For Families > Keeping Kids Healthy > Talking About Tough Topics

Talking with Children About Difficult Subjects: Illness, Death, Violence and Disaster

by Staff of the NYU Child Study Center, Updated by Claude Chemtob, Ph.D., September 2010

Children ask a lot of tough questions. Questions that touch on death, whether related to a serious illness, a traumatic event or an international tragedy, such as an act of terrorism, war or natural disaster, are some of the hardest to answer. Parents may wonder if they should protect their children from these potentially frightening subjects or confront them head on. And, because more often than not parents are themselves emotionally affected by these types of events, helping children deal with them is made harder.

Professionals and teachers may also wonder how much information to provide or how to help children if they are confused, troubled or asking tough questions in the wake of upsetting news or events, personal or global. The following list of tips addresses some concerns and questions parents and school professionals may have regarding conversations with children on these difficult topics.

Contrary to adults' fears, talking about illness, death, violent acts or threatening events will not increase a child's level of distress. It is very important to engage in an open discussion about children's feelings, fears and worries. Avoiding discussion of scary and sad events and the strong feelings they engender likely has more potential for harm than talking about them does.

However, as with other topics, it's important to consider the age and developmental level of the child when entering into a discussion. According to the National Institutes of Health, research has shown that two main factors influence a child's understanding of death: their developmental level, and their experiences.

Even children as young as four or five typically have some awareness of death, both on a small scale, like a dead insect in the yard, and a much larger one, like the devastating earthquake in Japan. But not all children know how to talk about their feelings and concerns. Additionally, it is important to consider the child's personality, such as whether the child is fearful or anxious by nature, and previous experience, like the death of a relative, when talking about stressful life events.

While every situation is unique and talking with a child about a terminally ill aunt is by nature different from talking about a news event that, while potentially horrifying, doesn't impact your child directly, here are some general tips to bear in mind.

Talking with children about traumatic news or events

Be extra aware of their emotions
If your child has been exposed to upsetting news, either about someone they know or on TV, be aware of their emotional state. Does your child seem distant, shut down, or more anxious than usual? Don't assume you know what they are feeling, but pay extra special attention and invite open ended discussions (more on this below).

Be aware of your own emotional state
Children, especially young ones, are highly attuned to their caregivers' emotional states. They will pick up on tone of voice, body language and conversations that you have with other adults, as well as any more overt signs of stress, agitation, fear or sadness. While it's important to be honest in a direct discussion with your child, try as much as possible to shield your children from your own overwhelming emotional reactions to upsetting news. You want to share your own emotions, for example, "Yes, mommy is very sad because grandpa is sick," but if you can be calm while discussing the news with your child, it will help to reassure him or her. In fact, it can create a teachable moment: The child learns that it is normal to have strong and confusing reactions to sad news or worrisome situations and that adults may experience such reactions as well, but that adults are there to help the child make sense of the situation and his or her feelings.

Find out how your child is feeling by inviting open-ended conversation
Ask a direct, open-ended question and convey your sincere interest in hearing what your child has to say. "Have you heard that Aunt Miriam is sick?" or "Have you heard about the big fire at the hotel in Pakistan?" Your next question might be, "What did you hear about it?"

Find out what your child has seen or heard
As part of your conversation, ask your child what they know about the news at hand. You may discover that he or she believes someone with a gun is going to come into school and start shooting people, or that everyone he or she knows is going to die from the flu. Once you know your child's specific fears, you are in a better position to be reassuring.

Be sympathetic and non-judgmental about children's reactions and feelings
As mentioned previously, children's reactions will vary depending on their developmental stage and their past experiences. There is no right or wrong way to react to traumatic news, or to grieve if someone the child knows has died. Be accepting of your child's way of reacting, but also teach him or her that there are many ways people can respond. A child who prefers not to talk about it should have his or her wishes respected, for example. However, you can indicate that you understand that he or she does not want to talk just now, but many kids find that it helps to talk. Maybe your child will want to talk later. You can also introduce less verbal ways of interacting supportively, perhaps drawing, or taking a walk together.

Don't provide unnecessary details
While you don't want to shield your child from the truth, keep in mind his or her age and what is appropriate. The younger your child, the less information will be able to be absorbed at once. Certain details may be too upsetting and not necessary for his or her understanding of the situation at hand. Keep answers brief, simple and age appropriate, and for very small children, repeat your answers if necessary.

