Implications for School Practices of the Association of Child Bereavement With School Grades | Child Development | JAMA Network Open | JAMA Network
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Invited Commentary
April 8, 2022

Implications for School Practices of the Association of Child Bereavement With School Grades

Author Affiliations
  • 1REACH Institute, Department of Psychology, Arizona State University, Tempe
JAMA Netw Open. 2022;5(4):e224908. doi:10.1001/jamanetworkopen.2022.4908

The study by Liu et al1 is of particular interest at this time when the world is experiencing an upsurge of child bereavement from the death of a parent due to the COVID-19 pandemic.2 The questions of highest scientific and public health interest are as follows: What is the impact of parental death on children? What potentially malleable factors make a difference in the healthy development (ie, resilience) of bereaved children? What can be done to promote the resilience of bereaved children?

This study1 strengthens the evidence base for an association between death of a parent and lower school grades by a very clever use of sibling data to control for the influence of family environment, as well as controlling for other potential confounders. In addition, the fact that the findings are from a population-based longitudinal cohort study heightens the importance of the study. However, the broader implications for understanding the outcomes of child bereavement globally are limited because the study reflects data from a single country that has a well-developed safety net. More studies are needed to assess the outcomes of child bereavement from the death of a parent in other culturally and economically diverse countries.

The findings from this study1 need to be put in the context of evidence that parentally bereaved children are at elevated risk for multiple mental health problems3 and impaired developmental competencies.4 The association of parental death with school grades is only 1 lens through which to view how parental death impairs children’s healthy development, but it is an important one. Academic success is an important developmental task in middle childhood and adolescence that has implications for children’s longer-term educational and vocational success and mental health. It is likely that academic functioning, mental health, and grief have reciprocal associations with each other. Therefore, it is important to view parental bereavement from the perspective of the whole child. It would be interesting to learn about other health and mental health outcomes experienced by the parentally bereaved children in this study.1

This study’s findings concerning subgroup differences in the association of parental death with school grades are difficult to interpret.1 Why would there be larger associations with school grades for paternal rather than maternal death or natural causes of death rather than death by accident or suicide? What explains the inconsistent findings between age at the time of death and magnitude of association between bereavement and school grades? To begin to understand these subgroup associations, it is necessary to understand the mediating pathways that explain bereaved children’s elevated risk. Of particular interest are factors that are associated with school grades and that could potentially be changed either by public policy or by evidence-based programs. The authors1 suggest several potentially malleable factors, including the family’s economic well-being or the surviving parent’s grief or depression. However, it is also important to consider the growing body of empirical evidence showing that resilience of bereaved children is associated with a number of potentially malleable factors that could be changed by evidence-based programs, including caregivers’ mental health and the quality of parenting they provide to bereaved children, as well as children’s grief, emotion regulation, and coping.5

The finding that parental bereavement is associated with children’s success in school is not surprising. It is difficult for children to focus on their academic work when they are grieving or depressed and are dealing with the multiple disruptions in their family system following the death of their parent. How schools respond to a bereaved child can play a pivotal role in facilitating their healthy development. Schools naturally need to address issues such as how to welcome the child back to the classroom after the death, how to inform classmates about the death, and how the teacher can support the child and deal with changes in bereaved children’s schoolwork or behavior in the classroom. Liu et al1 make the reasonable suggestion that schools may be helpful by providing additional educational support and by supporting the bereaved caregiver. There is increasing public awareness of the need to support bereaved children because of the many children who have experienced the death of a parent or caregivers due to the COVID-19 pandemic. Evidence of growing efforts to help schools support bereaved children can be seen in a recent initiative by the New York Life Foundation to support grief-sensitive schools.6 The growing awareness of the need to support bereaved children makes this a propitious time to consider what else schools might do to promote the healthy development, as well as academic success, of these children. In addition to what they do in the classroom, schools can also be a link to evidence-based programs that bereaved families can access either in their community or online. There is increasing evidence for the efficacy of some programs to promote the resilience of bereaved children, by supporting either effective coping or the caregiver’s ability to support their grieving children.7 As the institution that has direct contact with almost all bereaved children, schools can play a critical role in promoting the academic success, as well as healthy development, of bereaved children by becoming educated as to the evidence-based programs that are available in their community and helping bereaved families access these resources.

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Article Information

Published: April 8, 2022. doi:10.1001/jamanetworkopen.2022.4908

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Sandler I. JAMA Network Open.

Corresponding Author: Irwin Sandler, PhD, REACH Institute, Department of Psychology, Arizona State University, 900 S McAllister, Tempe, AZ 85287 (

Conflict of Interest Disclosures: None reported.

Liu  C, Grotta  A, Hiyoshi  A, Berg  L, Rostila  M.  School outcomes among children following death of a parent.   JAMA Netw Open. 2022;5(4):e223842. doi:10.1001/jamanetworkopen.2022.3842Google Scholar
Unwin  HJT, Hillis  S, Cluver  L,  et al.  Global, regional, and national minimum estimates of children affected by COVID-19-associated orphanhood and caregiver death, by age and family circumstance up to Oct 31, 2021: an updated modelling study.   Lancet Child Adolesc Health. Published online February 24, 2022. doi:10.1016/S2352-4642(22)00005-0PubMedGoogle Scholar
Kaplow  JB, Saunders  J, Angold  A, Costello  EJ.  Psychiatric symptoms in bereaved versus nonbereaved youth and young adults: a longitudinal epidemiological study.   J Am Acad Child Adolesc Psychiatry. 2010;49(11):1145-1154. doi:10.1097/00004583-201011000-00008PubMedGoogle Scholar
Brent  DA, Melhem  NM, Masten  AS, Porta  G, Payne  MW.  Longitudinal effects of parental bereavement on adolescent developmental competence.   J Clin Child Adolesc Psychol. 2012;41(6):778-791. doi:10.1080/15374416.2012.717871PubMedGoogle ScholarCrossref
Sandler  IN, Wolchik  SA, Ayers  TS, Tein  J-Y, Coxe  S, Chow  W. Linking theory and intervention to promote resilience in parentally bereaved children. In: Stroebe  MS, Hansson  RO, Schut  H, Stroebe  W, eds.  Handbook of Bereavement Research and Practice: Advances in Theory and Intervention. American Psychological Association; 2008:531-550. doi:10.1037/14498-025
New York Life Foundation. New York Life’s grief-sensitive schools initiative. Accessed March 16, 2022.
Bergman  A, Axberg  U, Hanson  E.  When a parent dies: a systematic review of the effects of support programs for parentally bereaved children and their caregivers.   BMC Palliat Care. 2017;16(1):39. doi:10.1186/s12904-017-0223-yPubMedGoogle ScholarCrossref

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