Abstract: This study draws on my doctoral dissertation (Saad, 1996), which compared the portrayal of female chronically ill characters with that of male chronically ill characters in children's books. There were two parts to this investigation. First, I conducted a content analysis of 54 children's chapter books with chronically ill main characters published in the United States between 1970 and 1994 and still available. Each book was then matched with a reader who had the same chronic illness as the book's main character. Second, I interviewed the readers about their impressions of these books. The content analysis and interview results were analysed using qualitative methods and descriptive statistics.

The study had three major findings:

1. Most (72.9%) readers found the books at least slightly unrealistic. This finding is in opposition to Drennon's 1993 study, which indicated that only 5.8% of readers thought the books were at least slightly unrealistic.
2. Four-fifths (80.8%) of children's books studied had female chronically ill main characters, 18% had chronically ill male main characters, and 1.3% had a chronically ill main character of each gender.
3. When books were considered as a group, a pattern of sexism, racism, and heterosexism emerged.

These findings were used to recommend ways in which existing literature can be used with chronically ill and able-bodied youngsters.

Introduction

Because children's literature provides many youngsters with their only opportunity to become acquainted with certain populations (Drennon, 1993), teachers intentionally use children's books to introduce their students to particular groups of people (MacDonald, 1993; Wagoner, 1984) or to certain ideas (Bawden, 1980). Literature lends itself to teaching about sensitive topics for many reasons: Fictional stories are interesting, youngsters sometimes find it easier to talk about literature than to talk about their own lives, literature provides a springboard for discussing emotions (Goldman, 1993/1994), and literature can not only teach facts but also influence affect (Bower, 1980; Monson & Shurtleff, 1979). Teachers may, therefore, prepare their able-bodied students for the mainstreaming of chronically ill children by introducing them to chronically ill characters in books; but to be effective, the books must be chosen with care (Dobo, 1982; Monson & Shurtleff, 1979).

Physicians also use books with their chronically ill clients (Drennon, 1993; Walker & Jones, 1986). Chronically ill children and their parents might seek out such books themselves as a way of coping with illness (Moos & Tsu, 1977) and to reflect on their illnesses (Coles, 1989). Books can help shape the way children interpret their illnesses, for instance, storytelling can make an illness "a curse" or "a blessing in disguise" (Seaburn, Lorenz, & Kaplan, 1992, p. 386). Consider the following letter, written to the editor of a comic book featuring a disabled superhero:

Dear Editor:...I feel just like Captain Storm when he's in action in the Pacific. I relive every action he stomps into, wedging that wooden leg of his in one of the holes bored into the PT's deck. He makes me feel as I can accomplish what he can - even with that handicap...Oh, yes, I know that Captain Storm is only a comics character. But the chap seems awfully real. Well, to me, anyway. You see, I lost a leg too... (Kokaska, 1984, p. 287).

Literature can show chronically ill people that they are not alone; that others have similar problems and feelings (Walker & Jones, 1986). Books with negative or stereotypical portrayals of chronically ill children, therefore, may be harmful to this population (Baskin & Harris, 1977).

Definitions

I define chronic illness as a protracted (lasting for at least one year) physical disorder that is progressive or changeable. I use the term disability to refer to conditions which last at least a year but which are neither progressive nor changeable. Thus, spinal cord injury is a disability; multiple sclerosis is a chronic illness. This investigation includes only books with chronically ill characters. I included chronically ill characters and excluded disabled characters because people with chronic illness face issues of uncertainty and mortality that typically are not encountered by people with disabilities.

