Many children who have a serious illness such as leukemia learn to adjust to their situation over time, with the right support. But like adults, children have good days and bad days. If your child is having a bad day, it may be hard to tell whether the cause is the leukemia, the treatment, or your child just being a child.
Behaviour changes depend on your child's age. Each age and stage of life brings a different set of challenges. A toddler with leukemia will behave differently from a school-aged child.
Crying, anger, fussiness, acting out, or tantrums can all be normal behaviours for younger children at certain times. School-aged children may feel more guilty or nervous about what is happening. Some children may show more serious behaviours, such as becoming withdrawn, anxious, not sleeping well, having problems with relationships or in school, or refusing to have treatments.
Teenagers often feel frustrated because of their loss of independence. As they approach adulthood, they are faced with new issues, both physical and social, that further affect their care. They are also more sensitive to changes in their appearance. Irritability, temper tantrums, and withdrawal can be normal behaviours for teenagers.
More serious behaviour changes need to be attended to quickly. These can include severe, frequent changes in your child’s mood and emotions, as well as difficulty regulating their behaviour. Talk to your health care team if you are concerned.
There are a number of possible causes to the behaviour changes you may see. Some of these include:
- changes in routine
- fatigue, which can lead to irritability
- feeling unwell from treatment
- the stress caused by treatment, changes in appearances, or issues in the family
- medication side effects such as steroids (dexamethasone)
What can you do about changes in behaviour?
Talk to your child’s care team if you are concerned about your child's behaviour. There are also several approaches you can take at home to reduce problem behaviours:
- Stick to a routine when you can. Although life has become unpredictable, keeping to routines as much as possible will help. Children thrive on routine. As your child's lifestyle changes, be open to establishing new routines.
- Develop a strategy to deal with inappropriate behaviour. For example, find alternate ways for your child to express their negative feelings or behaviours; try saying “When you get angry, I would like you to...”. In some situations, ignoring the behaviour may be the best strategy. Too much attention can cause negative behaviours to increase.
- Recognize good behaviour when you see it. Recognition could involve special time set aside with parents.
- React to inappropriate behaviour with consequences that are suitable for your child’s age or stage of development. The response should be prompt, consistent, and clear.
- Play therapy. For younger children, playing is a great way to let your child express their thoughts and feelings. For example, your child may find needles less frightening if they can first play with empty syringes.
- Involve your child in discussions about their treatment. This is especially important for teens since they want to be part of any decisions. Discussions will help your teen deal with the loss of control and independence that may come with their treatment.