Last reviewed December 2012
- Helping younger children, 3-5 years, adjust
- What words should I use?
- What younger children, 3-5 years, understand about death
- Support services, resources and information
Children’s understanding of illness and the implications of bad news varies depending on their age and family experiences. The information below gives an overview of the needs of younger children, 3-5 years, which can be helpful when working out what to say to them and how you might respond to lessen the impact of the news on them. Professional help may benefit a child who does not seem to be coping.
|Understanding of disease||Possible reactions||Suggested approaches|
•They have a basic understanding of illness.
• Children may believe that they caused the illness e.g. by being naughty or thinking bad thoughts. This is call magical thinking.
• Children are egocentric and think everything is related to them – Did I cause it? Can I catch it? Who will look after me?
• Fear of the dark, monsters,
animals, strangers and the
• Sleepwalking or sleeptalking.
• Stuttering or baby talk.
• Hyperactivity or apathy.
• Fear of separation from significant others, especially at be.dtime and going to preschool
• Aggression (e.g. hitting or biting), saying hurtful things or rejecting the parent with the cancer
• Repeated questions about the same topic, even if it has been discussed several times.
• Provide brief and simple explanations about cancer. Repeat or paraphrase when necessary.
• Talk about cancer using picture books, dolls or stuffed animals.
• Read a story about nightmares or other problems.
• Assure them that they have not caused the illness by their behaviour or thoughts, nor will they catch cancer.
• Explain what children can expect; describe how schedules may change.
• Reassure them that they will be taken care of and will not be forgotten.
• Encourage them to have fun.
• Listen and be alert to their feelings, which they may express through speech or play.
• Continue usual discipline and limit setting.
• Let children get physical activity every day to use up excess energy, get rid of anxiety and to provide a positive outlet for any
It’s often hard to find the right words to start or continue a conversation. These ideas may help you work out what you want to say. Although grouped by age, you may find that suggestions in a younger or older age bracket are more suitable. See here for tips on how to answer specific questions.
Newborns, infants and toddlers
Obviously babies don’t need explanations, but the older toddlers get, the more they understand basic ideas about themselves and their family.
“Mummy is sick and needs to go to hospital to get better.”
To explain changes and reassure them
“Mummy has to stay in bed a lot and isn’t able to play, but she still loves you.”
“Daddy and Mummy need to go away for a couple of nights, so Grandma is going to come and stay at home with you.”
Younger children, three to five years
Preschool children can understand very basic explanations about many things, including illness, family routines and cause and effects.
“I have an illness called cancer. The doctor is giving me medicine to help me get better. The medicine might make me feel sick or tired some days, but I might feel fine on other days.”
To address misunderstandings
“Sometimes girls and boys worry that they thought or did something to cause cancer. No-one can make people get cancer, and we can’t wish it away either.”
“How do you think Daddy got cancer?”
To explain changes and reassure them
“Mummy needs to go to the hospital every day for a few weeks, so Daddy will be taking you to preschool/school instead. He’s looking forward to doing that.”
“Pop is sick so we won’t see him for a while, but he loves you very much.”
“I love your pictures, so maybe you can draw me some to take to hospital.”
Younger school-age children, 6–9 years
Young children can understand basic explanations about many things, including illness and family routines. They need reassurance to correct misunderstandings so they continue to feel loved, safe and cared for.
“I have an illness called cancer. It means some lumps are growing inside my body that shouldn’t be there, and they’re making me sick. I am going to have an operation in hospital to have the lumps taken out. Then I’ll have some more medicine to make sure they don’t grow back.”
“The doctors say that Dad has a problem with his blood. That’s why he’s been very tired lately. The illness is called… Dad’s going to have treatment to make him well again.”
“Lots of people get cancer. We don’t know why it happens. Most people get better and we expect I will get better too.”
To address misunderstandings:
“We can still have lots of kisses and cuddles – you cannot catch cancer from me or from anyone.”
“Cancer is a disease of the body that can be in different places for different people.”
“Even though your school friends say that cancer is really bad and I will get very sick, they don’t know everything about this cancer. I will tell you what I know about my cancer.”
To explain changes and reassure them:
“The doctors will take good care of me. I will have treatment soon, which I’ll tell you about when it starts.”