Literature Review

I analyzed children's books to determine their portrayal of male and female characters with chronic illnesses and the effects of the juxtaposition of gender and illness in children's literature. Sexism and the stereotypical portrayal of chronically ill individuals in children's literature have been documented (Davis, 1984; Kortenhaus & Demarest, 1993; Reinstein, 1984; Rudman, 1995; White, 1986). Drennon (1993) conducted an analysis of children's books with chronically ill characters that explored the medical and developmental accuracy in children's books with chronically ill characters. Her suggestions for future research included the following:

Because accurate medical information is critical, a similar study should be conducted in which children's realistic fiction books about chronically ill children published after 1990 are analysed.... (p. 167-168)

Disability activist Asch (1984) makes suggestions for psychological research: "We must study the effects of school...environment upon the disabled" (p. 533), while Fine and Asch (1981) address the issue of the education of disabled girls. They argue that these girls need to see affirmative images of themselves, and list several questions they believe should be addressed by research. My study was designed in part to begin to address these questions.

Because reading can powerfully change readers' attitudes, it is crucial for educators to ensure that these changes will be beneficial. Teachers and other professionals who give children books with chronically ill characters are striving to build bridges, not to reinforce prejudices. It is impossible for professionals to know how the books affect attitudes without knowing their content. My study was formulated to make information about the content of children's books with chronically ill characters available to parents, educators, and health care providers.

Methods

Research Design

There were two components to this study: a qualitative content analysis of 54 children's books with chronically ill main characters and then a series of interviews with readers of these books. I developed a content analysis instrument and interview questions for analysing the books' portrayal of male and female characters with chronic illnesses. Each book was matched with a reader who had the same chronic illness as the book's main character. Readers were interviewed individually for their thoughts about the portrayal of the ill characters. Finally, I compiled and analysed the data from the interviews and the content analyses. I compared the results for each book, noting similarities, differences, trends, and patterns.

I employed 100% sampling. Every book that met the following criteria was included in the study:

• The book was a trade book originally written in English and published in the U.S. between January 1, 1970 and December 31, 1994.
• The book was readily available, whether in print or out-of-print.
• The book was a chapter book marketed for children or adolescents.
• The book was realistic fiction, which "includes those stories that could have happened to real people living in the natural, physical world and social environment as experienced or imagined by the author" (Huck & Kuhn, 1968, p. 217).
• The main character of the book was a human character with a chronic physical illness.

In cases in which there was a series of books by a single author about a single chronically ill character, only one of the books from the series (the first book in the series featuring the chronically ill main character) was included in the content analysis.

Readers

Readers, who were children and adults with chronic illnesses, were chosen from a variety of avenues including referrals from professionals and other readers and from Internet discussion groups focusing on health or on children's literature. There was one chronically ill reader for each book. Each reader had to speak English well enough to read a children's book; have completed the third grade in school; and have a chronic illness. I paired readers with books in which the main characters have the same illness as the readers, and also noted reading levels when matching books with readers; for example, the 10-year-old reader was not asked to read a book marketed for high school students. Finally, I made every effort to pair readers with books appropriate to their interests; for example, the tenth grade boy was asked to read a book about a high school student.

The participants in this study were relatively homogeneous. There were 53 (96.4%) white participants, one (1.8%) mostly European and partly Asian participant, and one (1.8%) Asian-American participant. There were no black participants. Most of the participants were well-educated: 11 (20%) were currently in school; eight (14.5%) were high school graduates; 20 (36.4%) were college graduates; 13 (23.6%) had master's degrees; and three (5.5%) were MDs or PhDs. As with most recreational readers (McKenna, Kear, & Ellsworth, 1995), the readers in this study (74.5%) tended to be female. Readers lived in 18 of the 50 states and in five foreign countries. Twenty-nine (52.7%) readers were interviewed via electronic mail, and 26 (47.3%) were interviewed face to face. Readers were matched with books by type of illness but not by gender. Thirty-six of the 55 readers read books about same gender main characters, whereas 19 readers read books about characters of the other gender.

