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UC Davis Comprehensive Cancer Center

UC Davis Comprehensive Cancer Center

Helping your child cope

Cancer creates many changes and challenges for children and their families. As a parent or caregiver you may be asking:

  • What does my child know about cancer?
  • How will my child feel about the treatment?
  • How can I support my child?

Children of different ages understand and react differently to cancer and its treatment. Your child's personality, normal coping style, support system, treatment plan, age and developmental level will affect how he or she copes with cancer. When children are faced with stress, their normal behaviors may change. They often become more dependent on adults, or may act younger than their age (baby talk, wetting pants after being potty- trained, etc.). Your child may not know how to handle the many feelings that have been caused by the cancer diagnosis.

You are a very important part of your child's life for many different reasons. You know what your child has experienced in the past, and how your child usually handles stress. You can help the health-care team to understand your child. You and the health-care team can work together to find new ways to help your son or daughter cope with cancer and its treatment.

Below we describe some of the common responses of children of different ages to stress and cancer. We've provided specific suggestions for how to help children in each age group cope.

Infant (birth – 12 months)

Infants look to parents or caregivers to meet their needs. They rely on adults for food, comfort, play and care. Infants learn about the world around them through their senses (smells, colors, tastes). They trust in people and things that are familiar. Infants have no concept of the meaning of cancer or its implications. They do respond to the new people and the environment around them.

Issues
How you can support your infant

Separation from familiar people

Be with your infant as much as possible.
Leave a shirt with your smell on it if you need to go.
Rock or hold your infant when in the hospital.
Keep a familiar blanket and toys in the crib.

Fear of strangers

Have familiar people care for your child.
Limit the number of people and voices in the room.

Development

Let your child explore toys using his or her hands and mouth.
(Check for small pieces that may choke your infant).
Use gentle touch and massage to comfort your infant.
Talk to and play games, like peek-a-boo, with your infant as you would at home.

Sense of safety

Keep your infant's crib safe.
Ask that any procedures be done in the treatment room.
Wake your infant before a painful procedure.
Continue or develop familiar feeding, bedtime, and bathtime routines, like rocking, touching, singing.

Toddler (12 months – 3 years)

Toddlers are beginning to want to do more on their own. Your toddler's favorite words may be “me do” or “no.” Growing toddlers need to be able to do some things by themselves to promote a sense of control. Toddlers show you how they feel in their actions because they do not have the words to describe their feelings. They have a hard time understanding how the body works. Toddlers tend to think that they make things happen. They can create their own false ideas about how they got sick and what happens to them (I hurt because I was bad).

Issues
How you can support your toddler

Fear of separation

Be with your toddler as much as possible.
When you leave, tell your toddler where you are going and when you will be back.
When you are gone, leave something of yours, like a picture or shirt, for your toddler to keep until you return.

Fear of strangers

Have familiar people care for your toddler.
Provide security objects like a blanket or stuffed animal.

Loss of control

Let your toddler make choices whenever you can.
Apple juice or orange juice?
Do not offer a choice when no choice exists.
Are you ready for your medicine?
Give your toddler a job to do. Hold this Band-Aid. Let your toddler plan and be in control of the game or activity.

Loss of normal routine

Try to keep eating, sleeping, and bathing routines as normal as possible.
Let your toddler play with favorite toys.

Behavior changes

Give your toddler safe ways to express anger and other feelings. (Play-Doh, painting, building blocks)
Tell your toddler that it is all right to feel mad or sad.
Spend time with your child and offer reassurance.
Set limits with your toddler and discipline when needed.

Fear of treatment: medicine, tests, vital signs

Assure your toddler that he or she did nothing wrong.
Keep security objects, like blankets, pacifiers, favorite toy, nearby.
Tell your toddler what will happen just before the treatment or procedure.
Use simple words, pictures, or books to tell them what will happen.

