Tips for Caregivers of Grieving Children with Developmental Delays

Posted on January 22, 2026 by Bridget McHallam, Child Life Intern

When a child with developmental delays experiences the death of someone close, caregivers often wonder how to explain what has happened and how to offer support that fits the child’s unique needs. Grief looks different for every child, and understanding their developmental stage, not just their age, is key to helping them make sense of loss.

Understanding How Children Perceive Death

A child’s understanding of death is shaped by their developmental level, not their chronological age. For instance, a 10-year-old with developmental delays may think and grieve more like a 4-year-old.

Children learn about death through three core concepts. Their grasp of these ideas grows as their cognitive and emotional development progresses:

Universality: Everyone and everything that lives will eventually die.
Younger children may believe death only happens to certain people or can be avoided.
Irreversibility: Once someone dies, they cannot come back.
Children with limited cognitive understanding may think death is temporary, like sleeping or going away.
Functionality: When someone dies, their body stops working (no breathing, eating, or feeling).
Concrete explanations can help children connect the concept to what they observe.

Understanding where your child is in relation to these ideas helps you tailor your explanations and expectations.

Behaviors You May See

Children who struggle to express emotions verbally often show grief through behavior. Grief can affect mood, sleep, routines, and social connection—not just trigger sadness. You might notice:

Increased irritability or mood swings
Regression (bedwetting, baby talk, comfort items)
Aggression or acting out
Changes in sleep patterns (trouble falling asleep or oversleeping)
Nightmares
Clinginess or separation anxiety
Repeated questions about the death
Withdrawal or loss of interest in play
Increased attachment to routines or rituals

Using visual supports, like photos, drawings, or social stories, can help children process what’s happening.

How to Support Your Child

Offer reassurance and structure. Routines provide comfort and predictability when everything else feels uncertain.
Encourage expression. Let your child show feelings through drawing, play, or storytelling.
Create opportunities for remembrance. Simple gestures like lighting a candle, making a memory box, or attending a memorial can help them say goodbye.
Be patient. Grief may come and go or appear later; repeating questions or behaviors often reflects ongoing processing.
Be present. Quiet companionship can comfort more than words.
Label feelings. Simple statements like, “It’s okay to feel sad or confused,” validate their emotions.
Model healthy grieving. Share your own feelings in ways that feel natural: “I miss Grandma, and when I feel sad, I like to look at our photos together.”
Seek outside support. Grief counselors, child life specialists, or therapists experienced with developmental differences can offer additional guidance.

Supporting a grieving child with developmental delays takes patience, honesty, and compassion. By meeting them where they are developmentally and offering consistency, love, and understanding, caregivers can help children navigate loss in a way that feels safe and meaningful.

Cognitive Development Chart

This developmental chart is designed to help you understand where your child with developmental delays may be in their cognitive development. It can offer insight into how your child is making sense of the world and how you can best support them during times of grief.

Step 1: Determine what developmental stage your child is in based on cognitive characteristics and grief reactions described.

Step 2: Apply stage-appropriate support strategies.

Step 3: Reassess regularly—children may shift stages depending on stress, routines, and grief intensity.

For additional guidance or questions about your child’s developmental stage, please contact the Children’s Program: [email protected] or 855-774-5100.

Developmental Stage	Cognitive Characteristics	How Grief May Show Up	How to Support
Sensorimotor Stage	Understands the world through senses and physical actions Limited understanding of time, cause and effect, or permanence Lives in the “here and now” May use gestures and basic words; communication may be nonverbal	Increased fussiness, clinginess, or need for physical comfort Changes in sleeping or eating Searching behaviors (looking for the deceased person, their belongings) Repetitive behaviors or regression (loss of skills) when routines change Distress without understanding why they feel upset	Provide consistent routines and predictable caregiving Offer extra physical comfort: holding, rocking, sitting close Use simple, concrete language (“Dad is not coming back. You are safe.”) Maintain familiar objects and sensory comforts Use visual support (photos, simple social stories) to explain changes
Preoperational Stage	Magical thinking (“my thoughts caused this”) Limited understanding of permanence; may think death is reversible Thinks in concrete, literal ways Difficulty understanding sequences of events Curious and often repeats the same questions	Confusion about what “death” means Fear of separation from caregivers Misunderstanding death as sleep, disappearance, or punishment Behavioral changes: tantrums, regression, toileting changes, fears May reenact death or conversations through play May repeatedly ask the same question about what happened	Use short, clear statements: “Death means the body stopped working.” Avoid euphemisms (like “went to sleep”) Repeat explanations as many times as needed Provide opportunities for symbolic play (dolls, drawings, storytelling) Reassure safety and permanence of caregivers Encourage expression through drawing, music, or sensory tools
Concrete Operational Stage	Can understand simple cause and effect Begins to grasp permanence and universality of death Still thinks concretely; abstract emotions are confusing Logical thinking emerging but still limited May understand others’ perspectives inconsistently	Worries about their own or caregiver’s death May ask factual or biological questions about death Sadness, anger, guilt, or withdrawal Difficulty verbalizing complex feelings Somatic complaints (stomach aches, headaches) Increased need for structure and predictability	Offer honest, concrete explanations of death and grieving Give them choices to increase sense of control Normalize all feelings: “It’s okay to feel angry or confused.” Encourage expression through art, journaling, or physical activities Provide clear routines and prepare them for changes Offer reassurance that they are not responsible for the death
Early Formal Operational Stage	Emerging ability for abstract reasoning, but may still rely on concrete explanations More aware of social and emotional dynamics May understand complex concepts inconsistently Better able to predict consequences but may misinterpret them	Strong emotional reactions but difficulty regulating them Self-blame or existential worries Desire for independence but also fear of loss Isolation, withdrawal from peers, or acting out Risk-taking behaviors (depending on developmental maturity)	Use a mix of concrete and simple abstract language Provide opportunities for private expression (journals, music, art) Encourage safe conversations about fears or guilt Provide structure while respecting their independence Offer peer support groups adapted to their developmental needs
Formal Operational Stage	Can think abstractly and hypothetically Understands complex emotions, symbolism, spirituality Can consider multiple viewpoints and future consequences May struggle with emotional overload despite understanding	Existential questions (“Why do people die?”) Identity struggles (“Who am I without them?”) Increased anxiety, depression, withdrawal Need for independence but simultaneous longing for support Possible risk-taking (depending on emotional regulation skills)	Encourage open discussion of complex feelings Validate existential and identity-related questions Offer choices to promote autonomy Provide access to peer groups, counseling, or support circles Teach emotional regulation strategies (breathing, grounding) Create safe space for independence and connection

Citations

Van Dyke, L. (2003). Lessons in grief & death: Supporting people with developmental disabilities in the healing process.
Behm, S. Grief by age: Developmental stages and ways to help. Eluna. https://elunanetwork.org/resources/developmental-grief-responses/
Dougy Center. (2025). Developmental responses to grief, ages 2 to 18. https://www.dougy.org/assets/uploads/Developmental-Responses-to-Grief-ages-2-18.pdf

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