The Memorial Symptom Assessment Scale for children was used to investigate quantitative relationships in child patient's current experience of eight specific symptoms (pain, tiredness, nausea, itch, worry, sadness, insomnia, anorexia), retrospective expectations, forward appraisals of symptom change, help-seeking behavior, and a psychological measure of locus of control. Children with cancer were compared with an age-sex matched cohort of general surgical inpatients (mean age 11.3 years, n = 32). Oncology patients reported fewer symptoms than surgical patients, but had higher prior expectations, and were less likely to anticipate symptom improvement (especially if having a stronger internal locus of control) or talk to a health professional about symptoms. It is concluded that forward appraisals of symptom change add a useful dimension to assessments for children during periods of hospitalization. © 2005 by The Haworth Press, Inc. All rights reserved.