond with people. Without intervention, this detachment could lead to an overattachment to material things such as food and toys or the progressive loss of infants' will to live and grow as in a nonorganic failure-to-thrive illness.
Piaget's (1950) cognitive theory helps clinicians understand how children three and younger think of death. …