Table 1.
Impact of Cancer Treatment Across Development
| Psychosocial Challenges | Cognitive Challenges | Behavioral Result | |
|---|---|---|---|
| Infant/Toddlers (0–2 years) | Difficulties with regular feeding, comfort, and cares in can lead to caregiver mistrust and attachment disruptions. | Developing sensory and motor curiosities can be particularly disrupted by pain, nausea, and discomfort of treatment. | Worsening abilities to self-soothe and be soothed. Increased irritability with touch or aversion to it. |
| Preschool(3–5 years) | Failure to develop sense of personal control over environment and physical tasks such as toileting, feeding self, walking can lead to fearfulness, anxiety, doubt, frustration, and guilt. | Imagination and magical thinking develops. Fantasy and fears can be complex around physical and environmental difficulties of treatment. Complex abstract thought about death is still limited. | Temper tantrums and procedural resistance can develop when unable to have control, experiencing inconsistent limits/messages, and changing routines. Token economy can be helpful motivator. |
| School Age(6–11 years) | Disruptions in school, sports, and activities valued by family units can lead to sense of inferiority and guilt/shame. | More concrete understanding of treatment including length, number of treatments, and developing understanding of death. | Frequent aversion to medicine, nutrition, and other differences compared to family members due to sense of unfairness and disruption of normalcy. |
| Adolescents (12–18 years) | Inability to find acceptance in peer groups and explore different roles can lead to frustration and confusion. Profound loneliness and isolation can develop without intimate peer relationships. | Abstract reasoning and theoretical concepts of death develops. Concepts learned in one context can be applied to others. Critical thinking, planning, and agency in care are possible. | Risk-taking and non-adherence due to sense of invincibility or active denial. Behavior often for the benefit of social/peer values and activities with less influence or care about family values |