This paper examines the role of companions in healthcare encounters, focusing on a previously unexamined context: the oncology visit with immigrant patients. By employing a methodological approach ...that combines elements of Goffman's footing and Conversation Analysis, this study discerns the social dynamics and communicative patterns among doctors, patients, and companions. Our focus on the companion yields an intricate picture of their multifaceted and dynamic participation, highlighting how their roles are not predefined and stable, but rather they are co-constructed and ongoingly negotiated among participants. Specifically, our analysis reveals that while companions initially maintain a peripheral position, aligning with the oncologist's focus on the patient as the primary recipient, they readily engage in active participation when the patient recruits them or when patient recipiency is problematic. As the anamnesis progresses, our investigation highlights the significance of the companion, showing their adept moves in response to the actions of both the patient and the oncologist. Their ability to offer linguistic assistance, insights into the patient's life circumstances, and documentation of previous tests is finely tuned to the developing interaction between the oncologist and the patient. In these ways the companions contribute to a more nuanced understanding of the patient and the overall effectiveness of the visit. The study's findings have significant implications for patient-centered care, particularly in diverse healthcare settings with immigrant patients. By recognizing and leveraging companion participation, healthcare practitioners can create more inclusive and equitable healthcare practices, optimizing their contributions for patient well-being.
•This study examines companions' roles in oncology visits with immigrant patients.•Utilizes Goffman's footing and Conversation Analysis.•Reveals dynamic nature of companion involvement.•Companions adapt based on patient and oncologist actions.
Purpose: The purpose of this clinical focus article was to illustrate the potential of employing conversation analysis (CA) as a method for assessing social communication that is neurodiversity ...affirming. Method: This clinical focus article will provide an overview of CA and explain how it offers a theoretically grounded means of analyzing autistic children's everyday social interactions. Our aim is not simply to add a new assessment instrument to the disciplinary toolbox but to use the occasion to spur a reconsideration of how social communicative competence is currently conceptualized in the field and how those assumptions are reified through assessment practices. We will present a case illustration of a bilingual autistic child and his family. We will discuss the implications of a CA-informed assessment for reconceptualizing autistic social communicative competence. Results: The case study illustrates the contributions of CA for (a) shifting the focus of assessment from social communication as an individual skill to social communication as an interactional achievement and (b) surfacing social communicative competencies that may be dismissed as pathologies. Conclusions: CA offers a relational understanding of autistic communication and sociality that is compatible with a critical stance on disability. Insights from CA problematize deeply entrenched notions of autism and social communication in speech-language pathology.
Echolalia is a pervasive phenomenon in verbal children with autism, traditionally conceived of as an automatic behavior with no communicative function. However, recently it has been shown that echoes ...may serve interactional goals. This article, which presents a case study of a six-year-old child with autism, examines how social interaction organizes autism echolalia and how repetitive speech responds to discernible interactional trajectories. Using linguistic, discourse, and acoustic analyses, we demonstrate that the child is able to mobilize echolalia to mark different stances, through the segmental and suprasegmental modulation of echoes. We offer an interpretive framework that deepens our understanding of the complex interactions that children with autism can engage in by using echoes, and discuss the implications of this perspective for current views of atypical language development in autism.
This article explores morality as situated activity and approaches the discursive practice of accountability in Italian family dinner conversations as an avenue for understanding the construction of ...moral behaviour in everyday interpersonal interaction. The article focuses in particular on vicarious accounts, namely accounts, or explanations, provided by parents for a child’s misbehaviour. It examines the multiple socializing functions that vicarious accounts accomplish and the different dimensions of responsibility that they mobilize. While scaffolding children’s participation in episodes of accountability, vicarious accounts set up constraints on children’s autonomy of action, neutralizing more subversive and blameworthy interpretations of their problematic conduct. In this sense, vicarious accounts are qualified concessions and are face-saving acts both for the child whose action was signalled as improper and for the parent who initially requested the account.
•This study investigated spatial deictics and verb tense in a public library's family literacy class.•Discourse analysis revealed spatiotemporal coordinates to be entangled with emotions and ...exceeding space and time referentiality.•Spatial and temporal indexical terms served to position participants within a discursive paradigm of migration imbued by nostalgia.•Striving to build commonality via a shared sense of nostalgia paradoxically obfuscated meaningful differences among the class participants.
