From our observations of dying children and examination of the child's emotional and cognitive development, we have outlined some of the major considerations in the child's psychological reactions to his own dying. This has been illustrated by clinical vignettes. It has become increasingly apparent that a more systematic investigation of the child's psychological reactions to his own dying will have to take into account the adult's tendency not to perceive the dying child's behavior and verbal communications of his own fears because of the anxieties evoked in the adult by the dying child. It should be the aim of future research in this area not only to examine systematically how children express their knowledge or sense that they are dying, but also to determine the principles, techniques, and limitations of communicating with these children in a therapeutic manner. Intuition cannot be relied upon, especially in an area so highly charged with anxieties for the responsible adults. Only through a more thorough understanding of the dying child's ways of communicating his sense of dying will we be able to know and teach how to help the dying child psychologically and come to appreciate the limitations of our knowledge and psychological therapy.