Building a child-centered participation framework as a stepping stone to build trust in a medical encounter

Résumé 0

This presentation offers a first analysis of the 32-minute consultation between a pediatrician, a 5 year-old child and his mother that was presented in the first, introductory presentation. We focus here on a stepping-stone strategy the paediatrician uses to make the child at ease and build trust: making him her main addressee. In the context of this interdisciplinary project, three types of information will be shown to reveal the subtle construction of a child-centered participation framework: •qualitative analyses of the paediatrician’s verbal and non verbal behaviour (including the use of terms of address and pronouns, gestures, gaze, body orientation, touch, object manipulation) enable us to reveal how she makes sure to address the child directly, thus turning the mother’s status into that of a bystander (Goffman, 1981), in a way that seems unusual to the mother and the child in this context (Tates & Meeuwesen, 2001). •thanks of the participatory nature of the PANIC2 project, we could identify, together with the paediatrician recorded, specific moments when she felt she was being “successful” in making the child more confident. Quantitative analyses based on the systematic coding of the data confirm that participation frameworks unfold differently around those landmarks.•a comparison of the linguistic properties of the utterances addressed to the child vs. to the mother shows that the paediatrician also involves the child in the conversation by adapting her speech, using features from child-directed speech. Although the child does not speak more as the encounter unfolds, the modality of his utterances progressively changes, from mostly non verbal to mostly verbal, and from mostly answering questions to asking questions himself. By involving children in the conversation, not only do paediatricians improve the bond with the child, but they also augment the possibility for the children to recall medical recommendations (Lewis et al., 1991), gain a greater sense of control over their medical care (Sisk et al., 2021) and socialise them into the role of patient (Stivers, 2012).