Skip to content

Children 3 to 5 years

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 cancer:

Young children do 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?
Children may think cancer is contagious.

Possible reactions to cancer diagnosis:

  • Thumb-sucking.
  • Fear of the dark, monsters, animals, strangers and the unknown.
  • Nightmares.
  • Sleepwalking or sleeptalking.
  • Bed-wetting.
  • Stuttering or baby talk.
  • Hyperactivity or apathy.
  • Fear of separation from significant others, especially at bedtime and going to preschool.
  • Aggression (e.g. hitting or biting), saying hurtful things or rejecting the parent with the cancer diagnosis.
  • Repeated questions about the same topic, even if it has been discussed several times.

Suggested approaches:

  • 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 aggression.

What should I say to children about cancer?

Preschool children can understand very basic explanations about many things, including illness, family routines and the cause and effects.

What to say about cancer

“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.”

What do younger children, 3-5 years, understand about death?

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.

Children 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.

Possible reactions:

  • 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 stressed.

Watch your child’s play for clues to their feelings. You can reach out to Cancer Council 13 11 20 Information and Support service for help and to ask questions.

This information is reviewed by

This information was last reviewed December 2018 by the following expert content reviewers: 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.

You might also be interested in: