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Once upon a time ...
  1. E Storr1,
  2. M C J Rudolf2
  1. 1Senior Teaching Fellow, Academic Unit of Primary Care, 20 Hyde Terrace, Leeds LS2 9LN, UK
  2. 2Consultant Community Paediatrician, Belmont House, 3/5 Belmont Grove, Leeds LS2 9DE, UK
  1. Correspondence to:
    Dr E Storr, Senior Teaching Fellow, Academic Unit of Primary Care, 20 Hyde Terrace, Leeds LS2 9LN, UK;


In this, the first of two articles discussing literature for and about children, we will be considering how writing for the young has changed, reflecting different and evolving perspectives on childhood. In the second article we will be asking whether literature can be used creatively and usefully in the training of doctors. The suggestion for the topic arose from a session we organised for paediatricians in the Communication and Management module of the MSc in Child Health at Leeds University.

  • childhood
  • humanities
  • literature
  • stories
  • writing

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In this article we want to look at the development of children’s literature over the past two centuries, considering how it reveals changing and sometimes contradictory attitudes to childhood. We have come a long way from seeing children simply as “miniature adults”. The development of psychoanalysis and related fields in psychology and the social sciences have deepened our understanding of childhood as a distinct phase with various developmental stages. Capitalism and industrialisation in the nineteenth century also had a huge influence on the concept of childhood, at least among the middle classes, who for the first time saw childhood as a period during which the young might be indulged materially and physically. This led to a vast increase in the literature and toys available in the Victorian era. Today, despite our more sophisticated appreciation of the complexity and uniqueness of childhood, it still perplexes and intrigues us.

Early stories for the young show adult attempts to control and instruct the child. Later books, many of which are now considered classics, reveal an attempt to get inside the child’s mind and are written much more from the child’s perspective. This view often sheds light on the adult world in a humorous, irreverent, or challenging way. Perhaps that is why we often remember books we read as children with such vividness and enjoyment and why researching children’s books for this article has been such a pleasure.

We are fully aware that this article is a hurried romp through the past, illuminating only a few texts, while neglecting many strands of narrative, such as oral story telling, fairy tales, animal stories, and literature from beyond the Western world. The books selected were ones we or our colleagues had enjoyed reading, or thought provided an insight into childhood experiences. Further reading is suggested at the end of the article.


It was not until the end of the eighteenth century that a children’s book industry developed, encouraging reading for pleasure and amusement. Up until then, books for the young were designed to teach, inform, and provide moral instruction, leading onto the study of the Bible and the catechism. However, as children became a much more substantial proportion of the population,1 there was a rapid growth in educational provision for all classes, leading to a new demand for popular reading material. Some of this demand was met by “chapbooks”, cheap pamphlets which featured romances, histories, and religious tracts. Increasingly they included themes to amuse and instruct children with pictures and attractive coloured wrappers.

Many of these early stories and books featured death and illness and emphasised the importance of leading a Christian life and preparing for an early grave, no doubt reflecting the high levels of morbidity and mortality in the eighteenth century. The Calvinist view of childhood dominated: namely that children came into the world branded with the mark of Original Sin and that it was every parent’s duty to make sure that children recognised their sinful ways, repented, and turned to God. A good example of this is Mrs Sherwood’s book The Fairchild Family published in 1818, which was written specifically to instruct, rather than to amuse. Modern readers may be surprised or even shocked by what is considered “good” for the children’s moral improvement. For example, Mr Fairchild takes Emily, Henry, and Lucy to see a thief swinging from a gibbet to demonstrate the evils of larceny. Death and illness feature frequently as punishment for various sins such as greed, vanity, and disobedience as demonstrated to the Fairchild children by the story of Miss Augustus Noble, the spoiled child of a local aristocrat, who burns to death after admiring herself in a mirror with a candle while her parents play cards. However, death is also celebrated in the scene where they witness the uplifting sight of little Charles, a servant boy, dying in a state of grace, who welcomes his imminent demise because he is about to be reunited with God.

The Fairchild Family remained popular well into the twentieth century despite its high moral tone and authoritative style, perhaps because the stories are well written with plenty of dialogue and lots of action.


By the middle of the nineteenth century, a new image of childhood emerged which was completely different from the Calvinistic view of the child as innately wicked and requiring constant chastisement. Victorian society idealised childhood as pure and innocent. The idea that only a child might put the world to rights and lead fallen adults back to salvation recurs as a theme in many books written at this time, including several of Dickens’ novels. In Great Expectations, it is Pip’s kindness to Magwitch at the beginning of the story, that leads to the convict’s reform and later success. Death, and particularly that of a child, also has a salutary effect on adults. For example, the deaths of Paul in Dombey and Son and Little Nell in The Old Curiosity Shop, have tremendous moral significance for the adults around them. The latter are brought nearer to God and salvation by witnessing the uncomplaining suffering of the young. It is interesting that illness and death provide excellent dramas in any plot, as evident today in the numerous “medical soaps” on television.

An idea that we will return to in the second article is that death or illness in a central character often transforms both the sufferer and the survivor. In Little Women, rebellious Jo is tamed and matures by witnessing her dying sister Beth’s patience and long-suffering. Similarly, in What Katy Did, when Katy falls from a swing and breaks her back, leading to several years in bed (!), she is instructed by her invalid Cousin Helen in the “School of Pain and the lessons of Patience, Cheerfulness, and Making the Best of Things”.2

If this makes you gag, we suggest you turn to Struwwelpeter for light relief. Struwwelpeter was written by a Dr Heinrich Hoffman for the amusement of his 3 year old son. It is comic, but horrific, a combination that seems to be particularly common in verse written for children. For example, Conrad who sucks his thumbs gets his comeuppance when the Red-Legged Scissor Man (fig 1) rushes in and cuts them off. When his mother returns from shopping, she is smugly unsympathetic:

Figure 1

From “The Story of Little Suck-a-Thumb”, Struwwelpeter.

“‘Ah!’ says Mamma ‘I knew he’d come

To naughty little Suck-a-Thumb’.”3

Children become ill, suffer horrible accidents, or die when they are disobedient, and the illustrations of these events are gruesomely satisfactory. Perhaps it is the absolute certainty that badness will be punished that appeals to the reader, adult and child alike. Certainly we can see these themes surviving in Hillaire Belloc’s Cautionary Tales and some of Roald Dahl’s poetry for children (although the latter points to adult moral lapses discovered by children, rather than the other way round).

Alongside the moral tales and books designed to improve children, there were some wonderfully creative and amusing books produced, including of course, Lewis Carroll’s Alice in Wonderland and Edward Lear’s Book of Nonsense. Both writers use a child’s view to question, mock, and wonder at the stuffy or incomprehensible adult world. They are immediately more appealing to the reader and do not patronise or idealise children, which must have been a great relief to the young reader fed on a diet of nostalgia and goodly tales.


The myth and elevation of childhood continued throughout the nineteenth century, possibly because in middle and upper class households, parents had little to do with the day-to-day care of their children, which was handed over to servants and governesses. Nostalgia for childhood as a Golden Age persisted, and interestingly at the end of the nineteenth century, a spate of novels appeared that dealt with controlling time or delaying growing up, such as Vice Versa, Peter Pan, and The Time Machine. It has been suggested that this was in response to the great ideological changes that were taking place at the time, which challenged many of the assumptions underpinning British culture and led to an insecurity and longing for the simplicity of the childhood. Not only was nostalgia for childhood common in fiction, but Victorian and Edwardian parents were also idealised and stereotyped. Fathers were portrayed as stern, noble, and authoritarian figures, while mothers were perfect, loving, and self sacrificing, particularly if they could be killed off early on in the plot and assume “angel” status.

Of course, for the majority of the population, childhood was still a hazardous time to be survived, rather than enjoyed. For many working class children the reality was work in factories, mines, or on the land from 7 or 8 years old, although officially childhood did not end until the age of 12. The class differential in education and prospects was highlighted in novels such as Little Meg’s Children and in many of Dickens’ graphic accounts of the misery of working-class life and the workhouse. Kimberley Reynolds4 suggests that there was no working-class tradition of children’s literature at the end of the nineteenth century because this sector of society did not have the luxury to conceptualise childhood as a separate and precious stage. By contrast, the late Victorian and Edwardian bourgeoisie was thriving and with it a prosperous children’s publishing industry.


The genre of children’s literature evolved as childhood was recognised as a distinct phase. There was a growth in the number of women writers at the end of the nineteenth century and certainly some of them were able to use books for the young to challenge conventional values and attitudes. E. Nesbit and Frances Hodgson Burnett are probably two of the best known children’s writers and were refreshing because they adopted the voice of the child in their writing. This new perspective meant the writing was much more realistic. In these stories the characters struggle with real emotions of jealousy, greed, and grief, and develop emotionally during the story, usually to become “better” children. They also expose the smugness and stuffiness of the adult world and question its values. This is particularly true in E. Nesbit’s books in which the main characters are almost always free from parental authority and consequently can have exciting, dangerous, and magical adventures without constant interference from adults.

The Secret Garden is interesting because physical wellbeing and psychological health are so clearly linked. Both the main characters, Mary and Colin, are sickly, unhappy, and rejected children. Colin is hypochondriacal, dictatorial, and spoilt, but meets his match in Mary who is unimpressed by his claim to be a hunchback and introduces him to a world outside of his darkened room and self-absorption. Through Dickon, a simple shepherd lad from a stable, loving family, the two children learn about the wonders of the natural world. They grow and develop in every way, nurturing the secret garden as they learn to nurture themselves and each other. In this story, adults and children are restored to health by taking an interest in things outside of their own preoccupations and exercising in the fresh Yorkshire air. (Incidentally, the latter is much more effective than Colin’s uncle, Dr Craven, in treating their malaise.)


