Turowetz2015a

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Turowetz2015a
BibType ARTICLE
Key Turowetz2015a
Author(s) Jason Turowetz
Title Citing conduct, individualizing symptoms: Accomplishing autism diagnosis in clinical case conferences
Editor(s)
Tag(s) EMCA, ASD, Autism, Ethnomethodology, Actor-network theory, Diagnosis, Child mental health, Children with disabilities, Medical EMCA, Applied
Publisher
Year 2015
Language
City
Month
Journal Social Science & Medicine
Volume 142
Number
Pages 214–222
URL Link
DOI 10.1016/j.socscimed.2015.08.022
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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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 symptomatic conduct in this way, clinicians may minimize or elide their own contributions, and those of the test instrument, to the child's performance, and thereby make the child alone appear responsible for what are, in fact, interactionally-occasioned behaviors.

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