| Summary: | 博士 === 臺灣大學 === 社會學研究所 === 98 === In Taiwan, “Early Treatment” was embedded into the Child Welfare Law, defining “developmental delay” as a risk factor in disability and thus a target in need of treatment as early as possible. This new subject/object marked the expansion of child health policies in Taiwan from control of contagious diseases to disability prevention for all children. This dissertation traces the process of assembling what I call “the regime of developmental risk,” and examines how parenting in daily child-rearing and treatment for developmentally delayed children engage deeply with this social transformation. My research was conducted as a multi-site ethnography, and gathered materials through document analysis, participant observation, and interviews with fifteen professionals across various domains in addition to fifty-eight caregivers rearing children under the age of ten.
In Part I of this dissertation, I analyze the transformation of the target of Early Treatment in Taiwan from “children with disabilities” to “children with developmental delays.” Although this process seemed to be a typical case of “medicalization,” it developed very different driving engines, strategies, and social arrangements. By tracing a social-political process full of contingencies, I demonstrate how a new regime of developmental risk emerged. Compared to the medicalized regime of disability, this risk regime produced very different subjects, purposes, power techniques, rhetoric strategies, and social scripts for actors. I argue that this risk regime is characterized by collective governance. Therefore, it needs various scientific claims and technologies to structure the developmental gaze at children for different actors, stabilize the surveillance practices across heterogeneous social worlds, as well as ensure the validity of individual children’s information as gathered by different agents.
The second part of the dissertation turns to the micro level. I use concepts of lay knowledge and user-professional relationships to elaborate the subjectivity issue rarely articulated in a traditional medicalization thesis or government framework. In the continuum between normalcy and disability, different locations assigned to each child would influence mostly their parents’ negotiation space with the risk regime. Because any social actor necessarily lives in multiple life worlds and faces intersecting practice regimes, her/his risk perception and management must have multiple levels. Especially in the case of parents with developmentally delayed children, the Early Treatment system in Taiwan appears hydra-headed, without integration or even consensus. For them, the management of child’s delayed body always confront with various issues of treatment uncertainty. As a result, parents not only use treatment resources, but also need to do sophisticated “articulation work” to ensure the whole treatment project for their specific child. In my opinion, they are a kind of “logistician.” Although parents’ engagement might not challenge the final target of this institutional governance, their actions indeed go far beyond the original social script set by the risk regime.
Finally, the contributions of this dissertation may be as follows: Facing the ever-changing issues of health and disease in present society, a framework of risk governance may be more appropriate than a medicalization paradigm to analyze how our society responds to various body controversies with blurred boundaries between normalcy and abnormalcy. In addition, parenthood, as the context of risk management, is characterized by an entanglement of morality, emotions, and individuality. Taking these peculiarities into consideration will enrich and deepen our understandings of governance techniques and lay expertise, as well as the co-production of, and contradiction between, practice regime and agent.
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