Children use imagery to make sense of asthma
17 June 2009

Children use metaphors to explain or describe their asthma, say American researchers.

Jane Peterson and Yvonne Sterling detail examples of metaphors used by African-American children to describe their asthma. The researchers followed ten children aged between 9 to 12 years over the course of a year, all of whom had been diagnosed with asthma at least a year before the study commenced.

All 10 children had distinct (but not always detailed) ways of talking about their asthma, but there was no apparent pattern to these with respect to gender, age or asthma severity.

One boy described his asthma as a jellyfish, saying that it ‘stings like a jellyfish’, whereas a 12 year old girl, whose asthma was described as not being severe, used the comparison of a troll that ‘sleeps all day in the dark… kind of hidden, until I wake him up with the activities I do.’

Another child described her asthma as dry crackers: ‘When you breath out, the crackers go out and when you breathe in the little pieces come back in.’ She adds that ‘If you take medicine, it kind of settles down the cracker pieces, so they don’t bother you.’

The authors commented in the Journal of Pediatric Health Care: ‘These metaphors were concrete, familiar to them, multi-vocal, and allowed for embellishment, incorporating new information as it is imparted to them by healthcare providers.’

They concluded: ‘Children who explain asthma in their own terms will feel valued and invested in their own healthcare as they find that their voices make a difference in decisions about their care.’

Erica Evans, Clinical Lead at Asthma UK, said: ‘This research highlights the importance of listening to people describe their asthma. 

‘Any insight parents, doctors and nurses can get into how asthma is affecting someone’s life, particularly children, can help when discussing a management plan. Using the similar descriptions such as “avoid the jellyfish” or “tackle the troll” – could all be beneficial in conveying to children the effects their treatment should have.’