Autism diagnosis as a social process.
Autism diagnosis as a social process.
复制标题
DOI：
10.1177/13623613211030392
复制
发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Russell G
中科院分区：
文献类型：
--
作者：
Hayes J;Ford T;McCabe R;Russell G
自闭症的诊断可能是具有挑战性的，特别是如果一个人来评估被认为是接近诊断阈值。从临床医生的角度理解诊断的经验和挑战是很重要的。在这项研究中，21个深入的采访进行了与临床医生在专业自闭症评估小组在成人和儿童的服务在英格兰。对访谈进行了录音，并按主题分析了记录。我们确定了四个主题，代表了临床医生如何经常在有限的资源背景下，将他们自己对自闭症的专业理解与其他因素（如标准化测试的结果以及患者和护理人员的观点）进行权衡：机构压力，使诊断有意义，通过自闭症透镜和工具来看待。这项研究阐明了诊断过程作为一个社会定位的活动。我们建议，专门在自闭症评估服务的利弊，他们需要有效运作的资源，以及他们如何在更广泛的卫生服务的背景下运作的检查将是适当和及时的。当一个儿童或成人被转介到自闭症诊断，来自不同背景的临床医生一起工作，作出诊断决定。一些研究在采访中询问了临床医生对诊断的看法以及面临的挑战。我们采访了英国儿童和成人评估服务的临床医生，以及来自不同专业背景的医生，了解自闭症诊断的挑战和可能影响评估过程的因素。我们发现自闭症诊断存在许多挑战，特别是当有人来诊断被认为接近诊断阈值时。临床医生告诉我们，做出诊断就像创造一个“故事”：观察许多不同的因素来讲述一个人的故事，而不仅仅是看诊断测试的结果。临床医生并不总是同意这些测试的结果，必须使用他们的专业临床判断来做出决定。临床医生担心人们必须等待自闭症评估的时间，以及评估过程中产生的压力。这项工作的发现可以帮助我们了解诊断是如何发生的，并考虑如何为成年人、儿童和家庭以及临床医生改进诊断。
The diagnosis of autism can be challenging, particularly if an individual coming for assessment is considered to be near the diagnostic threshold. It is important to understand the experiences and challenges of diagnosis from the perspective of clinicians. In this study, 21 in-depth interviews were conducted with clinicians working in specialist autism assessment teams in adult and children’s services in England. Interviews were recorded and transcripts were analysed thematically. We identified four themes that represented how clinicians were frequently engaged with juggling their own professional understanding of what autism is with other factors such as the results of standardised tests and the views of patients and carers, in the context of limited resources: institutional pressure, making diagnosis make sense, seeing through an autism lens and just tools. The study illuminates the diagnostic process as a socially situated activity. We suggest that an examination of the benefits and drawbacks of assessment services specialising in autism only, the resources they require to operate effectively, and how they operate in the context of wider health services would be appropriate and timely. 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.
登录
查看更多内容
DOI：
10.1016/j.jaac.2014.10.003
发表时间：
2015-01
影响因子：
13.3
作者：
Lai, Meng-Chuan;Lombardo, Michael V.;Auyeung, Bonnie;Chakrabarti, Bhismadev;Baron-Cohen, Simon
通讯作者：
Baron-Cohen, Simon
影响因子：
3.9
作者：
Crane L;Batty R;Adeyinka H;Goddard L;Henry LA;Hill EL
通讯作者：
Hill EL
影响因子：
3.9
作者：
Jones, Lydia;Goddard, Lorna;Crane, Laura
通讯作者：
Crane, Laura
影响因子：
3.9
作者：
Lord, C;Risi, S;Rutter, M
通讯作者：
Rutter, M
影响因子：
2.6
作者：
Huerta, Marisela;Lord, Catherine
通讯作者：
Lord, Catherine