Helping Children Cope

A cancer diagnosis and subsequent treatment process can be a frightening and difficult time for a patient and their family. For families with young children or teenagers, there is additional concern about how the children will react to the diagnosis and treatment process of a parent.

Sharing the news is not an easy task. The Abramson Cancer Center provides you with a practical set of information and resources to assist you in talking with your children about the diagnosis and treatment process, as well as information and interactive activities for your children.

Through Children's Eyes: Understanding Illness and Helping Them Cope

As a parent diagnosed with cancer, you will not only face your own fears, but also those of your children. To help your children cope with the life-changing experience of your diagnosis and treatment, it is important to consider their level of understanding about illness.

Remember that children are resilient and, with support, they can cope. Therefore, it may be beneficial to inform your child's teacher and/or school administrator so they can support your child during the school day. Communication is key throughout the entire cancer journey. Ultimately, you know your child best; the following information is for your reference.

Infants

Level of Understanding and Developmental Stage

  • Self-focused; beginning to see himself or herself as separate from the parent.
  • Minimal understanding of time.
  • While people or things may go away, they are always expected to come back. When a parent leaves or is absent, the child may cry or act out to make the parent return.
  • Understand being hurt or sick, but not the concept of illness.

Helping Them Cope
  • Familiar surroundings and people mean security.
  • Try to maintain their normal routine. If changes occur, explain it to the child in a way that they can understand the impact. For example, you might say: “I feel bad today and need to rest, so I can’t play with you right now.”
  • Provide as much love and attention as you can; hugs are very reassuring.
  • Reassure the child that they are healthy and that it is not their fault their parent is sick.

Toddler

Level of Understanding and Developmental Stage
  • Self-centered; they think concretely and simply.
  • Unable to conceive the future, but understand “yesterday” and “today.”
  • Attached to parents and primary caregivers and worry about separation.
  • Feelings are important and often expressed through actions.
  • Understand being hurt or getting sick as caused by an action (falling off their bike or catching a cold), but think that getting better happens quickly.
Helping Them Cope
  • Provide brief, simple answers to their questions and share your own feelings in the same manner.
  • Your normal tone of voice and presence are reassuring.
  • Encourage them to express emotions in an active way: drawing pictures, playing outside or listening to music.
  • Provide as much love and attention as you can; hugs are very reassuring.
  • Reassure the child that they are healthy and that it is not their fault their parent is sick.

School Age

Level of Understanding and Developmental Stage
  • Dependent on their parents, family life and routine, but beginning to want to spend time outside the family with friends.
  • Beginning to think logically and understand right from wrong.
  • Able to understand past, present and near future.
  • Starting to understand how the body works, as well as it what it means to be seriously ill.
  • Feelings can be expressed, but children may be overwhelmed with the depth.
Helping them Cope
  • Provide clear, honest information. Without it, they will use their imagination and come to incorrect assumptions.
  • Ask your child if they have questions or concerns.
  • Show your feelings to encourage them to share their own.
  • Reassure the child that they are healthy and that is not their fault their parent is sick.

Pre Teen

Level of Understanding and Developmental Stage
  • Beginning to focus more on friends than family.
  • Think logically and begin to develop abstract reasoning. They absorb new information quickly.
  • Want to “fit-in” and therefore are aware of what is socially acceptable.
  • Meaning of illness relates to the visible symptoms.

Helping Them Cope
  • Answer their questions and assure them that you will keep them updated.
  • Ask them about their understanding of cancer because children at this age may do their own research on the internet.
  • They may hide their emotions to appear more grown up; encourage them to share their feelings with you by sharing your feelings.
  • Encourage your child to remain involved with friends and other activities. Allow them to assume additional responsibilities around the home if they went to help, but try not to overload them.
  • Reassure the child that they are healthy and it is not their fault that their parent is sick.

Teenager

Level of Understanding and Developmental Stage
  • Self-centered and self-reliant; working towards independence.
  • Friends are very important, but they remain dependent on their families.
  • May feel conflicted about being independent and wanting to be close to their ill parent.
  • Understand the significance of cancer and serious illnesses and will be concerned with their parent's pain.
Helping Them Cope
  • Be honest and clear with them about your diagnosis and treatment.
  • Include your child in decision making when possible.
  • Encourage them to maintain their normal routine and activities. Their friends are an important source of support.
  • Offer to speak with their friends’ parents to explain what is happening.
  • Reassure the child that they are healthy and it is not their fault that their parent is sick.

Online Community Resources

American Cancer Society (ACS)
Source of news, information and support.

www.cancer.org

800-ACS-2345

Cancer Care for Kids

Offers counseling (on-line, telephone and face-to-face) education workshops by phone, resources.

www.cancercare.org

Children's Treehouse Foundation


Provides cancer centers and hospitals with training to launch support programs for children affected by cancer in the family.

www.childrenstreehousefdn.org

303-322-1202

Peter's Place: A Center for Grieving Children and Families

Located in Radnor, PA

www.petersplaceonline.org

610-687-5150

Oncolink®

Coping with cancer

www.oncolink.org/coping


Suggested Book List

No matter what your prognosis, it is natural for children to ask questions about death. They may also feel a strong sense of grief and loss about the illness and the impact it has upon you and your family.

If you would like additional information to talk with your children about the grief and loss they experience related to the cancer journey, you may find the following books helpful:

  • 35 Ways to Help a Grieving Child by the Dougy Center for Grieving Children
  • Guiding Your Child Through Grief by James P. Emswiler and Mary Ann Emswiler
  • Talking About Death: A Dialogue between Parent and Child by Earl Grollman
  • Sad Isn't Bad: A Good Grief Guidebook for Kids Dealing with Loss by Michaelene Mundy
  • How Do We Tell the Children? A Step-by-Step Guide for Helping Children Two to Teen

Reading a story or sharing a book with your child may be a helpful tool for encouraging a discussion about concerns and feelings. The following books are written for children and address important issues about diagnosis, treatment and life:

  • I Love You Forever by Robert Munsch
  • The Fall of Freddie the Leaf: A Story of Life for All Ages by Leo Buscaglia
For Younger Children:
  • Our Mom Has Cancer by Abigail and Adrienne Ackerman
  • Because Someone I Love Has Cancer: Kids Activity Book
  • by The American Cancer Society
  • Talking with My Treehouse Friends About Cancer: Interactive Workbook by Peter Van Derhoot
  • In Mommy's Garden: A Book to Help Explain Cancer to Young Children by Neyal Ammary
  • The Paper Chain by Claire Blake, Eliza Blanchard and Kathy Parkinson
  • My Mommy Has Cancer by Carolyn Stearns-Parkinson
  • The Rainbow Feeling of Cancer by Carrie Martin and Chia Martin
For Pre-teens and Teenagers:
  • Less than Perfect by Louis Albert
For Parents:
  • When a Parent has Cancer: A Guide to Caring for Your Children by Wendy S. Harpham MD
  • Cancer in the Family: Helping Children Cope with a Parent's Illness by Katherine Bruss, Joy Fincannon, Sue Heiney, and Joan Hermann
  • Helping your Children Cope with Cancer: A Guide for Parents and Families by Peter Van Derhoot