At this age, a child knows that you can become sick due to changes on the inside and not only because of outside forces. Illnesses are now not seen as due to magic or as a punishment, but can be cause by an infection with bacteria or a virus, for example. However, magical thinking can occur right up until teen years during stress.
They have a greater awareness of their own body than before. They may think of treatments as harmful or be afraid that their body is going to be changed. Exactly as with younger children say which part of their body is going to be treated and which parts will not be involved.
Children at this age can be afraid of the equipment they see in an operating theatre. It is also at this age that they start thinking about death. They may link sleep with death, and many young children worry that they will not wake up after the operation. Reassure them by saying that they will be looked after carefully all the time they are asleep and until they are wide awake.
Start preparing a child in this age group a week before going into hospital. Compared to younger children, children in this age group show a greater interest in what is going to happen. So, preparing them ought to be based on the questions they ask. Encourage them to use drawing and painting to tell you about their thoughts and worries.