The role of the nurse in preschool autism assessment.

Not all community child health teams carrying out preschool autism assessment have nurses as part of the team. The stimulus for this study was the need to make plain to commissioners and managers in one NHS Foundation Trust what nurses bring to the multidisciplinary assessment process which is unique to the nursing profession. It is known that the process of assessment and diagnosis of preschool children for autism can be difficult for parents. Parents have described the kind of professional care they find helpful during the process. The aim of the study was to define the particular role of the nurse in preschool autism assessment. This interpretive, hermeneutic study included all six nurses involved in preschool autism assessment as part of community teams in the Trust. They each generated texts for analysis by writing a reflective account of an episode of care, and by transcripts of one to one and group discussions with the researcher. Kim's (1999) critical reflective inquiry method was adapted for this study by including the researcher as participant. The beliefs and values which underpin the practice of these nurses and some dissonance between their ethical intentions and their actions in practice were made explicit through analysis of the texts, informed by relevant literature around autism, models of disability and models of nursing. This is a study of nurses, by nurses and for nurses. It contributes to nursing knowledge in four ways: by examining the beliefs and values which inform the practice of the nurse participants; by analysing the source of dissonance between the nurses' intentions and actions in practice; by defining the unique role of the nurse in preschool autism assessment from a nursing perspective; and by showing that the beliefs and values espoused by the nurses in this study motivate them to deliver care with the particular characteristics which parents find helpful. The findings are that these nurses hold in common a set of beliefs, values and intentions which, combined with a breadth of knowledge and clinical skills, prepare them to deliver, as part of an assessment team, the quality of care that parents have said they need.