Content Analysis

The method of qualitative content analysis was used for this study because content analysis is concerned with "what is said" in the literature being analysed (Bekkedal, 1973; Waples et al., 1940). When using the method of content analysis, researchers have traditionally sought meaning in pre-specified bits of data, such as words, sentences, or paragraphs. Marshall (1981) protests these constraints:

It always amuses me when I read books on how to do content analysis that you have to decide on some sort of level of analysis - looking at a word, a sentence, or a section. But the units are really fairly obvious -you get chunks of meaning which come out of the data itself (sic)." (Pp. 396-397)

As Marshall recommends, I searched for logical units of meaning in the data. Since Marshall also contends that it is more beneficial to search for emergent themes in content analysis than to use the more traditional method of fitting data into preconceived categories, I let the categories emerge from the data.

I examined all the materials generated by my data collection and reader interviews looking for emergent themes. Each theme that emerged was noted and filed; for example, it became evident that my content analyses described characters as "attractive." I then created an "Attractive Characters" file. I searched all existing data for the words "beautiful," "pretty," "handsome," and "attractive." I copied parts of interviews and content analyses containing these words into the "Attractive Characters" file. As I completed new content analyses, I copied relevant material from these new data into the "Attractive Characters" file. Finally, I achieved saturation: no new categories emerged from the remaining analyses.

Results: Analysis and Discussion

The study had these major findings:

1. Most of the readers (72.9%) found the books at least slightly unrealistic. This finding is in opposition to Drennon's (1993) study, which indicated that only 5.8% of readers thought the books were at least slightly unrealistic.

2. The more a reader could identify with a book's characters or events, the more the reader enjoyed the book.

3. Four-fifths (80.8%) of children's books studied had female chronically ill main characters, 18% had chronically ill male main characters, and 1.3% had a chronically ill main character of each gender. This preponderance of ill female characters reflects the traditional societal view that female bodies are inherently pathological.

4. While each book may not have been sexist, racist, or heterosexist in itself, when books were considered as a group, a pattern of sexism, racism, and heterosexism emerged.

Of the 78 books, one (1.3%) had a chronically ill main character of each gender. Sixty-three (80.8%) had chronically ill female main characters and 14 (18%) had chronically ill male main characters. This gender difference seemed so extreme that I decided to do a post-hoc analysis to determine whether this difference was statistically significant. A chi-square indicated that there was less than a 1% (p < .01) likelihood that this gender breakdown could have occurred by chance.

The preponderance of chronically ill female characters reflects the fact that females in our society are viewed as "less than" males: females are seen as less worthy, less talented, and less "good" than their male counterparts. Being female is sometimes considered to be an illness in itself (Behrendt, A. E., personal communication, 5/27/96). Women's bodies have been considered inferior to men's bodies since Biblical times. In the second century of the common era, Galen argued that women were men who lacked a vital heat and that this deficiency caused the female genitals to be located inside the body. Galen compared the female body to the eyes of a mole: just as the blind mole's eyes are imperfect replicas of other animals' eyes, the female organs are imperfect replicas of the male organs. This view persisted throughout the Middle Ages, Renaissance, and Reformation and was reiterated by Renaldus Columbus in the sixteenth century (Laqueur, 1990).

An assumption that there is something ontologically pathological in women's bodies evolved (Dickson, 1990). Implied in this view is the notion that a woman's natural body is dysfunctional and that women can therefore expect to be ill. Illness then, has historically been seen as the inevitable lot of women. This derogatory view of the female body lasted for centuries and persists even today; therefore it is not surprising that children's books contain many more ill female characters than ill male characters. This study demonstrates that illness and femaleness are portrayed as synonymous in children's literature: ill characters are almost always female, and the few male ill characters tend to be portrayed as feminine. Even today, children's books depict a world in which only girls have chronic illnesses. Since reading is a socializing influence, children who read avidly are likely to grow up believing that girls get sick and boys do not.

