I'm going to use my mediocre typing skills and report the doctor's clinical impressions: "Based on the assessment information. V's cognitive sills appeared to be at an average level, without significant difference between verbal and nonverbal skills. Borderline communication skills indicated on parental reports could be more indicative of social difficulties using language in social situations than language delays given performance on verbal cognitive measures. This would seem consistent with parental ratings indicating clinically significant levels of wihdrawal, possibly associated with anxiety concerns. Difficulties with anxiety and use of language in social situations could limit his ability to acquire and demostrate academic skills as indicated by below average performance on school readines measures. Difficulties with anxiety could also promote occurences in problem behavior to escape anxiety producing situations and/or receive access to attention and alternate activities. To minimize occurences of problem behavior individuals should focus on instructional tecniques, as compared to reactive strategies. Although parental reports indicated concerns regarding possible Autism Spectrum Disorders (ASD) given tendency towards compulsive behavior, social difficulties, and sensitivity to environmental stimuli, these concerns would seem to be associated more with anxiety concerns, than an autism diagnosis. V easily used nonverbal gestures to regulate social interactions, frequently redirected the examiner's attention to accomplishments, and consistently changed his nonverbal behavior in response to examiner's social overtures. These behaviors would be inconsistent with Autism Spectrum Disorders (ASD). Minimal indications associated with autism would seem consistent with previous assessment information." diagnosis: Speech/language delay Academic underachievement Anxiety Monitor activity level for ADHD Just to be more specific, the speech delay is for the receptive language and he tests at the 21 months age range. That is REALLY low. The anxiety and speech delay being the source of all problem according to doctor. I have been told so many things, I really feel lost. This doctor advises us to get a language assessment geared toward language in social settings. Does that even exist??? His diagnosis is based on parent report. And I promiss I was truthful in my answering questions. Both husband and I had not realised it was that bad... What do you guys think? Time to really believe it has nothing to do with Autism Spectrum Disorders (ASD)? Time to contact the school district again and talk about the speech delay? Time to consider medications (husband really against it)?