The implicit construction of ‘children at risk’: On the dynamics of practice and programme in development screenings in early childhood

Abstract

This article presents findings from an ethnographic study on preventive paediatric check-ups in Germany. In accordance with system-theoretical and governmentality approaches (referencing Foucault), preventive check-ups are conceptualised as fields where risk concepts related to children’s development are applied, produced and reworked. In order to show how the construction of development risks in the check-ups’ conduct is linked to a variety of preventive functions, the methodology of the article combines the analysis of field documents and ethnographic field notes. In the first analytical section, on the programmatic level, the ambivalence between different preventive tasks is reconstructed by analysing documents of the check-ups’ current revision process. This process is discussed as a (political) struggle for treatment options. In the second section, these findings are contrasted with results from a practice analysis of the check-ups’ conduct. These practical processes in the field are interpreted as struggles for the allocation of treatment responsibility between paediatricians and parents. In the concluding section, the authors highlight how the specific institutionalisation of preventive paediatric check-ups in Germany forces the pace for implicit constructions of ‘children at risk’ and extemporised practices of parents’ health education.