Children’s understanding of illness and their reactions to news of a cancer diagnosis will vary depending on their age, personality 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.
Learn about the different views of:
As children grow up, their understanding of the world will also develop. As they mature, they may become ready for more in-depth conversations.
Newborns, infants and toddlers (0-3 years)
Very small children 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. They may become clingy or unsettled, especially if they need to be weaned from breastfeeding suddenly.
Toddlers may react to physical changes in their parent or relative (such as hair loss) or noticeable side effects (such as vomiting). They may react with more frequent thumb sucking, bedwetting or baby talk.
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newborns and infants:
toddlers:
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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? They may also express their concerns or feelings through imaginative play.
Young children might become aggressive, or return to behaviour that is developmentally younger than their age, such as thumb sucking, bedwetting or baby talk. They may seek comfort by using security blankets or a special toy, or they might have trouble falling asleep or being separated from their parents. These behaviours are how some kids will communicate their worries and fears if they don’t have the words.
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Primary school children (5-12 years)
In the early primary school years, children have a basic understanding of sickness, and by later primary years, they are usually ready for more details about cancer. 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.
Primary school children may feel a range of emotions such as irritability, guilt, envy or sadness. They may lose interest in school and refuse to go, become distant or quiet, or feel separation anxiety at the thought of leaving a parent. They may return to behaviour that is developmentally younger than their age (such as bedwetting or thumb sucking), and be extra concerned about the health of others.
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Teenagers (12-18 years)
During the teen years, young people start to think more like adults. 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 they may avoid talking about difficult issues and are more likely to deny feeling scared or worried.
Teenagers may also worry about being different and not fitting in. They may not want to tell anyone at school because they want to stay “normal”. There are a range of responses your teenager might have, and these may change over time – from hiding their feelings and withdrawal, to “lashing out” in anger and rebellion. Some may want to help more around the house; others may take risks (e.g. with drugs and alcohol), or stay out late. As teenagers, they are still working out how to respond to strong emotions and big changes.
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→ READ MORE: Talking about the diagnosis
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Joanna Fardell, Senior Research Fellow and Deputy Director, The Behavioural Sciences Unit, School of Clinical Medicine, UNSW Medicine, UNSW, NSW; Dr Diana Adams, Medical Oncologist, Macarthur Cancer Therapy Centre and GenesisCare Campbelltown, NSW; Emma Bowne, 13 11 20 Consultant, Cancer Council SA; Ken Colbert, Consumer; Cara Dahl, Team Leader – Online Support, Cancer Hub, and ACA Registered Counsellor, NSW; Elizabeth Egan, Clinical Nurse Consultant – Oncology, St John of God Subiaco Hospital, WA; Dr Maria Ftanou, Director, Psychosocial Oncology Program, Peter MacCallum Cancer Centre, VIC; Nat Fuss, Senior Clinician, Canteen, SA; Helena Hobson, Senior Social Worker, Cancer Centre, Fiona Stanley Hospital and South Metropolitan Health Service, WA; Nadine Macbeth, Social Work Team Leader, Cancer and Chronic Care, Westmead Hospital, NSW; Damian Ragusa, General Manager – Services and Programs, Camp Quality; The Team at Redkite; Alexandra Wright, Consumer.
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 booklet.
We also thank and acknowledge Dr Paula K Rauch, American Cancer Society, Macmillan Cancer Support, Jessica Watt and Diane McGeachy for permission to use their work as source material.
View the Cancer Council NSW editorial policy.
