Attending to Parent and Child Rights to Make Medication Decisions During Pediatric Psychiatry Visits

Abstract

This chapter examines how children diagnosed with ADHD come to participate in medication decisions in pediatric psychiatry visits. Drawing on 45 video-recorded follow-up visits involving 16 families and 14 clinicians, findings show that children infrequently participate during treatment discussions. Clinicians overwhelmingly initiated medication discussions with parents, thus orienting to parents’ deontic authority as decision makers. Six children across 10 visits participated in the treatment recommendation phase and most often by clinician invitation. Clinicians who invited children’s participation prioritized parents’ deontic authority while also attending to children’s deontic rights. More specifically, they employed open-ended Wh-question designs to seek children’s independent assessments (How does that sou:nd.) or perspectives (Well what do you think Sammy.) of a medication recommendation that was already accepted by the parent. This practice reveals how some clinicians work to balance the pressures of attending to both parents’ and children’s deontic rights to make treatment decisions.