<p>Research involving pre-school children continues to present ethical, methodological and practical challenges. Children in this age group are often excluded from studies or represented through proxy reporting by their parents. If they are not permitted to participate directly in research studies, the results may reflect adult perspectives rather than the genuine needs and experiences of children. This can result in the provision of services and interventions that do not align with children’s best interests. To explore preschool-aged children’s participation in healthcare situations from the child perspective and the child’s perspective this article presents a Q-methodology study, a mixed-methods research technique that examines subjective viewpoints. To our knowledge, this method has not previously been used with children aged three to five. The article addresses the following research questions: Which characteristics of Q methodology support or limit the expression and representation of children’s voices and perspectives in research involving them? What are the benefits and challenges of using Q-methodology in research involving young children aged 3–5 years, their parents, and health professionals? The children participated enthusiastically in ranking the statements but provided few reasons for their preferences. Parents were able to explain some of their children’s choices based on their experience of previous healthcare encounters. Adult participants sometimes adopted an ‘adult perspective’, ranking statements on how children should behave instead of answering on the children’s behalf. Q-methodology has been found to be child-friendly, age-appropriate and child-centered when working with pre-school children.</p>