'Not at the diagnosis point' : Dealing with contradiction in autism assessment teams
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved..
Social science literature has documented how the concept of diagnosis can be seen as an interactive process, imbued with uncertainty and contradiction, which undermines a straightforward notion of diagnosis as a way to identify underlying biological problems that cause disease. We contribute to this body of work by examining the process of resolving contradiction in autism diagnosis for adults and adolescents. Autism is a useful case study as diagnosis can be a complex and protracted process due to the heterogeneity of symptoms and the necessity to interpret behaviours that may be ambiguous. We audio-recorded and transcribed 18 specialist clinical assessment meetings in four teams in England, covering 88 cases in two adult, one child and one adolescent (14+) setting. We undertook a qualitative analysis of discursive processes and narrative case-building structure utilised by clinicians to counteract contradiction.We identified a three-part interactional pattern which allows clinicians to forward evidence for and against a diagnosis, facilitates their collaborative decision-making process and enables them to build a plausible narrative which accounts for the diagnostic decision. Pragmatism was found to operate as a strategy to help assign diagnosis within a condition which, diagnostically, is permeated by uncertainty and contradiction. Resolution of contradiction from different aspects of the assessment serves to create a narratively-coherent, intelligible clinical entity that is autism.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:268 |
|---|---|
| Enthalten in: |
Social science & medicine (1982) - 268(2021) vom: 27. Jan., Seite 113462 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Hayes, Jennie [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Autism |
|---|
| Anmerkungen: |
Date Completed 24.05.2021 Date Revised 10.11.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.socscimed.2020.113462 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM318203618 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM318203618 | ||
| 003 | DE-627 | ||
| 005 | 20231225164849.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.socscimed.2020.113462 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1060.xml |
| 035 | |a (DE-627)NLM318203618 | ||
| 035 | |a (NLM)33253991 | ||
| 035 | |a (PII)S0277-9536(20)30681-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Hayes, Jennie |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a 'Not at the diagnosis point' |b Dealing with contradiction in autism assessment teams |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 24.05.2021 | ||
| 500 | |a Date Revised 10.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a Social science literature has documented how the concept of diagnosis can be seen as an interactive process, imbued with uncertainty and contradiction, which undermines a straightforward notion of diagnosis as a way to identify underlying biological problems that cause disease. We contribute to this body of work by examining the process of resolving contradiction in autism diagnosis for adults and adolescents. Autism is a useful case study as diagnosis can be a complex and protracted process due to the heterogeneity of symptoms and the necessity to interpret behaviours that may be ambiguous. We audio-recorded and transcribed 18 specialist clinical assessment meetings in four teams in England, covering 88 cases in two adult, one child and one adolescent (14+) setting. We undertook a qualitative analysis of discursive processes and narrative case-building structure utilised by clinicians to counteract contradiction.We identified a three-part interactional pattern which allows clinicians to forward evidence for and against a diagnosis, facilitates their collaborative decision-making process and enables them to build a plausible narrative which accounts for the diagnostic decision. Pragmatism was found to operate as a strategy to help assign diagnosis within a condition which, diagnostically, is permeated by uncertainty and contradiction. Resolution of contradiction from different aspects of the assessment serves to create a narratively-coherent, intelligible clinical entity that is autism | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Autism | |
| 650 | 4 | |a Diagnosis | |
| 650 | 4 | |a Discourse | |
| 650 | 4 | |a Narrative | |
| 650 | 4 | |a Sociology of diagnosis | |
| 650 | 4 | |a UK | |
| 650 | 4 | |a Uncertainty | |
| 700 | 1 | |a McCabe, Rose |e verfasserin |4 aut | |
| 700 | 1 | |a Ford, Tamsin |e verfasserin |4 aut | |
| 700 | 1 | |a Parker, Daisy |e verfasserin |4 aut | |
| 700 | 1 | |a Russell, Ginny |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Social science & medicine (1982) |d 1981 |g 268(2021) vom: 27. Jan., Seite 113462 |w (DE-627)NLM012634646 |x 1873-5347 |7 nnns |
| 773 | 1 | 8 | |g volume:268 |g year:2021 |g day:27 |g month:01 |g pages:113462 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.socscimed.2020.113462 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 268 |j 2021 |b 27 |c 01 |h 113462 | ||