This is the work of two psychologists: Michael Siegal is Professor of Psychology at the University of Sheffield and has published extensively in the area of developmental psychology; Candida Peterson is Professor of Psychology at the University of Queensland and has published both popular and academic texts in the field of Child Development, including A Child Grows Up (1974). The target audience is described as “students and professionals in psychology and disciplines such as education, law, medicine, nursing, physiotherapy, counseling, social work and student welfare” as well as any “readers who are simply concerned to know more about how children think and learn.” However, reading the first six pages was enough to convince one that a minimum background knowledge in developmental psychology and research designs is essential to appreciate the richness and critical analysis of current literature on children’s understanding of biology and health contained in this relatively slim, but linguistically intense volume.
In the first chapter, Michael Siegal reviews and contrasts the two fundamental proposals about children’s health cognition development, namely the “innate predisposition” framework based on Piagetian theory and the adaptive-evolutionary model, which emphasizes empirical knowledge acquisition.
The second chapter, by Inagaki and Hatano, addresses mind-body relationships and demonstrates that even very young children (age 4 to 6) have reasonable understanding of bodily phenomena and can distinguish bodily functions from mental ones. The implications of these findings are as follows: 1) we should regard young children who have taken ill as capable of understanding their illness and needed treatment. 2) Even young children can understands the basic principles of Preventive Medicine and Health Promotion, although they favor a vitalistic explanation about how living things use food to survive and grow.
In the third chapter, Ken Springer argues that a critical milestone in children’s understanding of biology takes place when they learn that babies grow inside their mothers (approximately two thirds of American 4 and 5-year-olds understand this) and that there is more to family than the surface features of proximity and caring. However, most 4 and 5-year-olds still know very little about the father’s role in reproduction and the exact location of prenatal events.
The adult concept of Death includes the following components: irreversibility, cessation/non-functionality, inevitability and causality (breakdown of bodily functions), as explained in the fourth chapter. Preschoolers think of death as temporary and reversible. Around age four or five, a vitalistic biology, organized around the concept of “life,” emerges and helps to organize new knowledge about what the body needs to survive. There is a close relation between life-theorizing, knowledge of bodily functions and a mature concept of death, which is only possible in the Formal Operational Stage of development.
Charles Kalish reviews children’s understanding of Contamination and Contagion, which is central to reasoning about causal relationships surrounding illness, in the fifth chapter. Recent evidence shows that, contrary to past beliefs, even young children understand that there is an intermediate mechanism, other than proximity, involved in contagion. For instance, even 3 and 4-year-olds can tell you that getting sneezed on by a sick person can make you sick because of invisible particles contained in the sneeze material. Kind-hierarchies of illness are built out of overt hypotheses that transcend the natural and nominal representations of illness.
Children and Pain is the complex subject of the sixth chapter: although the Piagetian model contends that pre-operational stage children attribute pain to wrongdoing by the individual, there is little empirical evidence to support this “immanent justice” theory. By 5 or 6 years of age, children have formed a causal understanding of pain as a distinctively biological phenomenon, which occurs both in humans and animals, not in plants, although children are quicker to associate pain with visible tissue damage on the surface than with internal, invisible, damage. Research has shown that children who are “information-seekers” tend to cope more successfully with painful procedures than do “information avoiders.”
The seventh chapter reviews how children learn about food in a social context and are predisposed to like sweet and salty foods. While they reject any new flavor cues initially they do learn from the natural gastrointestinal consequences of eating. Although interesting, this chapter is less relevant to the subject of this text, children’s conscious understanding about health and illness.
Chapters 10 and 11, however, have very relevant implications for health education and competence-to-consent assessments. In particular, a rational, experimental hands-on approach to health education is recommended to teach children effective tools for reasoning about infectious diseases sensibly and coherently. Finally, it is argued that accurate knowledge of the causes and cures of illness are only one of the elements in a child’s cognitive competency to make medical decisions. Another entails the rational ability to weigh choices, probabilities and alternatives against one another in evaluating treatment choices; an ability a majority of formal operational thinkers believe to be extremely limited before the age of 18.
In summary, this book offers an excellent, in-depth review of the literature but is not recommended for bedtime reading.