Funeral directors and teachers ask me regularly: is there actually evidence that play helps when a child is grieving? The honest answer has layers. On some parts the literature is clear, on others it is thin, and on the material itself there is almost no research at all. Below I separate the one from the other.
What children understand about death
The concept of death is not a switch that flips at a certain age. Research distinguishes separate components: that death is irreversible, that bodily functions stop, that all living things die, and that death has causes. Speece and Brent showed back in the 1980s that most children acquire these components between the ages of five and seven, and that they do not arrive at the same time. More recent research confirms this picture and refines it: irreversibility and inevitability tend to come before the understanding that all living things die.
In practice this means two things. A four-year-old asking when daddy is coming back is neither confused nor unfeeling; part of the concept is simply not there yet. And age is a poor measure: experience, and what has been said at home, make the difference.
Excluding children does not protect them
The reflex to keep children away from illness, dying and funerals comes from good intentions. The research does not support it.
The best-known example comes from Sweden. Kreicbergs and colleagues surveyed parents whose child had died of cancer. Of the parents who had talked with their child about the approaching death, none regretted it. Of those who had not, more than a quarter did regret it, and that regret was strongest among parents who suspected their child already knew.
Around the funeral itself the picture is less clear-cut, but points the same way. In a US study of over three hundred children who lost a parent, children from families without rituals did less well over time, and attending the visitation was associated with better outcomes one and two years later. Silverman and Worden had earlier found that nearly all children attended their parent’s funeral.
What matters is what these studies actually show. They are observational: they show association, not causation. A recent review by Burrell and Selman therefore concludes carefully that the benefit of a ritual lies mainly in being able to shape it yourself and say goodbye in a way that means something, not in attendance as such.
What play does
That play is a way for children to process what they cannot yet put into words is not a controversial idea in developmental psychology. For play therapy as a treatment there is also meta-analytic evidence: Bratton and colleagues found a large average effect across 93 studies, and the later, methodologically stricter meta-analysis by Lin and Bratton found a moderate effect across 52 controlled studies.
A firm caveat belongs here, and I would rather make it myself than have someone else make it. Play therapy is treatment by a trained therapist across multiple sessions. That is not the same as letting a child play with a hearse the day before a funeral. Those meta-analyses do not establish that funeral toys work; they establish that play is a serious medium in working with children.
What we do not know
As far as I know there is no controlled research on funeral toys. Nor is there likely to be any soon: you do not randomise grieving children into a control group, and the outcome measure would be unclear. What I say about it therefore comes from practice and from what adjacent research makes plausible, not from effectiveness studies. Anyone claiming that this material processes grief or prevents problems is claiming more than can be claimed.
What that means in practice
Three things are well supported, and those three are enough to act on.
Honest information, pitched at the child, is better than silence. Involvement in what is happening is better than exclusion, provided the child has a say in how. And for young children, play is a serious way of understanding, not a distraction from the real work.
The material I develop is a tool for that. It makes the conversation concrete: you can show what happens at the crematorium instead of describing it. It also gives the adult something to hold on to, which is not a side issue, because many professionals say they postponed the conversation because they did not know how to begin. What it does not do is take over the work. Staying close, being honest, and letting the child set the pace remain human work.
Sources
- Speece, M. & Brent, S. (1984). Children’s understanding of death: a review of three components of a death concept. Child Development, 55(5), 1671–1686.
- Panagiotaki, G. et al. (2018). Children’s and adults’ understanding of death: cognitive, parental, and experiential influences. Journal of Experimental Child Psychology.
- Kreicbergs, U. et al. (2004). Talking about death with children who have severe malignant disease. New England Journal of Medicine, 351, 1175–1186.
- Fristad, M. et al. (2001). The role of ritual in children’s bereavement. OMEGA – Journal of Death and Dying, 42(4).
- Silverman, P. & Worden, J.W. (1992). Children’s understanding of funeral ritual. OMEGA – Journal of Death and Dying, 25(4).
- Burrell, A. & Selman, L. (2022). How do funeral practices impact bereaved relatives’ mental health, grief and bereavement? OMEGA – Journal of Death and Dying, 85(2).
- Bratton, S. et al. (2005). The efficacy of play therapy with children: a meta-analytic review of treatment outcomes. Professional Psychology: Research and Practice, 36(4).
- Lin, Y.-W. & Bratton, S. (2015). A meta-analytic review of child-centered play therapy approaches. Journal of Counseling & Development, 93(1), 45–58.