Some may argue that although the majority of characters with chronic illnesses are female, this does not mean that females are seen as more unhealthy than males. Perhaps more introspective "girls' books" are more likely to incorporate discussion of chronic illnesses than "boys' books", which focus more on sports and adventure, but of course this is also a potentially problematic assumption about gender that may not serve young readers well. Furthermore, there exist a number of books with healthy male protagonists who have ill or disabled sisters (examples include Welcome Home, Jellybean (Shyer, 1988) and Al Capone Does My Shirts (Choldenko, 2004). Since these are "boys' books," it is interesting to note that the characters with disabilities are sisters, not brothers.

Sexism, Racism, and Heterosexism

Many of the books in this investigation are not sexist, racist, or heterosexist in themselves, but when the books are considered as a group, it becomes clear that, with few exceptions, chronically ill characters are female, heterosexual, and white. The main characters in these books are white and heterosexual because whiteness and heterosexuality are seen as the norm: in the world of children's books with chronically ill main characters, people of color and gays and lesbians rarely even exist. It is important to note that in the 54 books analysed, there are only two main characters that are not white. Both of these characters are black and have asthma. This does not accurately reflect reality. Some illnesses, such as HIV/AIDS and asthma, are more prevalent among non-whites than among whites (National Center for Health Statistics, 1993; Thompson & Gustafson, 1996). There are no gay main characters in the books studied.

Chronically ill girls, but not chronically ill boys are portrayed as people with serious life obstacles. It is notable that 56.1% of chronically ill girls (and 26.7% of chronically ill boys) have divorced parents or parents or friends who have died. When compared with male main characters, female main characters are more secretive, self-pitying, mean, rude, impulsive, and self-centered. Female characters act out their anger more often than males. Female characters are less likely than male characters to exhibit good judgement in choosing a romantic partner. While both male and female characters are depicted as having a number of favorable traits, female characters but not male characters also have several destructive traits.

Sexist stereotyping is even more evident in peripheral characters than in main characters. In the books in this study, 26.7% of the male characters and 22% of the female characters have "irritating" grandmothers, and none of the characters have "irritating" grandfathers. Three characters, in fact, find their grandfathers exceptionally supportive and trustworthy. It is noteworthy that all the "irritating" grandparents are female, but all the close grandparent friends are male. Six female characters and 2 male characters have jealous siblings. All eight of these jealous siblings are female. Four characters have siblings that are portrayed as always right, and these four siblings are older brothers. These data are similar to those reported by Collins et al. (1984), who demonstrated that female peripheral characters adhered to stereotypical feminine roles in picture books.

The characters in the books in this study are generally white and heterosexual. When people of color and gays do appear (there are no lesbians), they are often stereotyped peripheral characters. The black girl in It Can't Hurt Forever has no role other than supporting the white main character; the black girl in Trick or Treat Trouble demonstrates all the wrong ways to respond to an epileptic seizure. The gay men in Mayday Rampage all have HIV infection; however, it is likely that these trends are beginning to change. More children's books that portray non-white characters are being published, as are more young adult novels featuring gay and lesbian protagonists. It follows that there will soon be a more diverse population of books with chronically ill characters.

This sexism, racism, and heterosexism are problematic because children's books have a profound effect on their readers: "To a child, a book is a revelation. It shows him his (sic) place in the world, his future - as if he (sic) looked into a gypsy's crystal ball" (Bawden, 1980, p. 24). Part of the reason for the significant impact of children's books is the fact that children may be relieved and comforted to learn that others share the same inadmissible feelings and impulses (Bawden, 1980). Another reason stories have such an impact is that each story is an invitation for the reader or listener to identify with the main character.

