How will I know if my children need extra help?

Parents usually understand their children’s behavior and can usually predict how their children will respond to stress. When children are upset, they often react with a more dramatic version of how they behave normally. Quiet children may become more withdrawn, loud and active children crank it up a notch, and children with learning problems start doing worse in school. Some children complain of physical illnesses or may seem sad or lonely much of the time. Any type of change that persists for weeks may be a sign that the child needs more attention.

Pay attention to how and what your kids are doing.

It may be useful to watch how your children play with their friends, what they say to their dolls and action figures, or what they draw in school. Because young children usually cannot talk easily about their feelings, their behavior helps tell you what might be going on. We’ve talked before about the tendency of young children to regress in their development during times of stress. For example, a young child might have trouble staying toilet trained. Teens might argue more or be more distant as a way of acting out their distress.

Cancer may not be the reason for all the problems.

Remember that not all your kids’ problems are related to the cancer. Sometimes it can feel as if cancer has totally taken over a family’s life, but you may need to look beyond cancer as the source of problems. This can be especially tough when the disease has progressed, because everyone will be more upset than usual. Look closely at your child’s behavior and think about what else might be going on. Is your child having trouble adjusting to a new teacher? Are they upset about not being invited to a party? Are they struggling for more independence? Although cancer in the family can certainly add a lot of stress, there may be other things going on in your child’s life that could explain their behavior. You won’t know unless you ask.

Try to get your children to tell you what’s troubling them. A simple “You seem very thoughtful (sad, worried, etc.) these days – can you tell me what’s going on?” may give you new insight into your child’s behavior. Check with the school to see if the behavior also has been noticed there. Maybe a teacher is incorrectly assuming that because a parent is ill, the child should be treated differently. Often this just makes the child feel more isolated. Check out all of the possibilities before you decide what you need to do to help your child feel better.

Also remember that a child’s personality is an important factor in how they’ll react to illness in the family. Some children are easy-going and kind of “roll with the punches” while others are prone to drama and “make a mountain out of a molehill.” Different things work for different children in a family, so think about how you handled each of your children before cancer was part of your lives. Those same methods will often work again, even though the problems may be different.

Find out as much as you can about any problem the child has.

It often helps to get as much information as you can about a problem from all possible resources. This means speaking with your child’s teacher, guidance counselor, pediatrician, or a counselor or social worker on staff where you’re being treated. It’s also a good idea to ask your child what you might do to help them feel better.

Don’t forget to remind them that they had nothing to do with your getting sick or your cancer coming back. As illogical as this idea may seem to adults, experts know from experience with families dealing with cancer that children usually believe, at one time or another they had something to do with a parent’s illness. If your child seems distressed and talking about it with them doesn’t help, the child may need outside help. Children can become depressed or anxious just like adults, but they might not show it in the same ways.

Depression in children can look different from depression in adults. For instance, a common sign of depression in a child is a change in behavior, like suddenly getting poor grades in school or losing friends. Most children seem able to cope with having a parent with cancer, but there may be times when it gets to be too much. If a child seems to be having trouble, it may mean a more serious problem than a normal, sad response to cancer. Extra help is needed if a child:

  • Displays or talks about feeling angry, sad, or upset all the time
  • Cannot be comforted
  • Admits to thinking of suicide or of hurting herself or himself
  • Changes from one mood to another quickly
  • Has changing grades
  • Withdraws or isolates himself or herself
  • Acts very different than usual
  • Has appetite changes
  • Has low energy
  • Shows less interest in activities
  • Has trouble concentrating
  • Cries a lot
  • Has trouble sleeping
  • Day dreams or seems distracted a lot of the time

When a child shows 1 or 2 of these symptoms, it may help to offer more support. But if the usual ways of handling these problems aren’t working, or if the problem goes on for more than a couple of weeks, the child may need extra help. (For more serious problems, such as if the child is thinking about hurting himself or herself, help is needed right away.)

It may help to talk with the child’s pediatrician, school counselor, or with the social worker or counseling staff at the hospital where the parent is being treated. These experts know how children tend to react to illness in the family, and they may be able to offer useful ways to look at the problem. They can evaluate the child and make sure that any needed help is given. They can also suggest books, videos, and/or children’s support groups that may help. Rarely, a child may need to see a psychiatrist for medicine or counseling.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Revised: December 12, 2014