“Even though things might change a bit at home, you’ll still be able to go to tennis lessons while Dad is having treatment.”
“Mum is going to be busy helping Grandma after she comes out of hospital. There’s ways we can all help out, but mostly things won’t change for you.”
“You don’t have to tell your friends about me having cancer if you don’t want to, but I would like to let your teachers know so they understand what’s happening at home.”
In preparing children for the loss of a parent or other loved one, it can help if you understand how death is perceived at different ages.
|Understanding of death||Possible reactions||Suggested approached|
• Understand the concept of death but struggle with the permanence of it (e.g. they may ask when the dead parent is coming home).• Death can be hard to explain because young children don’t have an adult concept of time. They only understand what’s happening now. For example, a four-year-old knows what it’s like to have two sleeps till her birthday but doesn’t grasp the meaning of a reduced life expectancy.
• May feel it is somehow their fault.• Angry with their parent for not giving them enough attention.
• Can react as if they were much younger when they are feeling
• Watch their play for clues to their feelings.
The information below includes a list of reliable internet sites, books, library resources and organisations where you can learn more about cancer-related issues.
|Organisations that can help||Contact details||Information|
|Cancer Council||13 11 20||Cancer Council offers a range of information and services to help people with cancer, their families and friends, including telephone support groups, Cancer Connect and the online forum www.cancerconnections.com.au.|
1800 226 833
|The national support organisation for young people aged 12 to 24 living with cancer, children of people with cancer and siblings of people with cancer.|
|Kids Helpline||Kids Helpline is a telephone, web and email counselling service with a fun, interactive website for kids, teens and young adults. It offers confidential counselling for anything worrying a child.|
|Lifeline||A general telephone counselling service.|
|youthbeyondblue||Supports young people dealing with depression, anxiety and other mental health problems. They provide tips on how to talk about depression and get help.|
|Australian Centre for Grief and Bereavement||This organisation provides information and support for people caring for children and adolescents who have been impacted by trauma and loss.|
|Young Carers (Carers Australia)||This organisation supports young people who are caring for a parent who is physically or mentally ill. They run support programs and provide information.|
|Websites for children, age three to 12 years||Contact details||Information|
|Bear Essentials||www.bear-essentials.org||This site has a comprehensive range of activities for children aged four to 12.|
|Bearing Up Club||www.bereavementcare.com.au||An internet club for kids dealing with bereavement. Once a child is registered, they can join an online chat room. The developers of this site, Mal and Valerie McKissock, are well-known bereavement therapists who have written grief books for children and adults dealing with grief.|
My Mum’s Got Cancer by Dr Lucy Blunt, Jane Curry Publishing, 2013
Safina and the Hat Tree by Cynthia Hartman, Nomota Pty Ltd, 2004
Sammy’s Mommy Has Cancer by Sherry Kohlenberg, Magination Press, 1993
My Mum Has Breast Cancer: a family’s cancer journey by Lisa Sewards, Harrison Sewards, Self-published, 2007
My Name Is Buddy: a story for children about brain tumours visit http://buddybook.landofpuregold.com/readbook.htm
Books for younger readers
She’s Got What? A story about cancer
by Carrie Lethborg and
Angela Kirsner, St Vincent’s Hospital Melbourne, 1999
When Someone You Love Has Cancer: a guide to help kids cope (Written from a Christian perspective), Alaric Lewis Abbey Press, 2005
Beginnings and Endings with Lifetimes in Between by Bryan Mellonie and Robert Ingpen, Penguin, 2005
I Miss You: a first look at death, Pat Thomas Barron’s Educational Series, 2001
Because... Someone I Love Has Cancer (Activity book for kids aged 5–10), American Cancer Society, 2002
What About Me? (Comic book for children aged eight to 14 who have a parent with cancer), Cancer Council SA, reprinted 2011
Information reviewed by: A/Prof Jane Turner, Department of Psychiatry, The University of Queensland; Frankie Durack, Counsellor and Play Therapist, WA; Carol Hargreaves, Cancer Council Helpline Consultant, Cancer Council NSW; Dr Carrie Lethborg, Clinical Leader, Cancer Social Work, Coordinator, Psychosocial Cancer Care, St Vincent’s Hospital, VIC; Angelita Martini, Consumer and Karin Steinhoff, Consumer.