Twenty-five leukemic children aged 6 to 10 years related significantly more stories that contained elements of preoccupation with threat to their body integrity and functioning than did 25 control children with nonfatal chronic illnesses. Although they made no overt reference to the concept of death, the children with fatal illness showed an awareness of intrusion into their body integrity and functioning, and expressed a greater degree of both hospital-related and nonhospital- related anxiety than did the children in the control sample. The fatally ill child of 6 to 10 years appears to be aware of the seriousness of his illness, even though he may not yet be capable of talking about this awareness in adult terms.