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Diagnosis as a social determinant: The development of prosocial behaviour before and after an autism spectrum diagnosis


  • Russell, Ginny
  • Kelly, Susan E.
  • Ford, Tamsin
  • Steer, Colin


Jutel and Nettleton (2011) discuss diagnosis as not only a major classification tool for medicine but also an interactive social process that itself may have ramifications for health. Consideration of diagnosis as a social determinant of health outcomes led to the formulation of our research question: Can we detect a change in the development of prosocial symptoms before and after an Autism Spectrum Disorder (ASD) diagnosis? We examined the developmental trajectory of prosocial skills of children, as impairment in social skills is given as a core symptom for children with ASD. We used a validated scale measuring prosocial behaviour for a sample of 57 children where the measure was repeatedly recorded over ten years. We plotted the developmental trajectory of the prosocial trait in this sample who were enrolled in a longitudinal birth cohort study based in South West England. Multi-factorial fixed effect modelling suggests that the developmental trajectory of this measure of behaviour was not significantly altered by ASD diagnosis, or the consequences of diagnosis, either for better or worse. Further analysis was conducted on a subset of 33 of the children who had both pre-diagnosis and post-diagnosis information, and the same result obtained. The results indicate that prosocial behaviours may be resistant to typical ‘treatments’: provision of educational and specialist health services triggered by a clinical ASD diagnosis. The implications of this for considering diagnosis as a social determinant are discussed.

Suggested Citation

  • Russell, Ginny & Kelly, Susan E. & Ford, Tamsin & Steer, Colin, 2012. "Diagnosis as a social determinant: The development of prosocial behaviour before and after an autism spectrum diagnosis," Social Science & Medicine, Elsevier, vol. 75(9), pages 1642-1649.
  • Handle: RePEc:eee:socmed:v:75:y:2012:i:9:p:1642-1649 DOI: 10.1016/j.socscimed.2012.06.019

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    References listed on IDEAS

    1. Schaepe, Karen Sue, 2011. "Bad news and first impressions: Patient and family caregiver accounts of learning the cancer diagnosis," Social Science & Medicine, Elsevier, vol. 73(6), pages 912-921, September.
    2. Singh, Ilina, 2011. "A disorder of anger and aggression: Children's perspectives on attention deficit/hyperactivity disorder in the UK," Social Science & Medicine, Elsevier, vol. 73(6), pages 889-896, September.
    3. Dumit, Joseph, 2006. "Illnesses you have to fight to get: Facts as forces in uncertain, emergent illnesses," Social Science & Medicine, Elsevier, vol. 62(3), pages 577-590, February.
    4. Jutel, Annemarie & Nettleton, Sarah, 2011. "Towards a sociology of diagnosis: Reflections and opportunities," Social Science & Medicine, Elsevier, vol. 73(6), pages 793-800, September.
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