From time to time we all have difficulties knowing how to be certain that another person knows what we mean. At times this is unimportant, but when we want a response from that person we need to know that they have understood. When it comes to complaining about our own discomforts, the uncertainty of knowing whether our message has been adequately received is pressing. It becomes an acute problem when we rest in hope that those to whom we have presented our discomforts will take what we feel is appropriate action to help us feel better.

Sometimes we have opportunities to appraise beforehand relative strangers who might help us. Children like to be familiar with teachers who might have to help them in a crisis. They have their own ways of finding out whether they could rely on them in an emergency. People can visit their future general practitioner before they register with a practice, although this is seldom encouraged. It is sometimes very difficult to find answers on such a preliminary visit, as we remain uncertain which questions to ask and uncertain to what degree we can rely on the answers we receive.

Whether the potential care-giver is a parent, doctor or teacher, the aim of a child often appears to be to find out what makes a difference to that person.

1. Experience of illness within the family

2. Words used to describe illness

3. Experience of accidents within the family

4. How it is suspected that the child is ill, together with how the child lets the parents know.

5. When decision-making is difficult, how the uncertainty is resolved

6. How the child's attendance at nursery/school is decided if the child is a little unwell

7. Allocation of the role of health expert between the parents

8. Who the best worrier is about illness in the family

9. The child's ‘attachment person’ when ill

10. The things done in the family to ‘make things better’

11. Experience of various kinds of health workers

12. Things the family does to keep as healthy as possible

13. The family's view on the causes of illness and the nature of germs

14. The place of cautionary tales

15. Tooth fairies

16. How illness in one family member affects how everyone else gets on together

17. Any other comments

In Chapter 1 I outlined some of the similarities between the difficulties experienced by children in learning the language of complaining, that is the ways in which they can share their discomforts with others, and the problems which a researcher can have in trying to elicit children's views on illness. Inherent in both is a form of dialogue directed at sharing the nature of someone's internal world. A consultation consists of the same sort of dialogue in which one person is trying to present a problem and another is trying to be open enough to hear what that problem is. A shared language is required.

In order to lay the basis for research methods which can be used to explore children's views and at the same time point out the sorts of communicative skills held by children, I will summarise here some of what is known about the development of children's communication. This will not be a comprehensive documentation of child development and socialisation; my intention is rather to provide a theoretical framework that can be drawn on when evaluating both what children say about illness and the research on the subject. (For those readers who have a knowledge of the development of communication this part of the chapter could be unnecessary for their understanding of the rest of this book.)

The previous chapter described the ecological systems within which the child learns of illness, the systems' structures of rules, the questions and explanations, and routines and rituals. In addition the range of ways of communicating about illness and their variety of effects were described. The subsequent chapters will present the children's views of illness which evolved within that framework. I will often focus on causality, as the causes of illness are seen to have a very central place in organising people's conceptual frameworks about illness. It appears to be around causality that we attribute intentions and construct the moral order pertaining at times of illness; our concepts here organise to a high degree our ways of responding and determine our expectations of appropriate behaviour from others. Nevertheless I refer to causality rather than causes. As the nature of the child's understanding of sufficient causes for illness is presented, it will be seen that straightforward ideas of cause and effect are hard to find.

The children's views reported here emphasise what they regard as facts about illness, rather than the possible functions of illness within a system. The latter were mentioned in the previous chapter and incorporated by the children in two ways: they mistakenly become part of the child's facts about illness, as well as enabling the child to be effective in altering systems through illness. With growing reflection it is seen how the effects can be turned to advantage in negotiating status on the basis of illness rationales.

It is now time to describe the framework to the child's world, the primary structure. It was this which shaped and was shaped by the children I observed. It is a framework of overt and covert rules and regulations built up on functional myths which these families found necessary for ordering their daily lives. These myths represent the ways in which they have found it necessary to account for the unknown, especially as encountered in their dealings with illness in their children. As already mentioned no disrespect for these myths is implied by calling them such; instead I am wanting to emphasise their historical social construction.

The family rules presented here represent my deductions to account for the ways in which the elicited views and described behaviour are linked together into a coherent whole. They are of necessity rather intangible (Ford, 1983), and I have not tried to alter the framework in order to test the forces binding it, or the relationship of the framework to the elicited views of the children. This represents the next stage in what would have to be a long-term project, and is what Bronfenbrenner (1979 p. 41) would term a ‘transforming experiment’.