Understanding children and teenager’s reactions

Children’s reactions to cancer depend on their age.

Babies and toddlers won’t understand what’s happening. Keeping their routines familiar when possible will help.

Children aged 3 to 5 won’t fully understand the cancer. But they will notice emotions and changes to routines. They might think wishing can make things happen, or that your illness is their fault. They may also become clingy. Keeping to routines, reassuring them that the cancer isn’t their fault and setting boundaries can help.

Children aged 6 to 12 will understand more about cancer. They might not tell you their fears. You may notice changes in their behaviour. Let them help out and make sure they keep up with school and friends.

Teenagers usually understand the cancer but may not want to talk. They might want to help out more, but also want their independence. Encouraging them to ask questions, asking their opinion and giving them space when they want it can help.

If you or your child need support, your GP, teachers, psychological services at your hospital or local counselling services could help.

How children and teenagers might react

Children’s understanding and emotional reactions can depend on how old they are. They’re usually able to understand more about illness as they get older, but this depends on the child.

Some younger children may understand things more easily than older children.


Babies and toddlers

Babies and toddlers won’t understand what’s happening. They will be aware of changes to their routine, and especially changes to who’s looking after them. Try to create an environment that’s as familiar and consistent as possible, especially for when you’re not there. If possible, choose someone to care for your child who knows them well and is able to look after babies and toddlers. Keep to familiar routines when you can.


Children aged 3 to 5

Young children don’t really understand illness, but they pick up on tensions, changes in adults’ emotions and physical changes. They react to changes in their routine and to being separated from you.

They may also believe that wishing or hoping can make things happen. They might feel guilty that they’ve done something to cause the cancer. Or, if you’re in hospital, they might worry that they’ve made you go away.

Older children in this group are beginning to understand what illness is, and they may worry that they’ll get cancer too.

This age group can become clingy and scared of being separated from their parents. They may start to do things they’ve outgrown, like thumb-sucking, bed-wetting, talking like a baby or having tantrums. They may become quieter than usual or have bad dreams.

How to help

  • Use a doll, teddy or simple drawing to explain where the cancer is, where you’ll have an operation, or both.
  • Ask someone they know and trust to take care of them.
  • Keep to everyday routines when you can.
  • Let them know that the cancer isn’t their fault and they can’t catch it.
  • Set usual limits and boundaries, but don’t be surprised if they start doing things they’ve outgrown.

My children are old enough to understand what’s happening, but find it difficult. The youngest worries about losing me and is becoming clingy. My teenager works things through by himself.

Liz


Children aged 6 to 12

At this age, children can understand more detailed explanations about the cancer and its effects on the body. They often have fears they may not mention to you. This includes worrying you are going to die, that they’ve caused the cancer, or that they can catch it. They may try to be especially good, setting impossibly high standards for themselves. You may see changes in their behaviour, concentration, schoolwork or friendships.

How to help

The suggestions for children aged 3 to 5 still apply to many in this age group. You may find the following tips helpful too:

  • Use books to explain the cancer and its treatment.
  • Reassure them that many people with cancer get better.
  • Make sure they keep up with school, other activities and friendships.
  • Let them know it’s okay to enjoy themselves.
  • Give them little things to do to help out.


Teenagers

Teenagers usually understand what’s going on in terms of the cancer, but they can be reluctant to talk about it. They may find it hard to talk to you, or show how they feel. It’s important to encourage them to ask any questions they have and make sure they feel involved.

Some teenagers may be keen to help out. But they may find that when they want to be more independent and spend less time in the house, they have more responsibilities at home. This can make them feel angry and guilty at the same time. Sometimes their behaviour may seem hurtful to themselves or others.

How to help

  • Tell them about sources of information that may help, such as Riprap and Hope Support Services
  • Ask them what they think and include them in the same way as you’d include an adult.
  • Help them see that talking about feelings is a positive and mature way of coping. Encourage them to talk to someone close, such as their friends, a relative or a family friend.
  • Make sure they keep up with friendships, activities and normal life as much as possible.
  • Give them time and space to themselves when they want it.
  • Keep to usual rules and limits – these can be even more important now than before.
  • Explain that they might need to help out a bit more with things like cooking, tidying up or looking after younger siblings. Allowing them to help shows that you need and trust them. But reassure them you don’t expect them to do everything and that people will be there to care for them too.
  • Show them you appreciate their help.


When children need help

Children can have lots of different emotional reactions. They can show their feelings through anger or bad behaviour. Your child may react to your illness with behaviour you wouldn’t normally accept. Some children may have problems with eating, sleeping or bed-wetting, or problems at school. They may seem sad and withdrawn, or have physical symptoms like going off their food, headaches or tummy aches.

These changes aren’t necessarily unusual, but if they carry on, or if there’s anything worrying you about your child, you can ask for help.

People who can offer you and your child support are:

  • your GP (family doctor)
  • teachers
  • the school nurse
  • social workers
  • psychological services at your hospital
  • local counselling services
  • health visitors (for pre-school-aged children).

Your cancer doctor or nurse can give you advice about counselling or psychological services to help you support your child.

You may be able to get help from social workers. In England, Scotland and Wales, social workers are accessed through your local authority (council). You can search for contact details of your local council online. In Northern Ireland, social services are accessed through Health and Social Care Trusts – visit nidirect.gov.uk

When teenagers need help

Teenage years are already a time of emotional ups and downs. But knowing that a family member has cancer can make things even harder.

Some teenagers may be less comfortable speaking about their emotions directly, and prefer to express themselves through writing, art or music. Remember that if they aren’t telling you how they feel, it doesn’t necessarily mean they don’t have anyone to speak to. They may well have the support of their friends, other adults, or both, such as an uncle, aunt, grandparent or other relative. It’s important to make sure they have someone to speak to outside of the family.

Teenagers may feel more comfortable joining a support group than speaking to a counsellor.

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