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"You Can Turn off the Light If You'd Like": Pediatric Health Care Visits for Children with Autism Spectrum Disorder
Olga Solomon1, Amber M Angell2, Larry Yin3,2
1USC Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California. olga.solomon@usc.edu.
Insights
Navigating healthcare visits with a child with autism spectrum disorder (ASD) requires renegotiating expectations. Successful pediatric and neurology appointments involve collaborative effort from child, parent, and doctor to overcome communication and sensory challenges.
Area of Science:
- Medical Anthropology
- Social Sciences
- Discourse Analysis
Background:
- Existing research focuses on typically developing children's healthcare interactions.
- Children with autism spectrum disorder (ASD) present unique interactional dynamics in clinical settings.
Purpose of the Study:
- To provide an ethnographic, longitudinal, discourse analytic account of child-parent-doctor interactions involving a child with ASD.
- To examine the renegotiation of expectations and collaborative work required for successful healthcare visits.
Main Methods:
- Ethnographic observation of pediatric and neurology visits.
- Longitudinal analysis of interactions.
- Discourse analytic techniques.
Main Results:
- Healthcare visits involving children with ASD necessitate renegotiation of tacit expectations among child, parent, and doctor.
- Successful visits are achieved through the interactional and relational work of all participants.
- Communicative and sensory limitations associated with ASD pose unique challenges.
Conclusions:
- Healthcare disparities can manifest within pediatric encounters, influenced by structural and interactional processes.
- Understanding these dynamics is crucial for improving healthcare experiences for children with ASD and their families.
Abstract:
Substantial scholarship has been generated in medical anthropology and other social science fields on typically developing child-parent-doctor interactions during health care visits. This article contributes an ethnographic, longitudinal, discourse analytic account of a child with autism spectrum disorder (ASD)-parent-doctor interactions that occur during pediatric and neurology visits. The analysis shows that when a child with ASD walks into the doctor's office, the tacit expectations about the visit may have to be renegotiated to facilitate the child's, the parent's, and the doctor's participation in the interaction. A successful visit then becomes a hard-won achievement that requires the interactional and relational work of all three participants. We demonstrate that communicative and sensory limitations imposed by ASD present unique challenges to all the participants and consider how health care disparities may invade the pediatric encounter, making visible the structural and interactional processes that engender them.
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