The Interactional Production of a Clinical Fact in a Case of Autism

• In Event: 388 - Regular Session. The Interactional Production of Identity and Authority

Abstract

The authority to diagnose is a distinguishing prerogative of modern medicine. While a growing body of research addresses various aspects of diagnosis, few studies analyze just how it is achieved through talk-in-interaction. This paper examines how clinicians assembled a diagnosis of a child who was evaluated for autism. Drawing on audio and video recordings at a clinic for developmental disabilities, I use a combination of ethnomethodology and conversation analysis to show how a critical fact about the child’s mental functioning was formulated, challenged, and transformed across three consecutive stages of his evaluation: (1) testing, (2) a case conference among clinicians, and (3) an informing interview where the diagnosis was delivered to the parents. I analyze how this fact emerged as an artifact of clinician-child interactions, and how clinicians used storytelling to render its diagnostic implications. In addition to examining how these stories are methodically produced, I argue that they frame the child’s behavior in ways that suggest a lack of competence while eliding the skills and competencies he may have been displaying.

Author

• Jason Turowetz, University of Wisconsin-Madison