Stories in which the main character is disabled appeal not only to readers with disabilities but to all readers: Gordon (1993) makes the following remarks about the fairy tale The Handless Maiden:

By the time I finished reading the story and von Franz's discussion of it, I was crying...The Maiden's loss of her hands invited me to understand the origins of my handlessness...Listeners of every age and both genders have discovered that they have been handless like the Maiden. (Pp. 266-267)

Gordon goes on to discuss the powerful impact of the story when she shared it with children who had been abused. A girl in the sixth grade wrote the following essay after reading The Blind Colt:

The story of The Blind Colt impressed me very much. I never thought that blind animals could get around or play tricks. I thought they should be killed...Animals are something like people. This summer when I was on a trip I saw a blind man playing a violin and travelling by himself and I thought of the little blind colt. Whenever I see a blind person again I'm going to act the same as if he wasn't blind. Instead of feeling sorry for him, I am going to admire him for his courage in learning to do things. (Smith, 1948, p. 272)

Literature can -- and does -- change children's attitudes. Schau and Scott (1984) conducted a meta-analysis of studies of children's books published between 1970 and 1982. The studies consistently indicated that sex-equitable materials generated more flexible sex-role attitudes in readers. Twenty-one studies demonstrated the ability of literature to affect children's attitudes; only two studies had inconclusive results. Two studies confirmed that attitude change caused by reading does persist over time (Schau & Scott, 1984).

In a study with excellent design and methods, McArthur and Eisen (1976) demonstrated some of the effects of the gender of the main character in children's books. Sixty-eight 3-, 4-, and 5-year-olds were read stories and then asked to complete a problem-solving task. The investigators found that boys persisted longer on the task when they heard stories in which a male character demonstrated achievement than when they heard stories in which a female character demonstrated achievement. Furthermore, boys demonstrated better recall of stories featuring male characters as compared to stories featuring female characters. The gender of the main characters had no statistically significant effects on girls' behaviors (McArthur & Eisen, 1976).

Sexism, racism, and heterosexism in children's novels with chronically ill characters are problematic. Because children's attitudes are so easily influenced by what they read, it is logical to assume that books can and do influence children's perceptions. Young people may internalize the erroneous idea that they are different, unworthy, or not good enough. It is therefore imperative that those who publish and purchase children's books not only consider whether each book is sexist, racist, or heterosexist, but also consider what kind of picture of the world is painted by all the books as a group. Again, adults should discuss the sexism, racism, and heterosexism in these books with children to help children develop an accurate worldview. Adults who read with young people can point out that some books do not feature diverse characters and that these trends are beginning to change. For example, Stuck in Neutral (Trueman, 2000), winner of a Printz Honor Award in 2001, features a male protagonist with cerebral palsy and epilepsy.

Study Implications for Professionals and Parents

In spite of these books' limitations, books with chronically ill characters can be helpful to chronically ill youngsters both when used informally and in bibliotherapy. Bibliotherapy is the use of books to help one cope with specific personal problems or issues (Cianciolo, 1965; Huck & Kuhn, 1968).

Able-bodied children can enjoy books with chronically ill characters. Sometimes the able-bodied youngster can gain specific information from the book. For instance, a book in which a character has HIV infection can be a powerful tool for teaching about the importance of safer sex. These books can also be especially helpful if able-bodied children have acquaintances with illnesses.

Books with chronically ill characters often lend themselves to classroom use. Teachers can use them in many creative ways. Books with positive portrayals of chronically ill characters of both genders can be read independently by students or read aloud by the teacher (Monson & Shurtleff, 1979). The following books would appeal to a wide variety of youngsters and would make excellent classroom read-aloud books: All But the Right Folks by Nichols (asthma), Madeline and the Great (Old) Escape Artist by Jones (epilepsy), Thin Air by Getz (asthma), and Wish You Were Here by Wolitzer (asthma).

Stories can lead to role-plays and other dramatizations thus providing helpful models for chronically ill youngsters (Hopkins-Best & Wiinamaki, 1985). Students might enjoy dramatizing specific types of scenes. For example, in a unit about sports, scenes from Hang Tough, Paul Mather by Slote (leukemia, baseball) and Golden Daffodils by Gould (epilepsy, handball) could be acted out. Scenes about negotiating sexual limits from Waiting for Johnny Miracle by Bach (osteosarcoma) and Invincible Summer by Ferris (leukemia) could be used as spring_boards for role-plays in sexuality education classes.

