Play & keeping life normal — during treatment

Whether your child can play with other children depends on their current blood counts, particularly the neutrophil count. When counts are low — a period called neutropenia — the risk of infection is raised and the oncology team may advise limiting contact with groups of children, particularly if any are unwell. Between treatment cycles, when counts recover, many children can play normally. Ask your treating team about your child's current counts before any group play, and ask them to show you the 'traffic light' threshold they use — most teams provide written guidance so you always know when caution is needed and when it is not.

When a child is fatigued, nauseous, or confined to bed, quieter activities are best: drawing, colouring, sticker books, puzzles, audiobooks, and gentle storytelling. Screen time rules can be relaxed sensibly during these periods — films and age-appropriate games provide distraction and emotional rest. Many children enjoy creative activities they can do lying down: making friendship bracelets, building with small interlocking blocks, or playing simple card games with a parent. The key principle is that the activity should follow the child's lead and energy level — on a low-energy day, simply listening to a favourite story read aloud counts as meaningful play.

Many children do attend school — even part-time — during treatment, and most paediatric oncologists encourage it when the child is well enough. School provides routine, social connection, and a sense that life continues. The decision depends on infection risk at any given point in the treatment cycle, the child's energy levels, and any practical adjustments needed (for example, wearing a mask, avoiding PE, or having a quiet room for rest). The CION team can provide a brief medical summary letter for the school explaining any temporary restrictions — this helps teachers make practical accommodations without your child feeling singled out.

Maintaining elements of identity and routine is one of the most powerful things a parent can do. Let your child wear their favourite clothes to clinic, choose what they eat on good days, and keep a manageable version of their usual bedtime routine. Continue small rituals — a favourite song, a particular bedtime story, Friday-night pizza — even in adapted form. Peer connection matters too: video calls with friends, messages from classmates, and visits from a best friend (when safe) help a child feel they still belong to their world. Many paediatric oncology units have a play therapist or child life specialist — ask for an introduction, as they are specifically trained to support this.

Yes, this is entirely normal and very common. Fatigue during and after certain treatment phases can be significant, and a child who is not interested in play is not failing to cope — they are responding naturally to what their body is going through. Anxiety, low mood, and withdrawal are also common reactions to a stressful situation. If your child seems withdrawn or sad for an extended period rather than just during the hardest treatment days, mention it to the oncology team. A paediatric psychologist or counsellor can help your child find ways to express what they are feeling, even when play itself feels like too much effort.

Play therapy — guided by a trained child life specialist or paediatric psychologist — uses play as a tool to help children process fear, anxiety, and difficult medical experiences. It is not the same as free play; it is a structured therapeutic approach that may involve medical play (acting out procedures with toy equipment), art therapy, storytelling, or structured games. Studies consistently show that children who receive psychosocial support, including play therapy, experience less procedural distress and cope better with the broader treatment journey. Ask the oncology team whether a child life specialist or psycho-oncologist is available, or request a referral if the service is not offered automatically.