Young Children Capable of Reporting on Their Own Health

One of the most perplexing things about children’s health is that parents and children do not agree about it. The importance of obtaining children’s perspectives of their own health is the subject of a major debate among pediatricians and child health researchers.

An analysis conducted by Anne Riley, PhD, associate professor with the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, concluded that children, even those as young as age 6, can adequately understand and accurately report on their own health. The study suggests that questionnaires and interviews to ask children about their health directly and independently of their parents can have many applications. This report is published in the July/August 2004 issue of Ambulatory Pediatrics.

“There is good evidence from developmental, psychometric, cognitive interviewing research and longitudinal studies that suggest children can successfully complete age-appropriate health questionnaires and provide valuable information about their own health. Parent reports differ from those of children, but are nonetheless valuable in their own right, especially for collecting information on medical history, behavior and health care,” said Dr. Riley.

Dr. Riley reviewed published research on child report questionnaires and longitudinal studies using children’s reports. The value and limitations of the data were examined in terms of parent-child agreement on the child’s state of health, the child’s cognitive development, the child’s ability to respond to questionnaires and influence his or her responses, psychometric studies of child-report questionnaires and how well the children’s reports related to future health in longitudinal research studies.

In addition to analyzing child report research, Dr. Riley and her colleagues have developed publicly available assessment tools to measure children’s and adolescents’ perceptions of their own health and well-being, as well as the parents’ perceptions of the child’s health. This set of instruments, the Child Health and Illness Profiles, includes the Child Edition (CHIP-CE) and Adolescent Edition (CHIP-AE). The CHIP-CE includes an illustrated 45-item questionnaire designed for children ages 6 through 11, and parallels the parent version. Previous studies conducted by the Hopkins researchers and published in the journal Medical Care found that the Child Report Form of the CHIP-CE predicts children’s future health care use as well as the Parent Report Form does.

“Children can tell us how they feel in a way that no one else can, and their future health is influenced by their early experiences. It is worth the trouble to ask children about their health before their habits and risk behaviors become established. Understanding children’s health behaviors, problems and worries can assist health providers, parents, teachers and health researchers to find ways to help children develop the best health possible,” said Dr. Riley.