Exploring Diagnosis
Exploring Diagnosis
Posted by Daisy Elliott
12 April 2021As the Exploring Diagnosis funding runs out this July, we have been reflecting on our project achievements. We have produced:
Jennie’s PhD explored how clinicians make diagnostic decisions about autism in secondary care. The process of diagnosis is complex and can be particularly challenging when cases are considered ‘borderline’ or where there are coexisting conditions. Utilising thematic and discursive qualitative methods, we found that uncertainty and contradiction are core to autism diagnosis. Clinicians develop strategies to manage the institutional necessary for a binary decision despite this uncertainty, including performing diagnosis as an act of interpretation, affect and evaluation, providing explanations for contradictory evidence, and drawing on pragmatism when necessary.
The result of this translation from uncertainty to certainty is the construction of a condition whereby it is possible to be both part of a spectrum as well as categorically defined. Overall, the PhD provides insight into our understanding of diagnosis as a social process.
In Tom’s PhD he investigated how people came to be labelled, or to label themselves, as autistic in adulthood. Previous research has shown that obtaining an autism diagnosis in adulthood comes with significant benefits (greater self-awareness and access to support services) as well as some undesirable drawbacks (shame and a sense of helplessness). Yet a medical diagnosis is not the only way of acquiring the label. An individual can also label themselves – that is, self-identify – as autistic, and they can be labelled as such by other autistic people. By conducting a series of qualitative interviews (n=42) with those who had acquired the label, Tom developed three theoretical concepts that illustrate how people go about obtaining the label ‘autistic’ and what it means to live with it: (1) autism as a ‘sticky-slippy’ label, (2) four ideal types of self-identification, and (3) the notion of a ‘lay diagnosis’ where people ‘passively spot’ and ‘actively seek’ autism in others.
Including:
All our work is open access and can be found here.
“As PI of ExDx I have thoroughly enjoyed the past 4 years. Thank you to all our participants and advisory group members, without whom we would not have been able to achieve any of this work. Also thanks to the ExDx team for working so hard and diligently to produce valuable research for the field of autism, Neurodiversity and the sociology of diagnosis.” – Ginny Russell