Parents and professionals should consider several questions and discuss these questions with children who read realistic fiction about chronically ill characters: In what ways is the book real and unreal? What makes the character believable or unbelievable? In what ways does the world portrayed in the book accurately reflect the real world? How are the people in the book like the people you know and different from the people you know? How could the book be changed to more accurately reflect your experiences? Such discussions will not only develop critical thinking skills but will also help young people recognize and therefore not internalize books' sexism, racism, and heterosexism. These discussions will also help youngsters develop a sense that their own experiences are valuable and valid.

Books included in study:

Chronically Ill Characters Of Both Genders

Arrick, F. 1992. What You Don't Know Can Kill You. HIV Infection.

Female Chronically Ill Characters

Aiello, B. & Shulman, J. 1989. A Portrait of Me: Featuring Christine Kontos. Diabetes.

Bach, A. H. 1980. Waiting for Johnny Miracle. Osteosarcoma.

Bennett, Cheri. 1993. Did You Hear About Amber? Juvenile Rheumatoid Arthritis.

Bess, Clayton. 1993. The Mayday Rampage. HIV Infection.

Blume, Judy. 1973. Deenie. Scoliosis.

Bunting, Eve. 1987. Will You Be My POSSLQ? Kidney Cancer.

Corcoran, B. 1984. Child of the Morning. Epilepsy.

Danziger, Paula. 1978. The Pistachio Prescription. Asthma.

Ferris, Jean. 1987. Invincible Summer. Leukemia .

Girion, B. 1981. A Handful of Stars. Epilepsy.

Gould, M. 1982. Golden Daffodils. Cerebral Palsy and Epilepsy.

Gould, M. 1986. The Twelfth of June. Cerebral Palsy and Epilepsy (sequel).

Hall, L. 1990. Halsey's Pride. Epilepsy.

Hermes, Patricia. 1980. What If They Knew? Epilepsy.

Howard, E. 1987. Edith Herself. Epilepsy.

Howe, James. 1983. A Night Without Stars. Heart Condition.

Jones, R. C. 1981. Angie and Me. Juvenile Rheumatoid Arthritis.

Jones, R. C. 1983. Madeline and the Great (Old) Escape Artist. Epilepsy.

Kent, Deborah. 1992. Why Me? Kidney Failure.

Kerr, M. E. 1975. Is That You, Miss Blue? Asthma.

Klass, S. S. 1981. To See My Mother Dance. Asthma.

Martin, Ann M.1986. The Truth About Stacey. Diabetes (first in series that includes:

1987. Boy-Crazy Stacey; 1987. Stacey's Mistake; 1988. Goodbye, Stacey, Goodbye; 1989. Welcome Back, Stacey; 1990. Stacey and The Mystery of Stoneybrook.;1991. Stacey and the Missing Ring; 1991. Stacey's Emergency; 1992. Stacey's Choice; 1992. Stacey's Ex-Best Friend; 1993. Stacey and the Cheerleaders; 1993. Stacey and the Mystery Money; 1993. Stacey's Big Crush; 1994. Stacey and the Mystery at the Empty House; 1994. Stacey and the Mystery at the Mall; 1994. Stacey's Book; 1994. Stacey's Lie.)

McDaniel, Lurlene. 1985. Six Months to Live. Leukemia.

McDaniel, Lurlene. 1987. I Want to Live. Leukemia (sequel).

McDaniel, Lurlene. 1989. Too Young to Die. Leukemia.

McDaniel, Lurlene. 1991. Now I Lay Me Down to Sleep. Leukemia.

McDaniel, Lurlene. 1991. So Much to Live For. Leukemia (sequel).

McDaniel, Lurlene. 1992. Mother, Help Me Live. Leukemia.

