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Doing Testing: How Concrete Competence can Facilitate or Inhibit Performances of Children with Autism Spectrum Disorder

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Abstract

This article contributes to the sociology of science and technology through the study of language use and social interaction. As an analysis of how clinicians examine children to diagnose developmental disabilities, it involves the sociology of testing and standardization, with our particular focus on Autism Spectrum Disorders. Whereas previous research has concentrated primarily on the outcomes of testing, such as diagnostic trends, little has been written about the tests by which these trends are produced. Our analysis shows how psychometric tests operate to shape the interactive environments (those established by the test instrument, scoring metrics, etc.). Additionally, the interactional environment (the practices by which protocols are implemented as clinician and child do the test) exerts an influence on performance. In short, the interactive and interactional environment may affect the measurement of ability and difference in children. We propose that the emphasis of clinical tests on measuring second-order, abstract competence—or the ability to produce general answers to theoretical questions—may obscure various kinds of first-order, concrete competence and “autistic intelligence” a child displays. As forms of first-order, concrete competence, we examine orientation in situ to testing history, narrative combinations of test items, and using filler words for test item answers.

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Notes

  1. See Eyal et al. (2010) and Silverman (2011) for a more comprehensive discussion of ASD patient careers.

  2. In a sense, we follow what Bowker and Star (1999, 320) have said about practices that are “right under our nose” and invisible in their ordinariness but that are “interwoven with formal technical categories and specifications” in the process of classification or diagnosis. See also Timmermans (1996) on the ways in which medical technological matrices and scripts can both create and suppress particular identities and moral orientations for individuals who come within their purview.

  3. Indeed, the emphasis on abstract competence—which, to the best of our knowledge, all contemporary cognitive assessment instruments share—may be taken to reflect (post)-modern society’s valorization of a certain style of reasoning. See Flynn (2007, 25), following Luria (1976) on how intelligence—and, by extension, ability, disability, etc.—cannot be defined apart from its social context, and what is functional or valued in that environment. See also Carraher et al. (1985) on the differences that working children, selling food and other goods on the streets of Recife, Brazil, exhibit when operating computationally in these real-life contexts in contrast to handling comparable, schooling-type mathematical problems in worded or operational forms.

  4. For a recent discussion of how non-human entities may have a type of agency in social life, see Sayes (2014). Additionally, see Clarke and Fujimura’s (1992, 5, 9, 14, 16) discussion of the importance of “situations,” inclusive of instruments, technologies, skills and techniques, and how testing instruments “are not neutral objects,” but rather can constrain and delimit what the laboratories or clinics that use them can produce in terms of findings and interpretations.

  5. “First order” is meant to convey the primacy of concrete competence as a mode of collaboratively engaging the world. We term abstract competence “second order” because it is parasitic upon first order competence for its realization. The distance between a child’s use of concrete competence and the capability for displaying abstract competence may be related to what Vygotsky (1978) has called the “zone of proximal development.”

  6. This extract is taken from a longer transcript and analysis thereof involving Ronnie and the clinician. See Maynard (2005, 516–517).

  7. A popular test of cognitive ability (others include the Wechsler and Stanford-Binet), the Woodcock-Johnson battery is not directly diagnostic of autism. However, cognitive testing plays an important part in the diagnostic process—in particular, cognitive ability is used to distinguish high- from low-functioning individuals on the spectrum. On this point, see also note 8 on the Brigance test. The Woodcock-Johnson test (in its 4th edition as of 2014) has not changed significantly over time (subtests have been added and scores re-normed to reflect changes in the population).

  8. It can be noted that, although Laura initiates repair (at lines 15, and lines 19–20) on Tony’s “gets frozen” answer twice, she gives no clue as to what is required. That is in line with the standardization of testing but it also demonstrates what Donaldson (1978, 17–18) has suggested about the “egocentrism” of commonsense or “human” knowledge. Just as Tony may be acting from his own “center” in answering the test questions, the procedures of testing prohibit an examiner from “decentering” away from the presumptions of questions and testing formats to supply minimal background meanings and knowledge that could enable better answering on a subject’s part. Although clearly this is how standardization is meant to work, we could refer to this as a kind of institutional epistemic egocentrism.

  9. This is a “one-way” mirror, behind which is an observation room. Those in the clinic where the testing occurs see the mirror; in the observation room, others can see through the glass into the clinic. A video camera is recording the interaction through the glass.

  10. Concrete competence is broader than the ability to comply per se, as it consists of the practical know-how that makes social activities possible, for neurotypical and autistic populations alike. The skills, in fact, may be related to context-embedded routines and their repetitive, recognizable, interdependent qualities, as documented in organization studies (Feldman and Pentland 2003; Becker 2004).

  11. Our findings may generalize to the diagnosis of physical disorders as well. Answering physicians’ questions requires the mobilization of concrete competence to produce abstract answers in pursuit of diagnosis. To the extent that such competence is mobilized in atypical ways, or interferes with the production of abstract competence, misunderstandings and misdiagnoses could arise.

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Acknowledgements

This study was made possible by grants from the University of Wisconsin Graduate School, the National Science Foundation (#1257065, Doug Maynard, Principal Investigator), and the National Institutes of Health (#17803, Doug Maynard, PI). We are also grateful for support from the Waisman Center at the University of Wisconsin and its Intellectual and Developmental Disabilities Research Center grant from National Institute for Child Health and Human Development (#P30 HD03352). This research was also supported by a grant to the Center for Demography of Health and Aging (P30 AG017266) at the University of Wisconsin. Waverly Duck, Trini Stickle, and Adam Talkington contributed in a variety of ways to our data collection and analysis, and we are grateful to the QS reviewers for helpful comments and suggestions.

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  1. Department of Sociology, University of Wisconsin, 1180 Observatory Drive, Madison, WI, 53706, USA

    Douglas W. Maynard

  2. Universitat Siegen, Siegen, Nordrhein-Westfalen, Germany

    Jason J. Turowetz

  3. Garfinkel Archive, Newburyport, MA, USA

    Jason J. Turowetz

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Maynard, D.W., Turowetz, J.J. Doing Testing: How Concrete Competence can Facilitate or Inhibit Performances of Children with Autism Spectrum Disorder. Qual Sociol 40, 467–491 (2017). https://doi.org/10.1007/s11133-017-9368-5

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