The Discursive Construction of Autism: Contingent Meanings of Autism and Therapeutic Talk

This dissertation was a discourse analysis study, drawing upon discursive psychology, poststructural understandings of discourse, conversation analysis, and a social relational model of disability. The purpose of this study was to explore how autism was performed as an interactional event among children with autism labels, the therapists who work with them, and their parents, in the context of a pediatric therapy setting. I interrogated how the participants’ everyday discursive practices were shaped and, at times, constrained by the social and political institutions that often work to define autism and the related, official plans of treatment. A total of 12 families agreed to participate, resulting in the participation of 12 children with autism labels, three to 11 years of age, six fathers, and 11 mothers. The participants included three speech therapists, two occupational therapists, one physical therapist, one teacher/social group facilitator, and one medical secretary/sibling support group facilitator. Data sources included conversational data from the therapy sessions of the participating children and their therapists, 14 parent interviews, eight therapist interviews, documents used within the therapy sessions, demographic surveys/information from the participating therapists and parents, and two interviews with a state advocate and clinical directors focused on qualifying for services. Findings from the interview data highlighted the varied meanings and performances of autism, while pointing to the related political and social conditions that make the naming and treating of autism (im)possible. Findings drawn from the therapy session data pointed to how the participants’ discursive practices worked to reframe “behaviors of concern,” and to transgress normative communication patterns. The following conclusions were drawn from the findings: (a) autism, as a construct, remains open to multiple meanings, while being inextricably linked to institutionalized practices; (b) in therapy talk, therapists and children with autism labels often co-construct alternative accounts of problematic behaviors; and (c) therapy talk can function to reframe non-normative communication and behavioral patterns, expanding what is constructed as “acceptable.” The findings point to the complexities of defining and performing autism labels, and highlight the ways in which therapy talk can function to reframe behaviors and communication patterns presumed to be pathological.