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The majority of studies on the effects of a diagnosis of learning disability in the family have employed traditional 'loss' and 'stress reaction' paradigms. In contrast to this approach, the current analysis employed a form of discourse analysis to explore the ways in which parents represented the 'problem' during the process of assessment of their child for an autistic spectrum disorder. The analysis suggested that parents employed three main discourses in their talk about the 'problem', which were termed the discourse of normal development, the medical discourse and the discourse of disability. The ways in which these discourses were used in constructing the 'problem', their relationship to each other and the discursive work underlying the diagnosis are discussed. Although this study focused on the specific case of autism, it is suggested that the findings could inform thinking around the complex ways in which medical diagnosis is constructed by families and extend our understanding of this important aspect of health care practice.

This paper presents a discourse analysis of parents' talk about the knowledge, expertise and authority of professionals, during assessment and diagnosis of their child for an autistic spectrum disorder at a Child Development Centre. Focusing on the positional level of analysis, it was suggested that parents' constructions of professional expertise and authority were inherently ambivalent and at times contradictory. It was further argued that this ambivalence is also reflected in an ideological dilemma between equality and expertise, regarding the role and positioning of 'human relations experts'. Discourse analysis was found to be a particularly useful tool in investigating aspects of the parents' talk relating to authority, knowledge and expertise. It is suggested that acknowledging this ambivalence and scrutinizing one's assumptions and practice, rather than denying the authoritarian aspects of health care, would provide the basis for more ethical and respectful clinical practice.

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