Negotiating who presents the problem: Next speaker selection in pediatric encounters

Using audio- and videotapes of acute pediatric encounters, this study (a) i dentifies pediatricians' practices of next speaker selection when solicitin g the problem presentation, (b) identifies factors that bear on next speake r selection, and (c) examines the consequences of physicians' selection pra ctices for who ultimately presents the problem. Although doctors most frequ ently select children as problem presenters, parents are the most likely to actually present the child's problem. However parents nonetheless orient t o their children's rights to answer questions that select process of intera ctional negotiation rather than dominance or control. This Study also sugge sts communication resources that may increase the child's participation in presenting the problem.