Drawing from a yearlong ethnographic study, this paper examines spatial deictics and verb tense use in conversation and instructional activities in a family literacy class at a Bay Area Public Library. More specifically, we employ discourse analytic tools to document how spatiotemporal coordinates are never solely product of cognitive calculation but always also entangled with emotions. In addition to enacting their referentiality with respect to places and moments in time, spatial and temporal indexical terms served to position participants within a discursive paradigm of migration, a chronotope imbued by nostalgia. We discuss how such discursive positioning constructs students’ identities as diasporic, their being in the here-and-now predicated on their being from elsewhere, and their being here-and-there simultaneous and coextensive.
This article offers an alternative approach to paradigms that cast culture solely as a nurturing influence on children's language development. It proposes a dimensional model of Child-Directed ...Communication (CDC) to delineate ways in which a community's habitus may impede the communicative potential of children with neuro-developmental conditions such as severe autism. It argues that certain features of Euro-American CDC are ill-adapted for autistic children. Due to inertia, caregivers often find themselves unable to transcend the limitations of CDC habitus. Yet, occasionally, a transformation in CDC emerges that more effectively engages children with impairments. The article analyzes one such transformation forged in the niche of a unique mother–son relationship in India and then introduced in the USA.
Rethinking language in autism Sterponi, Laura; de Kirby, Kenton; Shankey, Jennifer
Autism,
07/2015, Letnik:
19, Številka:
5
Book Review, Journal Article
Recenzirano
In this article, we invite a rethinking of traditional perspectives of language in autism. We advocate a theoretical reappraisal that offers a corrective to the dominant and largely tacitly held view ...that language, in its essence, is a referential system and a reflection of the individual’s cognition. Drawing on scholarship in Conversation Analysis and linguistic anthropology, we present a multidimensional view of language, showing how it also functions as interactional accomplishment, social action, and mode of experience. From such a multidimensional perspective, we revisit data presented by other researchers that include instances of prototypical features of autistic speech, giving them a somewhat different—at times complementary, at times alternative—interpretation. In doing so, we demonstrate that there is much at stake in the view of language that we as researchers bring to our analysis of autistic speech. Ultimately, we argue that adopting a multidimensional view of language has wide ranging implications, deepening our understanding of autism’s core features and developmental trajectory.
In this article, we leverage theoretical insights and methodological guidelines of discourse analytic scholarship to re-examine language phenomena typically associated with autism. Through empirical ...analysis of the verbal behavior of three children with autism, we engage the question of how prototypical features of autistic language—notably pronoun atypicality, pragmatic deficit, and echolalia—might conceal competencies and interactional processes that are largely invisible in mainstream research. Our findings offer a complex picture of children with autism in their use of language to communicate, interact and experience others. Such a picture also deepens our understanding of the interactional underpinnings of autistic children’s speech. Finally, we describe how our findings offer fruitful suggestions for clinical intervention.
In this paper we examine how doctor and patient coordinate actions in interaction towards the smooth accomplishment of the medical visit. Such coordination entails primarily the management of time ...and praxis, i.e. the apportionment of time to the tasks to be completed during the visit; and it is not an easy enterprise, for a number of reasons: 1) the tasks to be carried out during the visit are not familiar in equal measure to doctor and patient; 2) the extent of attention to be devoted to each task cannot be fully determined in advance but requires ongoing judgment and calibration; 3) generally, the timeframe of the visit is relatively limited. Our ethnographic and conversation analytic study of oncological visits shows that doctor and patient rely on a range of semiotic resources to achieve mutual understanding and coordinated actions. In particular, our analysis has identified textual artifacts and metapragmatic utterances as key semiotic components in the coordination and negotiation of the temporal trajectories and courses of actions that constitute and traverse the oncology visit.
•The structuring of time and activity in oncology visits was studied.•Ethnographic observation and conversation analysis of videorecordings were carried out.•The structuring of time and activity is a joint accomplishment by doctor and patient.•Textual artifacts and metapragmatic utterances are the key semiotic resources used.•Effective management of visits' timing may be more beneficial than having more time.
PDF
