Activity transitions and persuasion: Using growth charts in pediatric consultations

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This paper relies on 327 video recordings of well-baby visits in U.S. community practice clinics to explore when and how pediatricians transition to assessing children’s growth. Using conversation analysis supplemented by descriptive frequencies, we examine the primary ways in which participants transition into the activity of assessing the child’s growth. We argue that physicians most commonly orient to the discussion of physical growth as disjunctive with the prior activity. However, when physicians wind up at odds with a parent over whether or not there is a cause for concern with the child, they more often rely on conjunctive activity transitions. Surprisingly, the activity transition into growth assessment becomes a resource that physicians rely on to persuade parents of their view.