Citing conduct, individualizing symptoms: Accomplishing autism diagnosis in clinical case conferences

Social Science & Medicine
Jason Turowetz

Abstract

In this paper, I examine how clinicians at a clinic for developmental disabilities in the United States determine whether children being evaluated for autism spectrum disorder (ASD) showed symptoms of that condition. Drawing on a convenience sample of 61 audio and video recorded case conferences from two time periods (1985 and 2011-15), and combining Conversation Analysis with insights from Actor Network Theory, I find that clinicians describe (via a representational practice called "citation") children's conduct in ways that advance diagnostic claims. More specifically, they portray key actants in the assessment process in patterned ways: the test instrument is represented as a neutral tool of measurement, the clinician as administrator and instructor; and the child as the focal figure whose conduct is made to appear independent of the other participants and suggestive of diagnostic symptoms. These tacit representational conventions conform to and reproduce the assumptions of standardized testing, according to which clinicians and tests are to be neutral arbiters of the child's abilities, and thereby provide for objective, warrantable findings. At the same time, however, by designing representations around the child's symptoma...Continue Reading

References

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Sep 23, 2003·Sociology of Health & Illness·Stefan Timmermans, Marc Berg
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Aug 27, 2011·Social Science & Medicine·Annemarie Jutel, Sarah Nettleton

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Citations

Jul 8, 2017·Autism : the International Journal of Research and Practice·Brett Heasman, Alex Gillespie
Aug 4, 2018·Autism : the International Journal of Research and Practice·Brett Heasman, Alex Gillespie
Mar 7, 2019·Sociology of Health & Illness·Jason Turowetz, Douglas W Maynard
Feb 23, 2020·Sociology of Health & Illness·Jennie HayesGinny Russell
Jun 14, 2019·Frontiers in Psychiatry·Delphine JacobsKristien Hens
Dec 1, 2020·Social Science & Medicine·Jennie HayesGinny Russell

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