It is widely acknowledged that persons working with children should be equipped with the necessary communication skills to enable them to work effectively with sick children and facilitate sick children in becoming active partners in decision-making (Department of Health, 2003). Anecdotal evidence clearly recognises the importance and accepts the complexity of effectively communicating with sick hospitalised children (Jolly, 1981; Parish, 1986; May, 1999). Integrating cognitive and psychosocial developmental approaches into communication with children at different ages is thought to enhance its effectiveness (Thompson, 1991). However, there is little empirically derived knowledge that focuses on communication as it relates to members of the health care team and children specifically (Callery, 2005). The purpose of this paper is to present one key theme, namely, ‘the visibility of the child in the communication process' that emerged from an ethnographic study. The aim of the aforementioned study is to explore the nature of communication for children admitted for acute care to a specialist paediatric hospital. In keeping with ethnography and acknowledging the comprehension of children, various modes of data collection were employed, semi-participant observations, informal interviews, the draw and write technique and child-friendly activity worksheets. The sample of children ranged in ages from 6 –16years. The computer software package, NUDIST was employed in data analysis. The theoretical framework guiding the study draws on the principles of the Ecological Model of Human Development proposed by Urie Bronfenbrenner (1979). In this paper, the manner in which children themselves, their parents / guardians, health care professionals and the hospital environment contribute to the key emergent theme of visibility will be explored and illustrated. Strategies for counteracting this sense of visibility will be advanced.