While many children’s classics such as Alice in Wonderland, The Wind in the Willows, and E. Nesbit’s books were read by both sexes, a new genre was developing of gender specific fiction. The boy’s adventure story became immensely popular and was enjoyed by adults as well as children. Kimberley Reynolds, in her book Girls Only, comments: “Fictional boys endeavoured to do: to explore, challenge and master. Girls in books aspired to ethereal benignity”.5 By the end of the nineteenth century attitudes to what constituted masculinity had hardened, for a variety of complex political and economic reasons. Publications such as the Boy’s Own Paper and popular writers such as GA Henry and Talbot Baines Reed, promoted the ideals of manliness, which included bravery, athleticism, and good health.


Meanwhile fiction for girls got dumped with all those invalid married women who were held up as models of the feminine ideal—“white faced, frail and prone to headaches ... prostrated on their day-beds whilst frequent applications of eau-de-cologne are applied to their aching temples by ministering daughters”6 (see fig 2).

Figure 2

From The Girl’s Own Paper, c 1880s (reproduced in Girls Only by Kimberley Reynolds).

Unmarried women were quite another kettle of fish, and feisty spinsters feature frequently in children’s fiction, often taking over the running of the household when Mother has died (for example, Aunt Izzie in What Katy Did, Cousin Ann in Understood Betsy, and crabby Aunt Polly in Pollyanna). Or girl children become “little mothers” and look after their younger siblings and Father (if he is not absent at Work or War), thus perpetuating the idea that women belong in the home. Domestic dramas and school stories flourished, but these were given a low literary status, partly because juvenile fiction has always been viewed as inferior to adult writing, but also because writing for girls was considered of less merit than stories for boys or men.


Throughout the Edwardian period and between the wars, childhood continued to be seen as a time of innocence and purity (although Freud’s theories were soon to upset this perspective) and the literature of the time reflected this, perhaps providing a sense of hope and purpose during the disruptive war years. But in the period after the Second World War there were huge developments in juvenile fiction. The sense of dislocation and insecurity immediately following the war was evident in books such as The Borrowers, The Children of Greene Knowe, and Tom’s Midnight Garden. All of these novels feature children who are displaced or separated from their families and whose inner worlds become crucial in maintaining their sense of self in the absence of home and parents. The child’s perspective is skilfully observed and realistic and the reader sympathises with the loneliness of the child, and hopes for a happy resolution, but the tone is thankfully unsentimental. A new picture of childhood emerges which recognises that life is difficult and that children often have to deal with situations not of their own making, which are far from the cosy domestic ideal of the united happy family. (For a fascinating analysis of some of these books and several other significant classics, including Harry Potter, see Narratives of Love and Loss by Margaret and Michael Rustin).


The new realism we see emerging after the Second World War evolved further. Today modern children’s writers start from the perspective that children and young adults inhabit a complex and challenging world. Berlie Doherty, Ann Fine, Jacqueline Wilson, and Judy Blume write about events such as bullying, divorce, mental illness, sex and sexuality, drugs, disability, and even death (although this is less common than in Victorian fiction). There is a more sophisticated approach and openness in dealing with these topics and no longer a presumption that everything will end happily.

Roald Dahl probably deserves a special mention as the most popular children’s author of the 1980s and 1990s. Perhaps this is because he seems to be able to get inside the child’s mind so successfully, without judgement or condemnation. He revels in the disgusting and scary and his language is often onomatopoeic and amusing. Grown-ups frequently represent the enemy, to be triumphed over by the heroic child. It is a very appealing view for the young, even if sometimes as adults, we are disturbed by the sadistic nature of the parents, aunts, and teachers who inhabit his books.

Back in the real world, novels such as Dear Nobody deal with teenage pregnancy, illegitimacy, and relationships between the generations. In such a book and many others of its genre, it is clear that the way we understand and define childhood has changed. No longer is the end of childhood signalled by leaving home, sexual experience within marriage, and financial independence. Boundaries between childhood and adulthood are not so clear cut and life today seems increasingly complicated and dangerous.

A recent positive trend in children’s literature has been the growth in writing about disability and chronic disease. This new genre does not patronise the disabled or use them to promote the personal development of the main able bodied character, as previously. Similarly, there have been several books that include mental health problems. Jacqueline Wilson describes a mother with manic-depressive illness in The Illustrated Mum, and Anne Fine’s The Stone Menagerie starts with a 12 year old boy reluctantly visiting his batty aunt in a mental hospital, only to discover a bizarre couple living in the grounds who play an important part in his aunt’s improvement.

