Children’s understanding of illness and their reactions to bad news will vary depending on their age, temperament and family experiences. You may find that siblings, even of similar ages, respond differently. We give an overview of children’s possible reactions at different ages, which might help you work out how best to support them.
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Newborns, infants and toddlers (0-3 years)
Infants have little understanding of illness, but may pick up on their parents’ anxiety and other feelings. They are aware of periods of separation from their parents and can get upset when a parent is not there. Toddlers may react to physical changes in their parent or relative (such as hair loss) or noticeable side effects (such as vomiting).
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Preschoolers (3-5 years)
By the age of 3, children have a basic understanding of illness. Younger children may believe that they caused the illness (e.g. by being naughty or thinking bad thoughts). They may also think they can catch cancer. It is natural for young children to think everything is related to them – Did I cause it? Can I catch it? Who will look after me?
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Primary schoolchildren (5-12 years)
In the early primary school years, children have a basic understanding of sickness, and by later primary years, they are ready for more details about cancer cells. They may use simple cause-and-effect logic to fill gaps in their knowledge; for example, they sometimes feel that their bad behaviour might have caused the disease. They may understand that people, including parents, can die.
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Teenagers (12-18 years)
During adolescence, young people start to think more like adults. As their ability for abstract thought develops, they are able to understand complex cause-and-effect relationships, such as illness and symptoms. With increasing maturity, teenagers understand that people get sick, but are more likely to deny fear and worry to avoid discussion.
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We thank the reviewers of this book: Professor Kate White, Chair of Nursing, The University of Sydney, NSW; Sarah Ellis, Psychologist, Behavioural Sciences Unit, Kids with Cancer Foundation, Sydney Children’s Hospital, NSW; Kate Fernandez, 13 11 20 Consultant, Cancer Council SA; Chandra Franken, Program Manager – NSW & ACT, Starlight Children’s Foundation, NSW; John Friedsam, General Manager of Divisions, CanTeen, NSW; Keely Gordon-King, Cancer Counselling Psychologist, Cancer Council Queensland; Stephanie Konings, Research Officer, CanTeen, NSW; Sally and Rosie Morgan, Consumers; Dr Pandora Patterson, General Manager, Research and Youth Cancer Services, Canteen, and Adjunct Associate Professor, Cancer Nursing Research Unit, The University of Sydney,
NSW and Visiting Professor, Faculty of Health and Life Sciences, Coventry University, UK; Suzanne Rumi, Consumer; Michael Sieders, Primary School Program Manager, Camp Quality.
We would also like to thank the health professionals, consumers, organisations and editorial teams who have worked on previous editions of this title, and we are grateful to the parents and young people whose real-life stories have added to the richness and relevance of this book.
We thank and acknowledge Dr Paula K. Rauch, MD, Founding Director, Marjorie E. Korff PACT (Parenting At a Challenging Time) Program and Associate Professor of Psychiatry, Harvard Medical School, whose research and writing on helping parents talk to their children about cancer was used as source material for this book and has been adapted in several sections: pages 8 -11, Different views of cancer; page 24, Answering key questions: Are you going to die?; pages 26 -27, Involving the school or preschool; pages 30 -31, Prepare for hospital and treatment centre visits; and page 37, Encouraging family time. We also thank the American Cancer Society for permission to use and adapt material on pages 8 -11 from its book Cancer in Our Family: Helping children cope with a parent’s illness (2013); Macmillan Cancer Support for permission to use its book Talking to Children and Teenagers When an Adult Has Cancer (2013) as a source of information; Jessica Watt, Oncology Social Worker, Children’s Hospital Westmead, for her contribution on page 18, When another child has cancer; Diane McGeachy, Hobart Counselling Centre, for contributing material for page 38, Spending one-on-one time; and Dr Ranjana Srivastava, and The Guardian for permission to adapt €œHow do you tell your children you have cancer? €_x009d_, on pages 21 and 47 – full story is available at https://www.theguardian.com/society/2015/nov/29/how-do-you-tell-your-children-you-have-cancer.
View the Cancer Council NSW editorial policy.
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