Preschooler (3 years – 5 years)

Preschoolers are also trying to do things on their own. They take pride in being able to do things for themselves: “I can do it." Preschoolers are learning more words to tell you what they think and feel. However, they often use their play to tell you these same things. They can see the hospital and treatment as punishment for something they did wrong. Also, they often get confused by adult words and make up reasons for the things that happen.

Issues
How you can support your preschooler

Magical thinking (Made-up reasons for what happens)

Tell your child what will happen a little before the treatment.

Use of terms that your child may
not understand (A CAT scan has nothing to do with a cat.)

Use simple words, pictures, or books to tell your child about what will happen.

Fear of harm to the body and of the unknown

Let your child play with doctor kits and safe medical supplies, like a blood pressure cuff.

Loss of control

Allow your preschooler to make choices whenever you can.
Apple juice or orange juice?
Do not offer choices when choices do not exist.
Are you ready for your medicine?
Give your preschooler a job to do. Hold the Band-Aid.

Loss of normal routines

Praise your child for doing things independently, like dressing, brushing teeth, feeding

Behavior changes

Allow your preschooler to make choices whenever you can. Apple juice or orange juice?
Do not offer choices when choices do not exist.
Are you ready for your medicine?
Give your preschooler a job to do. Hold the Band-Aid

School age (6 years – 12 years)

School-aged children take pride in being able to do most things by themselves. They enjoy school because it helps them to learn and master new things. Their friends are becoming more important. School-aged children are able to think in terms of cause and effect, and have a better sense of time. They have more words to describe their bodies, thoughts and feelings. School-aged children can also understand more of how their bodies work. However, they still may have a hard time with, and be confused by, medical words.

Issues
How you can support your school-aged child

Loss of control

Allow your son or daughter to make choices whenever you can.
Do not offer choices when no choices exist.
Give your child a job to do.
Let your child practice things that are new and scary
Let your son or daughter go to school or do school work and activities.
Provide games, play, and activities.

Being away from friends and school

Have your child write letters, e-mail or call friends.
Let friends visit when your child feels well enough.

Fear of harm to body and unknown

Use simple words, pictures or books to tell your son or daughter what will happen.
Tell your child what will happen a few days before the treatment, if possible.
Let your child play with safe medical supplies, like a blood pressure cuff.

Teens (13 years – 18 years)

Teens are beginning to see themselves as individuals in the world. They are striving to be independent from the adults around them. As teens strive to think and act for themselves, their peers become even more important. Teens want to be like their friends and are concerned with how they are viewed by others. Illness and treatment cause teens to be different when they are trying to hard to be the same. Teens are able to see not only cause and effect, but also can see things from many points of view.

Issues
How you can support your teen

Loss of control

Allow your teen to make choices whenever you can.

Loss of independence

Let your son or daughter be active in social and school activities.
Involve your teen in the treatment plan by including
him or her when talking to the health-care team about the plan.
Encourage your teen to do as much self-care as possible, including bathing, dressing, grooming, eating

Body image

Give your teen chances to talk about physical and emotional changes.
Tell your son or daughter that having feelings about illness and treatment is all right.

Self-esteem

Point out things that your son or daughter does well.
Teens should be encouraged to do things that make them feel good about themselves.

Loss of privacy

Respect that teens may need to do some things by themselves when possible, such as using the bathroom, making phone calls, e-mailing.
Offer your teen private time.

Separation from peers

Encourage time with peers.
Allow friends to visit or call in the hospital or home.

Concern for the future

Answer questions openly and honestly.
Help your son or daughter plan for the future.
Encourage your teen to keep doing normal things like school.

Behavior changes

Give your teen safe ways to express feelings, especially anger, such as through physical activity, talking, writing.
Assure son or daughter that all feelings are normal, including guilt, fear, sadness.

 

Information adapted from the "Family Handbook for Children with Cancer.", CureSearch/Children's Oncology group. Last updated 5/2007.

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