Does "telling" less protect more? Relationships among age, information disclosure, and what children with cancer see and feel.

Parents report telling young children less about the diagnosis, treatment, and prognosis of cancer than older children and adolescents. This is often based on the desire to spare children from being overwhelmed. 43 children diagnosed with cancer reported on information disclosed to them at diagnosis, their causal attributions, illness-related stress, and coping strategies. Consistent with parental reports, children under 9 years (n = 18) were told less than children 9-14 years (n = 15) and adolescents (n = 10). Young children's reports of illness impact differed from older children and adolescents only with respect to school and social domains. Younger children reported fewer cognitive strategies than older children and adolescents. Even though young children were told much less than older children they reported similar levels of distress. This suggests that nondisclosure fails to mask the salient and distressing aspects of the illness.