Abstract
Many characteristics typical of autism, a neurodevelopmental condition characterised by socio-communicative impairments, are most evident during social interaction. Accordingly, procedures such as the Autism Diagnosis Observation Schedule (ADOS) are interactive and intended to elicit interactional impairments: a diagnosis of autism is given if interactional difficulties are attributed as a persistent quality of the individual undergoing diagnosis. This task is difficult, first, because behaviours can be interpreted in various ways and, second, because conversation breakdown may indicate a disengagement with, or resistance to, a line of conversation. Drawing upon conversation analysis, we examine seven ADOS diagnosis sessions and ask how diagnosticians distinguish between interactional resistance as, on the one hand, a diagnostic indicator and, on the other, as a reasonable choice from a range of possible responses. We find evidence of various forms of resistance during ADOS sessions, but it is a resistance to a line of conversational action that is often determined to be indicative of autism. However, and as we show, this attribution of resistance can be ambiguous. We conclude by arguing for reflexive practice during any diagnosis where talk is the problem, and for a commitment to acknowledge the potential impact of diagnostic procedures themselves upon results.
Highlights
In recent years, there has been an increasing focus in the academic literature on communication between those with autism, and those they interact with
Given this impairment in social communication skills which is seen to underpin a diagnosis of autism, a large proportion of the aforementioned literature has focused on identifying the ways in which the communication patterns of those with a diagnosis of autism differ from those who do not (e.g. Jones and Schwartz 2009; Keen 2003, 2005; Bruinsma et al 2004)
Analysing the scoring notes alongside the three categories of resistance we have identified in these data shows that it is this third category of resistance, resistance to a line of conversational action, that is the most consequential in terms of its likely diagnostic implications
Summary
There has been an increasing focus in the academic literature on communication between those with autism, and those they interact with. Presses on module 4 for the ADOS include: engaging in conversation about a range of ‘socioemotional’ issues (e.g. friends, loneliness, social difficulties) and everyday functioning (school/work); a construction task (akin to making a simple jigsaw); telling a story from a picture book; physical demonstration of an everyday task (e.g. brushing of teeth); creating a story with the use of physical objects (including, in our sample, a toy car, a sponge, and a cocktail umbrella); the retelling of a cartoon strip; free play with toys; and description of a picture featuring a social scene Throughout these activities the investigator searches for the social and communicative atypicalities associated with autism. University ethical review procedures and all participants gave written permission for their data to be reused for this piece
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