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, 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 and 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," Riley
said.
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, 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 and Adolescent Edition. 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 Johns
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,"
Riley said.