In search of what it means to preschool children to be ill

Preschool children frequently experience illness and consequently are significant users of health services. Despite children’s rights, children’s understandings of illness are rarely given due consideration in health care. Nursing practice tends to rely on adult accounts of the child’s illness. Children’s limited language ability is seen as a barrier to understanding their views. Thus this thesis is a search for what it means to preschool children to be ill. Careful analysis of the behavioural and cognitive literature on preschool children’s understandings of illness reveals a dependence upon abstract adult models of illness as a point of comparison. Despite being marginalized in the literature children’s kinaesthetic, intersubjective, situational, and spatial understandings of illness are uncovered. Existing research methodologies present barriers to understanding the world as children do. Drawing on the writings of Maurice Merleau-Ponty, Eugene Gendlin and other phenomenological scholars a new ethnographic phenomenological methodology is detailed. This methodology reveals a relational edge from which adults can begin to understand the world as children do. The methodology was used to identify how preschool children experience being ill from short-term illnesses and how they communicate those experiences to others. Field data was collected from 49 close observations with 10 children and eight parental interviews. Using field data and contemporary research, I explicate my thesis that preschool children understand illness inside-out, unimpeded by others. I examine how children, initially devoid of boundaries between inner and outer, and in advance of what they can say, articulate their meaning (‘inside’ experience/body sense) of the illness through movement and gesticulation (out) as expression. This inside-out expression of the illness experience is unimpeded by others. Adults in intimate situations with ill children can begin to understand children’s experience of illness by focusing on their own body-sense, which is related to the child’s body sense, because there is an incomplete differentiation between self and other. Knowing that children understand illness inside-out helps to understand the nature of preschool children’s experience of illness. Such understandings should influence adult interactions with sick children.