Cognitive level, age, and verbal ability as predictors of children's concepts of health and illness

This study was designed to investigate the relative contributions of cognitive level, age, and verbal ability to the prediction of children's concepts of health and illness. The rationale for the study was based on the premise that children's cognitive developmental level would have relevance when preparing programs for child health education. The sample consisted of 40 subjects ranging in age from 5 to 13 years who were already participants in the Preadmission Preparation Programs Study, a research project being conducted at B.C.'s Children's Hospital in Vancouver. There were 10 children selected from each of four age groups: 5-6; 7-8; 9-10; and 11-13. The subjects were administered a Health Questionnaire and a battery of Piagetian tasks representing both the concrete operational and formal operational stages of cognitive development. Verbal ability was measured by the Peabody Picture Vocabulary Test - Revised (PPVT-R). In a stepwise multiple regression equation, with level of health concept as the criterion variable and cognitive level, age, and verbal ability as the predictor variables, it was hypothesized that, (1) cognitive level would be a stronger predictor of level of health concept than the predictors of age and verbal ability, (2) cognitive level together with age would be a stronger predictor than either index on its own, and (3) verbal ability would account for a significant portion of the variance with regard to level of health concept over and above that already accounted for by cognitive level and age. The expected entry sequence into the prediction equation was cognitive level on step 1, age on step 2, and verbal ability on step 3. The results indicated that all three predictor variables, taken individually, were significantly correlated with the criterion variable; however, the expected entry sequence of variables into the prediction equation and the expected net effect of combined variables were not supported by the data analyses. Age was selected for entry on step 1 and verbal ability was selected for entry on step 2; cognitive level was not selected to enter the prediction equation. When forced into the equation on step 3, cognitive level contributed a negligible additional amount of variance to the efficacy of prediction. Although cognitive level correlates highly with level of concept, when the effects of age are partialed out, the contribution of cognitive level is not significant. Given some of the limitations of the study, small sample size and restricted range of scores for level of health concept and for the Piagetian assessment, it was suggested that in a further study with a greater representation of formal operational thinkers, there may be more support for the hypotheses. Directions for future research were discussed in terms of conducting a similar study with a sample that has a good representation of both concrete and formal operational thinkers so that the prediction strength of cognitive level can be tested within a restricted age limit. Another suggestion was that research focus on the interaction of specific cognitive concepts with health concepts to provide a greater understanding of the developmental sequence of conceptualization of health and illness. Implications for child health education were discussed in terms of knowledge of cognitive developmental level enabling medical personnel to communicate more effectively with children and plan appropriate intervention strategies for them.Education, Faculty ofEducational and Counselling Psychology, and Special Education (ECPS), Department ofGraduat