Forty children with spina bifida participated in interview sessions designed to assess their general cognitive development, their conceptualizations of health and illness, and their understanding of their specific disability The results of the study indicated that the children's ratings in the area of health and illness were quite similar to ratings in cognitive development, with the ratings successively progressing with chronological age In general, the children received higher scores in health and illness conceptualizations than general cognitive development, with their ratings being the highest in spina bifida-related explanations The data suggest the importance of awareness by health care professionals of children's conceptualizations of health and illness in order to provide pediatric patient education information that is sensitive to children's levels of cognitive development and their understanding of health and illness.