Background: Approximately 1 in 285 children in the U.S. are diagnosed with cancer before their 20th birthday. The short- and long-term symptoms experienced by these children disrupt their quality of life by restricting their ability to participate in daily activities, negatively affecting close relationships, as well as increasing feelings of distress and frustration. The purpose of this project is to describe how children with cancer between the ages of 6 to 12 characterize their symptoms and expressions they use in relation to these symptoms. Methods: This descriptive study involves analysis of cognitive interviews with children with cancer 6-12 years of age who participated in the Kids Instrument Development Study for Symptom Management (KIDS-SM) which is supporting the development of two instruments to measure aspects of symptom self-management among children with cancer. Transcribed interviews have been uploaded into Dedoose to support identification of statements and phrases specific to how the child describes symptoms as well actions the child describes taking in response to experiencing symptoms or to avoid experiencing symptoms. A constant comparative process will be used to develop a coding schema to identify common categories of responses. Results: Interviews have been completed with 21 children (11 girls, 10 boys; mean age: 10 years). Preliminary analysis reveal that children use a variety of expressions to relate symptom experiences, such as feeling pain or 'hurt', going cross-eyed, etc. Children describe specific roles for their parents and clinical teams and also speak about things they do independently to self-manage their symptoms such as reading books and taking Tylenol. Discussion; Understanding how children conceptualize their symptoms is vital to track to improve children's experiences during cancer treatment. Understanding children's perceptions of these symptoms while also considering interpersonal, intrapersonal, and transpersonal relationships and environments can enable a more comprehensive, individualized, and sensitive approach to care.