This chapter concerns alignments and disalignmnets, focusing on paediatric visits, and the ways in which doctors, patients and parents overlty or covertly align iwth each other and the activities at hand. First, prior work in the area is reviewed, foregrounding detailed analyses of paediatric interactoins. Secon, social distance, which has been discussed as a bakground factor in work on facework is here disussed as an emergent phenomenon, negotiated in interactions. A model of social choreography is presented, whre alignment is discussed with respect to the gradual emergence of social distance, upgradings, and resistance. Conversely, doctors recurrently exploit playful respectfulness, first naming, collaborative we-constructons, as well as other mitigations as ways of indexing increased alignment.

The multiparty pediatric visits constitute a rich arena for analyzing alignment in that parents third party contributions recurrently disambiguate doctors' covert recommendations. Doctors and parents step by step covertly negotiate diagnostic matters as well as treatment recommendations through talk, pauses and other minute conversational resources. What is covert or overt is therefore to a large extent an accomplishment in interaction.