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Migrant children's epistemic authority in paediatric consultations

Federica Ceccoli1, Claudio Baraldi2

  • 1University of Bologna, Italy.

Communication & Medicine
|February 28, 2025
PubMed

Insights

Migrant children in diabetes clinics can assert agency through talk initiatives and by responding to prompts. Pediatricians can support children

Area of Science:

  • Pediatric Endocrinology
  • Medical Communication
  • Discourse Analysis

Background:

  • Patient-centered communication is crucial for effective medical treatment but challenging in pediatric care.
  • Pediatricians often interact primarily with parents, requiring parental consent and potentially limiting child participation.
  • Migrant children may face additional barriers in asserting their voice in healthcare settings.

Purpose of the Study:

  • To investigate how migrant children exercise agency in pediatric diabetes consultations.
  • To identify strategies used by pediatric diabetologists and parents to support or hinder children's agency.
  • To analyze the discourse patterns that facilitate or impede child participation.

Main Methods:

  • Analysis of a corpus of 12 authentic interactions from an Italian pediatric diabetes outpatient clinic.
  • Application of discourse analysis to examine children's assertion of agency and epistemic authority.
  • Observation of pediatrician and parent interaction patterns with children.

Main Results:

  • Children assert agency by initiating talk (providing information, asking questions, contradicting adults) and by accepting conversational turns.
  • Pediatricians actively support children's agency, often by encouraging elaboration through feedback and targeted questions.
  • Parental competition for conversational space can negatively impact children's ability to exercise agency.

Conclusions:

  • Migrant children demonstrate agency in diabetes consultations through specific discourse strategies.
  • Pediatricians play a key role in fostering children's participation and agency.
  • Interventions should consider parental dynamics to optimize child-centered communication in pediatric care.

Keywords:
children's agechildren's initiativesepistemic authoritymigrant children's agencypaediatric consultations

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