College of Medicine and Health, University of Exeter, Exeter, UK.
School of Health Sciences, City, University of London, London, UK.
Sociol Health Illn. 2020 May;42(4):825-843. doi: 10.1111/1467-9566.13063. Epub 2020 Feb 21.
Diagnosis of autism in the UK is generally made within a multidisciplinary team setting and is primarily based on observation and clinical interview. We examined how clinicians diagnose autism in practice by observing post-assessment meetings in specialist autism teams. Eighteen meetings across four teams based in the south of England and covering 88 cases were audio-recorded, transcribed and analysed using thematic analysis. We drew out two themes, related to the way in which clinicians expressed their specialist disciplinary knowledge to come to diagnostic consensus: Feeling Autism in the Encounter; and Evaluating Testimonies of Non-present Actors. We show how clinicians produce objective accounts through their situated practices and perform diagnosis as an act of interpretation, affect and evaluation to meet the institutional demands of the diagnostic setting. Our study contributes to our understanding of how diagnosis is accomplished in practice.
在英国,自闭症的诊断通常是在多学科团队中进行的,主要基于观察和临床访谈。我们通过观察专门的自闭症团队的评估后会议,研究了临床医生在实践中如何诊断自闭症。在英格兰南部的四个团队中,共进行了 18 次会议,涵盖了 88 个病例,这些会议被录音、转录并使用主题分析进行了分析。我们得出了两个主题,与临床医生表达其专业学科知识以达成诊断共识的方式有关:在相遇中感受自闭症;以及评估不在场演员的证言。我们展示了临床医生如何通过他们的实际实践来产生客观的描述,并将诊断作为一种解释、影响和评估的行为来满足诊断环境的制度要求。我们的研究有助于我们理解诊断是如何在实践中完成的。