The Greenwood Institute, University of Leicester (and Leicestershire Partnership NHS Trust), Leicester, UK.
Psychology Group, Leeds School of Social Sciences, Leeds Beckett University, Leeds, UK.
Sociol Health Illn. 2020 Mar;42(3):544-564. doi: 10.1111/1467-9566.13030. Epub 2019 Nov 28.
Central to a contemporary understanding of childhood is the developmental and clinical-medical construct of the 'normal' child. When judged to fall outside of culturally, socially and historically situated parameters of 'normality', children become labelled as 'deviant from the norm'; for instance, in mental health contexts where this may provide the basis for psychiatric diagnosis. However, judgements of a child's 'normality' are further complicated by the range of individuals who may have a stake in that construction, including parents/carers, professionals and the child themselves. Using discursive psychology, we analysed 28 video-recorded UK child mental health assessments, to examine ways that parents presented concerns about their children's development. They did this by drawing on notions of 'ab/normal', in ways that functioned to legitimise their need for services and built a rhetorical case to demonstrate clinical need; often by contrasting the child with other 'typical' children and/or contrasting the same child's behaviour in different settings or contexts. We concluded that given the growing crisis in child mental health, initial assessments play a crucial clinical role in determining diagnosis and labelling, and therefore, a critical discussion of these concepts and processes is essential.
儿童的核心是“正常”儿童的发展和临床医学概念。当被判断为不符合“正常”的文化、社会和历史参数时，儿童就会被贴上“偏离常态”的标签；例如，在心理健康方面，这可能是精神病诊断的基础。然而，儿童“正常”的判断还受到包括父母/照顾者、专业人员和儿童本身在内的一系列可能对此有利益关系的人的影响。本文运用话语心理学，分析了 28 个记录在案的英国儿童心理健康评估，以研究父母表达对子女发展担忧的方式。他们通过利用“异常”的概念来做到这一点，这些概念有助于使他们获得服务的需求合法化，并构建一个修辞案例来证明临床需求；通常是通过将孩子与其他“典型”的孩子进行对比，或者对比孩子在不同环境或情境下的行为。我们得出结论，鉴于儿童心理健康危机日益严重，初步评估在确定诊断和标签方面发挥着至关重要的临床作用，因此，对这些概念和过程进行批判性讨论至关重要。
