Interaction order and the labeling of disorder: How parents mobilize personal knowledge in the clinic to resist medicalization of their children's behavior

This paper examines how parents of children diagnosed with autism resist the medicalization of their children's behavior. Drawing on video and ethnographic data collected over four years of fieldwork at a clinic for developmental disorders, the paper distinguishes two orders of practice – that of the clinic and that of the family – and argues that behavior which is interpreted as disordered in the clinic may be seen as ordinary in the home. These different interpretations reflect and renew distinct orders of sensemaking in the clinic and home, and parents may mobilize familial knowledge of the child to counter the medicalization of specific behavior patterns, even where they otherwise accept an autism diagnosis. In showing how medicalization and labelling are achieved and resisted in the mundane details of social interaction, the paper contributes to studies of diagnosis, disability, and deviance. Further, the myriad ways parents and clinicians contest which regions of a child's behavior get medicalized – i.e. which behavioral patterns are labeled disordered – present a challenge to binary conceptions of medicalization, recommending instead a more nuanced model of medicalization as a multi-dimensional continuum: more or less, rather than either-or.