Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb;26(2):488-498.
doi: 10.1177/13623613211030392. Epub 2021 Jul 9.

Autism diagnosis as a social process

Jennie Hayes  1 , Tamsin Ford  2 , Rose McCabe  3 , Ginny Russell  1
Affiliations

Autism diagnosis as a social process

Jennie Hayes et al. Autism. 2022 Feb.

Abstract

When a child or adult is referred for an autism diagnosis, clinicians from different backgrounds work together to make a diagnostic decision. A few studies have asked clinicians in interview how they feel about diagnosis and what the challenges are. We interviewed clinicians in child and adult assessment services in England, and from different professional backgrounds, about the challenges of autism diagnosis and the factors that might influence the assessment process. We found that there were a number of challenges in autism diagnosis, especially when someone coming for diagnosis was considered to be near the diagnostic threshold. Clinicians told us that making a diagnosis was like creating a 'narrative': looking at many different factors that told a story about a person, rather than just looking at the results of diagnostic tests. Clinicians do not always agree with the results of those tests and have to use their specialist clinical judgement to make decisions. Clinicians were concerned about the amount of time people have to wait for an autism assessment, and the resulting pressure on the assessment process. The findings of this work can help us to understand how diagnosis happens and consider ways in which it can be improved for adults, children and families coming for assessment, as well as clinicians.

Keywords: autism spectrum disorders; diagnosis; health services; policy; qualitative research.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Themes and subthemes discussed by clinicians involved in autism assessment.
Figure 2.
Figure 2.
Aligning or conflicting interests in diagnostic practice.
See this image and copyright information in PMC

References

    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
    1. Baker E., Gwernan-Jones R., Britten N., McCabe C., Gill L., Byng R., Gask L. (2019). Using interpersonal process recall to understand empowerment processes in a collaborative care intervention for people with a diagnosis of psychosis. Psychosis, 11, 350–361. 10.1080/17522439.2019.1640274 - DOI
    1. Braun V., Clarke V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. 10.1191/1478088706qp063oa - DOI
    1. British Medical Association. (2019). Failing a generation: Delays in waiting times from referral to diagnostic assessment for autism spectrum disorder. https://www.bma.org.uk/media/2056/autism-briefing.pdf
    1. Brown P. (1995). Naming and framing: The social construction of diagnosis and illness. Journal of Health and Social Behavior, 1995(Extra Issue), 34–52. - PubMed

Publication types