Autism diagnosis as a social process.
Jennie Hayes, Tamsin Ford, Rose McCabe and 1 others
PMID 34243682WHAT IT FOUND
Clinicians in autism assessment teams described long waiting lists and limited time narrowing assessments, while diagnosis involved building a shared narrative and interpreting tools such as the ADOS as partial, especially for women and girls.
Key findings
01Clinicians said waiting lists and time limits narrowed assessments, reducing school observations and access to specialist input.
02Clinicians described diagnosis as building a narrative that makes sense of a person's experiences, while managing families who want or reject a diagnosis.
03Clinicians said ADOS and similar tools are one part of assessment, not definitive, and can miss women and girls or be affected by co-occurring conditions.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study interviewed only clinicians from four NHS autism assessment teams in England, so it may not represent services elsewhere. Participants were mainly self-selected and only included if they were part of a wider observation study, so the sample may not cover all professional roles or settings. Parents and patients were not interviewed, so the paper cannot compare their views with clinicians' views. The audio cases discussed were chosen by the researchers, so the topics may reflect that selection. Race or ethnicity and socioeconomic status were not recorded.
Declared interests
The supplied text has a funding and conflicts heading but no statement of funders or author declarations. The publication record marks the work as Research Support, Non-U.S. Gov't.
The easy way to misread this
Do not conclude that autism diagnosis is unreliable or that ADOS scores can be ignored. This is a qualitative interview study of clinicians' experiences, not a test accuracy study. It reports that tools are one part of assessment and that clinicians also use judgement.