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Based on an ethnographic survey conducted bet­ween March and August 2009 in a diagnostic center specialized in autism, this article studies the implications of the emergence of standardized diagnostic tools on the authority of child psychiatrists. To what extent does the development of standardized tools rearrange forms of medical authority (over patients, between psychiatrists, and over other health professionals)? The crossing of different scales of analysis (macro, meso, micro) captures the contrasting consequences of standardized tools on professional authority. First, some child psychiatrists are in favor of standardized tools because these tools enable them to assert greater authority over other child psychiatrists and to appropriate the work of other health professionals without constraining their judgment. Secondly, while child psychiatrists were compelled in the use of standardized tools by organizations of parents with autistic children, these tools ultimately allow them to re-establish their authority on parents.