Children are important consumers of health care, yet neither children nor their clinical practitioners have received much attention from the health informatics community. Child health needs differ from those of adults, and the purpose of health encounters for children focus to a greater extent on health promotion and evaluation of developmental milestones. The early childhood period is critical because it is during this time the children develop the expectations and attitudes about health care that they will carry with them throughout their lives. The primary purpose of this project is to examine the congruence in communication between children and pediatric practitioners. From this examination implications will be drawn for designing pediatric clinical records and developing strategies for determining the extent to which the record serve the child's health information needs and the clinician's health service delivery needs.