LOUISVILLE, Ky. (AP) -- Adison Schanie painted an orange squiggle on a blank page—creating a design much like the orange-and-white scarf over her mother’s balding head.

The towheaded 3-year-old is just old enough to understand that her mother, Megan, is fighting breast cancer. And with the help of the Norton Cancer Prevention and Resource Center in Louisville, the girl is learning to cope through art.

When Schanie gave her daughter a book from the center prompting her to draw pictures about cancer, Adison filled it, drawing her own sad face on one page, and a picture of her mother on another, fully recovered with hair reaching down to her feet.

And during an art therapy session at the center, Adison drew four stick figures representing “happy,” “mad,” scared” and “sad,” telling her therapist that when she’s scared, “I tell a grown up,” and when she’s mad, “I just get over it.”

Adison is facing an experience common to thousands of families in a state with the highest cancer death rate in the nation.  Experts say children must deal with a flood of overwhelming emotions when cancer strikes a parent—picking up on family stress, getting anxious about changing daily routines and fearing separation from parents.

While Adison has been coping pretty well, her mother said she does get rowdy once in a while and sometimes has trouble going to bed. But she finds comfort in her slightly ragged stuffed Elmo toy, which she carries everywhere.

Adison rarely brings up the subject of cancer directly—so Schanie was surprised to see her draw so many pictures about it.  That’s one reason her mother figured Adison could benefit from art therapy.

“She’s obviously going to get upset,” said Megan, a 31-year-old mother of two from Louisville. “But my basic goal is for her to be happy, like any mom.”

Adison’s 1-year-old sister, Ryan, was too young to know what was happening when her mom prepared for her double mastectomy in September. But Adison, who will turn 4 in February, knew immediately that something was wrong. The way she put it, Schanie had a “germ” in her “booby.”

Eileen O’Neill Estes, Adison’s art therapist and director of expressive therapies at the University of Louisville’s college of education, said preschoolers often can understand cancer at a rudimentary level. And even younger children feel the upheaval when parents’ roles and routines change.

“Once there’s a cancer diagnosis, the whole family is affected,” said Estes, who contracts with the cancer resource center and also works with adults. “Even infants can respond.  Perhaps they don’t sleep through the night.”

Sometimes, children keep their feelings to themselves because they don’t want to upset parents who are already going through a traumatic time. And those feelings may come out in less-than-desirable ways, she said, adding, “Acting out is common.”

She said children tend to do better if parents keep their routines as constant as possible—as Schanie and her husband, Cameron, have tried to do.

Children are also very sensitive to family dynamics, Estes said, taking out a diagram designed to show how families deal with crises. It shows several figures in and around a tree, and clients are asked to identify and color the figure that represents each family member.

Adison chose the figure climbing the tree to represent her mother, and said her father was the one holding up the mother during her climb.

Adison takes cues from her father, and tries to be a support to her mom as well.

When Schanie is sleepy and sick after chemo treatments, Adison brings hugs, water, and once, a big red ribbon. When Schanie is able to get around, Adison sometimes offers a prayer at dinner:

“Thank you that Mommy’s feeling better.”

“Why do you like to help Mommy?” Schanie asked one morning as Adison sat on her lap.

Adison snuggled in close, rested against Schanie’s chest and answered: “I just do.”

Even when parents do everything right, cancer in the family is still scary and evokes lots of questions—which experts say need honest answers.

Jana Eberle, a 32-year-old mother of two also being treated for breast cancer, said her 3-year-old son, Isaac, recently asked:

“Why do you have to go to the doctor’s so much?”

“Mommy had a really mean disease,” responded Eberle, who was pregnant with her youngest son when she had the cancer diagnosed.  “She’s fighting it.”

At other points during her treatment, Eberle told Isaac she was taking medicine to make her better, and that she couldn’t hold him because she had “big boo-boos” on her chest from surgery.

Experts say chemotherapy treatments can be especially disconcerting from a child’s perspective because parents often leave feeling well and come back sick.

Estes tried to help allay Adison’s fears by giving her a tour of Schanie’s chemo room—in offices next door to the cancer resource center in Norton Suburban Hospital—and introducing her to her mother’s nurse. Adison saw a blank wall in the room and told Estes she wanted to draw a picture to hang there, so her mother would have something to look at during treatments.

“For kids, that small sentiment helps with the separation,” Estes said. “Part of them is with you.”

Schanie said she’s glad she learned about the cancer resource center, which also offers a lending library for patients and their families, massage therapy, nutritional counseling, a nurse educator to answer patients’ questions, classes and a room full of wigs and turbans. All services are free.

Schanie plans to try art therapy herself, and hopes it helps Adison express “anything she didn’t want to say to us.” Eberle, who has become friends with Schanie, said she’d like to get Isaac involved in the art therapy program, too.

Schanie said she doesn’t get upset watching Adison deal with the cancer. She just tries to patiently answer her questions.

And there’s a big one she has yet to ask.

“She’s never asked: Is cancer going to make you die?” Schanie said. “If she did, I’d say, ‘I hope not.’ And I’d tell her that I love her.”

But Schanie doesn’t dwell on the possibility of death. Instead, she does what she can to forge a lasting connection with her children.

“I want to make sure they know me,” Schanie said. “The only thing that makes me sad is that they might not remember me.”

(Copyright 2006 by The Associated Press.  All Rights Reserved.)