McDaniel, Lurlene. 1992. Sixteen and Dying. AIDS.

McDaniel, Lurlene. 1992. Someone Dies, Someone Lives. Heart Condition.

McDaniel, Lurlene. 1992. A Time to Die. Cystic Fibrosis.

McDaniel, Lurlene. 1993. The Legacy: Making Wishes Come True. Leukemia.

McDaniel, Lurlene. 1993. No Time to Cry. Leukemia (sequel).

McDaniel, Lurlene. 1993. Please Don't Die. Heart Condition (sequel).

McDaniel, Lurlene. 1994. All the Days of Her Life. Diabetes.

McDaniel, Lurlene. 1994. She Died Too Young. Heart Condition.

Miner, J. C. 1982. This Day is Mine: Living With Leukemia. Leukemia.

Nixon, Joan L. 1982. The Specter. Hodgkin's Disease.

Roberts, Willo D. 1987. Sugar Isn't Everything: A Support Book, in Fiction Form, for the Young Diabetic. Diabetes.

Sachs, E. A. 1981. Just Like Always. Scoliosis (2 Main Characters).

Sachs, E. A. 1984. Where Are You, Cow Patty? Scoliosis (sequel).

Singer, M. 1978. It Can't Hurt Forever. Patent Ductus Arteriosus (Heart Condition).

Wilkinson, B. S. 1975. Ludell. Asthma.

Wilkinson, B. S. 1977. Ludell and Willie. Asthma (sequel).

Williams, B. 1987. Beheaded, Survived. Diabetes.

Winthrop, E. 1979. Marathon Miranda. Asthma.

Winthrop, E. 1980. Miranda in the Middle. Asthma (sequel).

Male Chronically Ill Characters

Aiello, B. & Shulman, J. 1989. Hometown Hero: Featuring Scott Whittaker. Asthma.

Aiello, B. & Shulman, J. 1989. Trick or Treat Trouble: Featuring Brian McDaniel. Epilepsy.

Bates, B. 1988. Tough Beans. Diabetes.

Dacquino, V. T. 1982. Kiss the Candy Days Goodbye. Diabetes.

Getz, D. 1990. Thin Air. Asthma.

Greenberg, J. 1983. No Dragons to Slay. Cancer.

Kudlinski, K. V. 1994. Facing West. Asthma.

Miklowitz, G. D. 1987. Goodbye Tomorrow. HIV Infection.

Nichols, J. K. 1985. All But the Right Folks. Asthma.

Norris, G. B. 1970. The Top Step. Asthma.

Rinaldo, C. L. 1974. Dark Dreams. Heart Condition.

Slote, Alfred. 1973. Hang Tough, Paul Mather. Leukemia.

Winthrop, E. 1975. A Little Demonstration of Affection. Asthma.

Wolitzer, H. 1984. Wish You Were Here. Asthma.

References:

Asch, Adrienne 1984. "The Experience of Disability: A Challenge for Psychology." American Psychologist, 39: 529-536.

Baskin, B. H. & Harris, K. H. 1977. Notes From a Different Drummer: A Guide to Juvenile Fiction Portraying the Handicapped. New York: R. R. Bowker.

Bawden, Nina. 1980. "Emotional Realism in Books for Young People." The Horn Book Magazine, 56: 17-33.

Bekkedal, T. K. 1973. A Study of Contemporary Realistic Fiction for Children Published in The United States Since World War II. Unpublished Doctoral Dissertation, University of Illinois, Urbana-Champaign.

Bower, E. M. 1980. The Handicapped in Literature: A Psychosocial Perspective. Denver: Love Publishing.

Choldenko, Gennifer. 2004. Al Capone Does My Shirts. East Rutherford, NJ: Putnam.

Cianciolo, P. J. 1965. "Children's Literature Can Affect Coping Behavior." The Personnel and Guidance Journal, 43: 897-903.

