Embedded hierarchical relationships between children and adults constrain children's voice. For adults to support children's participation in decisions they need to learn new ways of working; to enable children to communicate their views, develop their ideas, make group decisions and take joint action. This article explores the different roles that caring professionals adopt when facilitating children's participation within Child-to-Child community health projects. It shows how even committed adults can struggle with shifting their practice and highlights the importance of facilitators adopting a reflective approach rooted in genuine dialogue with children in order to determine the most appropriate level of adult support.