Many of these difficult topics are dealt with humorously and affectionately, making it easier for the young reader to accept that human beings are complex, contradictory creatures, and neither adults nor children live up to the ideal.

If this gritty realism is too much and an escape into fantasy is needed, J.K. Rowling and Philip Pullman’s books provide excellent stories as well as tackling complex psychological issues. Adults and children enthuse about these novels, which immediately raises their literary merit from the bottom shelf of stories for children to serious writing for all.


We hope we have shown that literature for children and about children over the past 200 years illustrates that our view of childhood has changed, evolved, and become much more sophisticated. Many factors have contributed to this change, including industrialisation and the growth of capitalism, increased scientific and psychological understanding, and full time education for all young people. Improvements in health and economic circumstances mean the pattern of morbidity and mortality has altered, leading to an increased survival of those with disabilities or chronic diseases. The literature of each generation reflects the dominant ideology and so we can follow the shifting concept of what constitutes childhood through the writing produced for children, as well as the way in which children are portrayed in adult books.

In the next article, we will be discussing what doctors, and paediatricians in particular, might gain from reading literature written for the young. We will also be providing a list of recommended books and discussing the merits of using such texts in the training of doctors.


Works of fiction

Sherwood, Mary Martha. The Fairchild Family. London: Hatchard, 1818.

Stretton, Hesba. Little Meg’s Children. London: Religious Tract Society, undated.

Dickens, Charles. A Christmas Carol. London: Chapman and Hall, 1843.

Lear, Edward. A Book of Nonsense. 1846.

Dickens, Charles. Dombey and Son. London: Bradbury and Evans, 1848.

Hoffman, Dr Heinrich. Struwwelpeter. Leipzig: Friedrich Volckmar, 1848.

Carroll, Lewis. Alice in Wonderland. 1865.

Dickens, Charles. The Old Curiosity Shop. London: Chapman and Hall, 1866.

Alcott, Louisa May. Little Women. 1868.

Coolidge, Susan. What Katy Did. 1870.

Anstey, F. Vice Versa. 1882.

Henry, GA. With Clive in India, The Beginnings of Empire. 1884.

Reed, Talbot Baines. The Fifth Form at St Dominic’s. London: The Religious Tract Society, 1887.

Wells, HG. The Time Machine. 1895.

Nesbit, Edith. The Story of the Treasure Seekers. 1899.

Barrie, JM. Peter Pan. 1904.

Nesbit, Edith. The Railway Children. Wells Gardner, Darton & Co, 1906.

Belloc, Hillaire. Cautionary Tales. London: E. Nash, 1908.

Grahame, Kenneth. Wind in the Willows. 1908.

Nesbit, Edith. The House of Arden. London: T. Fisher Unwin Ltd, 1908.

Burnett, Frances Hodgson. The Secret Garden. London: William Heinemann, 1911.

Canfield, Dorothy. Understood Betsy. 1916.

Porter, Eleanor H. Pollyanna. 1916.

Norton, Mary. The Borrowers. London: Dent, 1952.

Boston, Lucy. The Children of Greene Knowe. London: Faber, 1954.

Pearce, Philippa. Tom’s Midnight Garden. London: Oxford University Press, 1958.

Dahl, Roald. James and the Giant Peach. New York: Knopf, 1961.

Blume, Judy. Deenie. William Heinemann Ltd, 1980.

Fine, Anne. The Stone Menagerie. Methuen Children’s Books Ltd, 1980.

Dahl, Roald. Revolting Rhymes. Jonathan Cape Ltd, 1982.

Dahl, Roald. Matilda. London: Cape, 1988.

Doherty, Berlie. Dear Nobody. London: HarperCollins, 1992.

Pullman, Philip. Northern Lights. London: Scholastic, 1995.

Pullman, Philip. The Subtle Knife. London: Scholastic, 1997.

Rowling, JK. Harry Potter and the Philosopher’s Stone. Bloomsbury Publishing plc, 1997.

Wilson, Jacqueline. The Illustrated Mum. Doubleday Publishers, 1999.

Critical and historical studies

Dusinberre, Juliet. Alice to the lighthouse. Macmillan Press, 1987.

Hunt, Peter, ed. Children’s literature: an illustrated history. Oxford University Press, 1995.

Reynolds, Kimberley. Children’s literature in the 1890s and the 1990s. Northcote House Publishers Ltd, 1994.

Reynolds, Kimberley. Girls only! Gender and popular children’s fiction in Britain 1880–1910. Hemel Hempstead, 1990.

Rustin, Margaret, and Rustin, Michael. Narratives of love and loss: studies in modern children’s fiction. H. Karnac Books Ltd, 2001.


Supplementary materials

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    Book List
    A book list of literature, suggested by paediatricians, illustrating children's experience of illness and health care is available here as a PDF (printer friendly file)

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