Don't avoid the subject
Parents may think they are protecting children by steering clear of potentially upsetting subjects. But children are often exposed to more than parents are aware, and a child's fears can grow out of proportion if there is no opportunity to address them. You may reinforce some of those fears inadvertently, especially if your child asks you directly about a topic and you avoid it. Children may then believe the subject is too scary to talk about. Thus in trying to protect your child, you may actually be generating more worry and fear. If you feel the need, do prepare yourself by talking through your own feelings first with someone you trust. The purpose of talking about these types of events is to convey to the child that the parent is available to help make sense of the experience, that having strong emotions does not need to result in feeling helpless or overwhelmed, and that, in short, it is normal to have strong and confusing reactions to these types of events. Let your child know that it is ok to ask you any other questions that he or she may have, either now or in the future.

If a family member or friend is seriously ill
Initiate a conversation with your child before the person's condition becomes grave, if possible. Depending on your child and the situation, you may want to take them for hospital visits, or express your care and concern through phone calls, cards or letters. Help the child find his or her way of expressing feelings about the event and the person. Your role is to enable the child to feel safe enough so that he or she can make sense of the events and what they mean.

Never coerce a child into being involved or make him or her feel guilty if he or she chooses not to call or visit, or if the contact is brief.

Inform your child soon after a death occurs. As part of your conversations with him or her, either before or after a death, you might remind your child that all living things die and make room for new things, and that it's okay to feel sad. As with hospital visits, don't force children to attend funerals. If they do attend, prepare them for what will take place.

Be honest
Children are very sensitive to dishonesty in adults. Tell the truth about how you're feeling. If you're scared, say so, but try to be as calm and reassuring as possible. It's also okay to say that you don't know the answer to a question. If a child asks about where people go after they die, for example, depending on your beliefs you might respond, "I really don't know the answer to that question. Different people believe different things," before going on to provide examples. Often these types of questions can be explored as a way of understanding why your child is asking. But exploration should not substitute for a direct response.

Be reassuring
Feeling safe and secure is very important to children, especially young ones. Even if you're afraid or sad, make sure they know you will do everything you can to keep them safe. No matter what happens, you'll be there for them just as you have been in the past. If a child fears that you will die, you might say something like, "I don't expect to die for a long time. I believe I will be here to take care of you for many, many years. But if something did happen to me and your mom, there are lots of people in your life who love you and would take care of you, like Uncle Eric and Aunt Suzanne."

You might also remind them of a time in the past when they were brave in the face of a scary situation. They have ways of coping with fears, and together, you as a family have likely gotten through difficult or upsetting situations in the past.

When talking about death, avoid euphemisms
If you tell your child Grandma went to sleep and isn't going to wake up, he or she may be terrified at nap time. If you say simply that Uncle Andrew got sick and died, your child may panic when he or she gets a runny nose. It may help to explain death as the absence of life - that when people die, they don't talk, eat, sleep, breathe, think or feel anymore. Dead flowers don't bloom and grow. A dead bird doesn't fly or sing.

Be aware of time and place
Although it is important to respond to questions when they arise, parents and school professionals are encouraged to have a discussion with children without distractions. The child should be given time and attention to discuss their perceptions, understanding, fears, worries and concerns. For example, if the topic comes up in the supermarket, tell your child that you're glad that the conversation arose and you'll go home and discuss it over ice cream. Similarly, if a child brings up the topic in a classroom setting not conducive to the discussion, school professionals are encouraged to discuss the matter in private with the child after class. Depending on the circumstances, teachers, school guidance professionals and clergy are often helpful to children in validating their feelings and helping them feel safe and able to process their experiences.

Don't force your child to have a conversation if they don't seem ready. Open the door, but don't push.

Don't minimize your child's fears
Do not dismiss or ignore a child's feelings. Avoid trying to cheer him or her up by saying it's not so bad. Children can feel embarrassed or criticized when their fears are minimized. Exploring the issues and finding positive ways of coping helps children master their fear and anxiety. Reassure children with facts about how people are protected (e.g., the police) and individual safety measures that can be taken (e.g., creating a hurricane preparedness plan). Avoid "what if" fears by offering reliable, honest information. Maintaining routines and structure is also reassuring to children and helps normalize a frightening event and restore a sense of safety.

Children can recover and you can help
Don't automatically assume that a traumatic event or death is so upsetting that a child will never recover. But, pay close attention to how your child is coping, and seek professional help as needed. Even if your child shows signs of difficulty, with appropriate care children can recover fully from even deeply traumatic events. Many people experience trauma, and most will recover.