Devorah Steinberg took note when the 7-year-old daughter of a cancer patient expressed surprise after learning that she that she didn't have to be afraid of "catching" cancer like the common cold.

Later, Steinberg told the girl's mom of her child's confusion, and the mother cried as she came to the realization: "'That's why she hasn't been kissing or hugging her dad."' When Steinberg saw the mother again, she tearfully reported that her daughter had been hugging and kissing her dad all week. He died three weeks later. The young girl was part of Kids Count Too!, which offers support and education to the children and grandchildren of cancer patients.

The program, developed by The Wellness Community in Newton Centre, gives children ages 4 to 12 pricerns. Perhaps most comforting, "they look around the room and see kids the same age as them - all facing cancer" in an elder, said Steinberg.

Meanwhile, the parents meet for support in another room, mny of them feeling a great sense of relief that the doors of communication are being opened a crack.

"It's amazing how much support comes for dealing with the kids comes from the parents group," said Linda Garrity, whose husband has cancer of the larynx. The youngest of her three sones, Ryan, 11, goes to Kids Count Too!, and Garrity said the parents often look at one another in amazement when they hear how much fun their children are having on the other side of the wall.

That's because the children "don't sit there and pour out their feelings," Steinberg said. Instead, through artwork, games and other activities, the kids are given the oportunity to open up in subtle ways.

For example, their parents may find a way to enter their child's emotional world when they ask a question about a drawing. One 8-year-old whose mom had cancer made a collage that featured the "Wizard of Oz" characters. Steinberg said the boy's mother asked why they were included, and he answered: "When you have cancer in the family, you have to be very smart, you have to have heart, and you have to have courage."

Garrity said the sessions have helped Ryan talk about things that really worry him, such as, "I'll never hear dad's voice again."

Perhaps one of the most difficult things for parents faced with cancer is deciding how and when
to tell their children. Understanding where the child is developmentally is crucial, according to. Pamela Willsey, program director at The Wellness Community. She identified several key
things to include in that initial conversation:
    Say the word cancer.
    Tell what part of the body is affected and outline the treatment.
    Tell the child what will happen as a result of treatment: "Mommy will lose her hair, she'll feel tired; and she may be grouchy because she doesn't feel well." Explain what the impact will be on the child. "Children are focused on their own security," said Willsey, and I this is quite normal. It's important to maintain the same rules, routine and expectations during a time when many other adjustments must be made. Prepare the
child for necessary changes: "Grandma will come and stay when Mom's in the hospital. Dad will bring you to school, and Mrs. Jones will pick you up and bring you home."

Emphasize that even during hospital stays, the child can come visit and talk with you on the
phone, she said.

Willsey said to be ready with comforting answers when children do ask difficult questions. If
a child asks, "Why did you get cancer?" reassure her that there's nothing anyone did to make you
get cancer. Children often worry about the other parent's getting sick. Explain the difference between common Illnesses, such as the flu, and chronic illnesses said Willsey, and reassure them: "It's not likely to happen to Daddy or you."

If a youngster asks, "Are you going to die?" Willsey suggests being open but positive. "Say,
'Yes, some people die of cancer, but that's not my plan. I'm going to take my medicine and do
everything in my power to try to get better."

The Wellness Community has begun a second children's program for Kids Count Too! participants who lost their family member. Steinberg said the new Kids Connection grew out of concern or children who, upon the death of a loved one, lost their friendships and support at The Wellness Community. It is open only to those who have participated in Kids Count Too!

Garrity initially had trouble finding any kind of support services for kids, and Willsey said they are not readily available. For families who cannot join The Wellness Community for geographic or other reasons, Willsey suggests contacting the social services office where cancer treatment is being sought to get support for both the patient and his family.

She emphasized that it's important to talk with children, even if you're overwhelmed, "because children know. They might not fully understand, but they have a sense of what is going on, and sometimes their fears are even worse thm reality."

-Nancy Kelleher