My littlest niece is having some issues. She is four and just went through her first round of evaluations and came through with all classic diagnose of F83 'Mixed specific developmental disorder.' In other words: There is something going on, but your kiddie is still so young, so let's start with symptom based interventions and therapy and have new evaluations in two years to decide what it actually is if anything. In the end it can turn out to anything from ADHD to asperger to mild mental retardation to learning difficulties to dyspraxia to dysphasia; and likely something else, those are just the most common I have heard. And for some it doesn't lead to anything or 'people are different, some are just little more different' like with my difficult child. With my niece, they found rather classic sensory issues (hypersensitive and sensory avoiding), clear delay in gross motor skills, advanced language skills, some anxiety issues and her being in the verge of selective mutism. For last year she was in the day care four days a week (while her dad was on part time parental leave and home with her one day a week) and that was overwhelming for her. In day care she acts very shy and she doesn't talk to adults much. And if she does, she whispers and only a word or two or very short sentence. With other kids she talks more freely. At home and also with us and other extended family she is very talkative and advanced verbally. Her dad has some Obsessive Compulsive Disorder (OCD) tendencies and says he used to be a very shy kid, but other than that there is no neurological or mental health issues in the family (well there is mother in law...) Last year she was in younger kids group (12 kids from age 1 to 3 with three qualified adults (one with BA in early education, two with AN in childcare) and one aide without required education to be considered qualified day care worker) but now she is in even bigger group due to her age. 18 full time and 2 part time 4 to 5 year-olds with similar group of adults. They are very worried how she can stomach that. She is waiting an opening in their special needs group that is smaller and has place for two kids with significant special needs (like autism or mental retardation or significant medical needs), two with milder special needs (she is waiting other of those spots) and four well developed 'support kids.' That group also has more adults per child. They have one early education teacher specialised to special needs kids and two day care workers with AN and 1-on-1 aides if some of the kids needs that. My niece will likely get a spot in middle of November. sister in law knows the family whose son's place niece will likely get and that family is expecting a new baby and also older son will stay home after the birth, his special needs are purely medical (type 1 diabetes) and he doesn't need early education services for the support. This group will be great because all the therapies atc. can be arranged to be held in day care. Now niece has to get to her FT and Occupational Therapist (OT) appointments outside of day care time. The plan is for her to be at the day care only three days a week till she gets the special needs group spot and mother in law is looking after her two days a week. They will start selective mutism interventions in day care, but neither I or sister in law has much idea what they will be. There will be a psychologist to advice day care workers about that in two weeks, so I guess sister in law will find out then too. sister in law is rather freaked out with selective mutism thing and has read lots of contradictory info about it online. She is also little confused with sensory issues, because she has known my difficult child his whole life and while also difficult child is hypersensitive, he was still very much a sensory seeker, and also very advanced in gross motor skills, so for sister in law it is difficult to get her brain wrapped around the idea that two so differently behaving kids can have essentially the same problem.