Welcome aboard! You have found a wonderful support system. As mentioned before we are diverse and often try to help from different perspectives but it is a "soft place to land". Before I start asking questions I'm offering supportive thoughts.
Does he have explosive episodes when he is with his grandparents? (Yes, I am a grandparent who has raised one grandson from birth and another for eight years or so.) If so have they seen a pattern for his behaviors at their house? I'm not trying to trigger anxiety but a few of our parents have found that their difficult child's just can't function well in a household with the normal chaos that comes with full family activity. Being an "only child" in a quiet environment can result in more normal functioning. It is great that he knows he is loved in both homes.
Have any of the experts done a neuro/psychological examination? If so did it indicate multiple dxs? Some of us have been surprised to discover that our difficult child's were not completely diagnosed prior to the N/P exam.
I'll save you from one of my very long posts and end this one by saying I am sorry that your family is having to cope with so much stress but you evidently are a loving dedicated Mom and your difficult child is lucky to have you seeking all the input you can find to help him live a happy life. Hugs DDD