Telling children bad news

Children often sense changes before anyone says anything. When adults stay silent or evade, a gap opens that children fill with their own imagination. That imagination is often more frightening than reality. Younger children in particular also sometimes relate events to themselves: “Dad is in hospital because I was naughty today.”

Clear, true and simple statements give orientation. They show the child: I am not being shut out, I am being told the truth, I can trust the adults. At the same time the child needs the security that someone is there for them – who is taking care of them, where they will sleep, what happens next.

The WHO guide on psychological first aid and the Field Operations Guide of the US National Child Traumatic Stress Network both include advice on children: closeness to caregivers, simple honest information and familiar routines. There are no fixed age rules for how a child “should” react.

First clarify the facts. Don't pass on rumours or unconfirmed guesses – if nothing is certain yet, say exactly that. Briefly sort out your own feelings so that you don't break down mid-sentence. You may be sad and show it; what matters is that you can stay present. Ideally the most familiar person should have the conversation.

Choose a quiet place and enough time, not in passing on the doorstep. Sit at eye level and keep physical contact if the child likes that. Speak in short sentences with clear words. Euphemisms can confuse: a child who hears that someone who died has “gone to sleep” may become afraid of sleeping. More honest and understandable is: “Grandpa has died. His body doesn't work any more, and he won't come back.”

Adapt the amount of information to the child's age. For toddlers, very simple words, closeness and a favourite object are enough; play and drawing help them express what they have experienced. Teenagers want more detail and a say – give them that, but don't overload them with tasks that adults should really carry. Also respect the family's cultural and religious beliefs when it comes to death and loss.

Children react very differently: some cry, some get angry, some go silent, and some seem indifferent and simply carry on playing. Carrying on playing as if unaffected is common too – children often process hard things in small portions. Don't judge the reaction and don't expect the child to react “correctly” straight away. Just stay with them.

Answer questions honestly, even when they are repeated. Children often ask the same thing again and again, sometimes days later – that is normal and helps them understand. “I don't know yet” is allowed. Make no false promises.

Say explicitly that it is not the child's fault. Then explain what happens now: who is taking care of them, where they will sleep, what happens tomorrow. Keep familiar routines as far as possible. Expect that it will not stay at one conversation – usually many short talks follow over the next days and weeks.

Many reactions after bad news are understandable and become weaker over time. But if a child barely sleeps for weeks, withdraws severely, stops eating or talks about self-harm, professional help is important: the paediatrician, a counselling service or child and adolescent mental health professionals. In acute danger, call the local emergency number (112 in the EU) immediately.

Make sure children don't unintentionally overhear news, phone calls or adult conversations before they have heard it from you. News picked up by chance is often more confusing and frightening than a calm conversation.

This text is not grief or trauma therapy. It is meant to help you start a hard conversation well. If you are heavily burdened yourself, get support – adults who comfort children also need someone to be there for them.

Loss of the home, for example after a fire or flood: explain what has happened and, above all, where you are living now and that you are staying together. Ask what the child misses most – sometimes a replacement for the cuddly toy or a familiar ritual can be found.

Evacuation and separation: if a parent cannot come along or is missing, say honestly what you know and what you don't: “Mum is still helping in town. We don't know yet when she'll come. As soon as we hear something, I'll tell you.” Keep that promise.

Illness, injury or death in the family: here the most familiar person is especially important. Children may say goodbye if they want to and ask questions about the hospital or funeral. Whether a child attends a funeral, for example, can be discussed together – with an explanation beforehand of what happens there.