Notes on talking cognition in the audiology clinic

The fitting of a hearing aid (HA) typically takes more than one consultation. In follow-up consultations, audiologists normally make use of standardized tests as well as client reports in order to evaluate how the client functions with his HA in his everyday life. In the course of interactively establishing such a report, clients at times mention issues regarding their cognitive abilitities, rather than only reporting physiological or technical issues. These mentionings can be direct (as in ‘do you think I am imagining this?’) or reported (as in ‘in such situations, I appear as an idiot’). The audiologist, however, is trained to deal with the intersection of technical or physiological evaluations. The issue, therefore, is how the client comes to mention cognitive abilities, despite the audiologists agenda.
Using conversation analysis as a methodology, video recorded audiology consultations are examined in order to show how the client’s mentioning of his cognitive abilities appear in a specific sequential environment: Right after the audiologist has expressed or implied reservations with regard to whether the client’s report on hearing experiences can be accurate. The remarks seem to appeal to a reconciliation on the audiologists’ part. This, however, seldomly seems to happen. It will be explored how and whether the sequences resemble patients’ ‘lay’ explanations in health care encounters (e.g. Gill and Maynard 2006) and thus whether similar issues of expertise are at stake.
More generally, it will be discussed how cases like these shed light on members’ categories of physical vs. cognitive functioning, i.e. how these categories are interactively constructed, and which social norms they may be based on.