Coles, Robert. 1989. The Call of Stories: Teaching and The Moral Imagination. Boston: Houghton Mifflin Company.

Collins, L. J., Ingoldsby, B. B., & Dellmann, M. M. 1984. "Sex-Role Stereotyping in Children's Literature: A Change From The Past." Childhood Education, 60: 278-285.

Davis, A. J. 1984. "Sex-Differentiated Behaviors in Non-Sexist Picture Books." Sex Roles, 11: 1-16.

Dickson, G. L. 1990. "A Feminist Poststructuralist Analysis of the Knowledge of Menopause." Advances in Nursing Science, 12: 15-31.

Dobo, P. J. 1982. "Using Literature to Change Attitudes Toward the Handicapped." Reading Teacher, 36: 290-292.

Drennon, A. H. 1993. A Descriptive Analysis of Realistic Children's Fiction About Chronically Ill Children, 1970-1990. Unpublished Doctoral Dissertation, Georgia State University, Atlanta.

Fine, Michelle & Asch, Adrienne. 1981. "Disabled Women: Sexism Without the Pedestal." Journal of Social Welfare, 6: 233-248.

Goldman, R. S. 1993/1994. "Using Literature to Teach Sexuality Education." Family Life Educator, 12: 4-9.

Gordon, S. 1993. "The Powers of the Handless Maiden. In Radner, J & Lanser, S (Eds.), Feminist Messages: Coding in Women's Folk Cultures. 252-288 IL: Illinois University Press.

Hopkins-Best, M. & Wiinamaki, M. 1985. "Bibliotherapy for Disabled Students in School-to-Work Transition." Techniques: A Journal for Remedial Education and Counseling, 1: 490-496.

Huck, Charlotte. S. & Kuhn, D. Y. 1968. Children's Literature in the Elementary School. (2nd Ed.). New York: Holt, Rinehart, & Winston.

Kokaska, C. J. 1984. "Disabled Superheroes in Comic Books". Rehabilitation Literature, 45: 286-288.

Kortenhaus, C. M. & Demarest, J. 1993. "Gender Role Stereotyping in Children's Literature: An Update." Sex Roles, 28: 219-232.

Laquer, T. 1990. Making Sex: The Body & Gender from the Greeks to Freud. Cambridge: Harvard University Press.

MacDonald, Margaret R. 1993. Tom Thumb. Phoenix: Oryx Press.

Marshall, J. 1981. "Making Sense as a Personal Process." Pp. 395-399 in Human Inquiry: A Sourcebook of New Paradigm Research edited by Peter Reason & J. Rowan Chichester, UK: John Wiley & Sons.

McArthur, L. Z. & Eisen, S. V. 1976. "Achievements of Male & Female Storybook Characters as Determinants of Achievement Behavior by Boys & Girls." Journal of Personality & Social Psychology, 33: 467-473.

McKenna, M. C., Kear, D. J., & Ellsworth, R. A. 1995. "Children's Attitudes toward Reading -- A National Survey." Reading Research Quarterly, 3: 934-956.

Monson, D. & Shurtleff, C. 1979. "Altering Attitudes Toward the Physically Handicapped Through Print and Non-Print Media." Language Arts, 56: 163-70.

Moos, Rudolph H. & Tsu, V. D. 1977. "The Crisis of Physical Illness: An Overview." Pp. 3-21 in Coping With Physical Illness edited by Rudolph H. Moos & V. D. Tsu. New York: Plenum Medical Book Company.

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Biographical note:

S. Chris Saad completed her undergraduate and masters degrees at Smith College, where she studied Elementary Education. After several years of teaching in elementary and special education classrooms, she completed a PhD at University of Pennsylvania's Graduate School of Education, where she wrote her doctoral dissertation about children's literature. She has done some adjunct teaching at the undergraduate and graduate levels. She currently owns and runs a children's bookstore in Philadelphia.