I strongly urge you to move towards an assessment so you can have some sense of direction. You need to have some idea of his difficulties, so you can begin to help him.
Whatever the diagnosis he eventually gets (if he gets one), he is already who he is. The label can make it easier to get support services at school, but he is your son, first and foremost. That doesn't change. The label often does.
difficult child 1 was originally diagnosed as ADHD when he was 6. When he was about 13 it was suggested he had Asperger's. This was at the same time as difficult child 3 was diagnosed as"mild to moderate autism spectrum disorder", now relabelled "high-functioning autism". The labels do shift a bit. Some people refer to Asperger's as being equivalent to "high-functioning autism" but we have one of each and they are NOT the same thing!
The distinction as applying here to us, has been "Is there a history of language delay?" A "yes" response" put him in the category of autism, while "no" puts it in Asperger's. For us.
difficult child 3 definitely had serious language delay issues. A big headache. But crikey, he's sure caught up now! He sounds like a walking thesaurus. But it's the HISTORY that is important here, not how he seems now.
We had an idiot school counsellor who said to me once, "Look how well difficult child 3 is doing! You must be so pleased that he's no longer autistic!"
I pointed out that the label doesn't go away, he is autistic because all the factors, including his history, confirm it. However, he has adapted well and is very good at masking his autism. As difficult child 3 said himself when he was 8 years old, "I'm getting very good at pretending to be normal."
In the earlier days we had people who treated the autism label as a tragedy. Family acted as if he had a terminal disease. difficult child 3's scripture teacher actually prayed with him for his autism to be healed. I was very angry about that because it sent a message to difficult child 3, that his autism meant that he was flawed and this was a bad thing. It also sent a message that all he had to do was pray and the autism would one day be magically all gone. I had a lot of work to do to explain to difficult child 3 (and his scripture teacher) that God doesn't necessarily work like that - he isn't a magic wish fairy. And also that autism is an integral part of difficult child 3's makeup.
difficult child 3 was diagnosed at 3, but it was really obvious by then. His prognosis then was not good - we were told he'd never go to a normal school, he would be uneducable, that his prodigious reading ability was pure savant skill, not reflecting genuine ability but simply something freakish that mimicked genuine intelligence. Crikey, were they wrong!
But then - if they had promised us that he would be fine, it would have set us up for failure.
Our journey with difficult child 3 has been an education. We have learned that you use every bit of help you can get. Work on the positives. Focus on encouragement, avoid punishment. Be consistent, challenge your child but not too hard. Support your child's apparently irrational fears, phobias and fads, but try to encourage them to try something different, as they can handle it. Don't yell. Teach by example. Avoid ambiguity - if they ask a question, you answer, "That's correct" instead of "That's right" because "right" is also a direction.
There were so many other aspects to this that we never realised - I wish we had. Over the years we have learned this ourselves, rather than been informed by health professionals. Often we've been the ones to educate the doctors.
We also raised the kids to embrace their autism, to view it as simply a different way of thinking and learning. They have found for themselves some benefits which they value. difficult child 1 is currently working for a carpenter, his job is to supervise the final sanding process of the furniture to make sure the job is done properly. His Obsessive Compulsive Disorder (OCD) (a facet of his Pervasive Developmental Disorder (PDD)) is helping him do this part of the job to perfection. He enjoys being in control of a high standard of finish to the company's furniture.
I hope you can get some definitive answers for your son, but it can take time.
Marg