• Katherine Bristowe, Debbie Braybrook, Hannah M Scott, Lucy Coombes, Daney Harðardóttir, Anna Roach, Clare Ellis-Smith, Myra Bluebond-Langner, Lorna Fraser, Julia Downing, Fliss Murtagh, and Richard Harding.
• Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.
• Palliat Med. 2024 Mar 1; 38 (3): 379388379-388.

BackgroundChildren and young people with life-limiting and life-threatening conditions have multidimensional needs and heterogenous cognitive and communicative abilities. There is limited evidence to support clinicians to tailor their communication to each individual child.AimTo explore the language children and young people use to describe their own condition, to inform strategies for discussing needs and priorities.DesignPositioned within a social constructivist paradigm, a secondary discourse analysis of semi-structured interview data was conducted incorporating the discourse dynamics approach for figurative language.Setting/ParticipantsA total of 26 children and young people aged 5-17 years with life-limiting or life-threatening conditions (6 cancer; 20 non-cancer) were recruited from nine clinical services (six hospitals and three hospices) across two UK nations.ResultsThe language children and young people use positions them as 'experts in their condition'. They combine medical terminology with their preferred terms for their body to describe symptoms and treatments, and use comparatives and superlatives to communicate their health status. Their language depicts their condition as a 'series of (functional and social) losses', which single them out from their peers as 'the sick one'. Older children and young people also incorporate figurative language to expand their descriptions.Conclusion/DiscussionChildren and young people can provide rich descriptions of their condition. Paying attention to their lexical choices, and converging one's language towards theirs, may enable more child-centred discussions. Expanding discussions about 'what matters most' with consideration of the losses and differences they have experienced may facilitate a fuller assessment of their concerns, preferences and priorities.

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