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Grief is a physical, emotional, behavioral, and cognitive response to loss (Worden, 2002 ). Children of all ages grieve (Doka, 2000 ). However, a child's expression of grief varies and is dependent on developmental age (Hunter & Smith, 2008 ). An understanding of the relationship between and age and manifestations of grief in children is crucial for practitioners to provide effective interventions to a grieving child. In the vignettes that follow, all names as pseudonyms.
Infants
Jane is a 12-month-old girl whose mother developed complications with a subsequent pregnancy and required total bed rest. The only viable option was for Jane to be cared for by an aunt and uncle whom she had met only a few times and who lived in a neighboring state. When the aunt and uncle came to pick her up, Jane protested and cried heartily as she was carried away from her mother to the car. She continued to have periods of tears and intense crying for a few days, but then became quiet and apathetic. Three weeks later, when her mother's condition improved, Jane was able to return home. However, when Jane entered her house, she appeared indifferent to seeing her mother again. Instead, she made her way into her bedroom and curled up on a chair with a blanket and sucked her thumb.
Jane's behavior exemplifies a grief reaction in a very young child. Bowlby (1980 ) theorized that infants are capable of grief once they develop a sense of object permanence with the caregiver, at approximately 6 to 8 months of age. Loss of the caregiver, either permanently or temporarily, is manifested by protest (crying), despair, and detachment. If the caregiver does not return after repeated protests over time (or cannot return, as in the death of the caregiver), despair develops, followed by detachment. A detached child does not readily re-attach to subsequent caregivers. Thus, for an infant, the most painful emotions associated with grief include intense feelings of abandonment and disruptions in forming future healthy attachments with others. Grief in infants is also exhibited in physical manifestations. Studies of infants separated from their mothers and placed in institutions have demonstrated grief reactions that were so extreme as to be life threatening,...