For years I have suspected that difficult child was on the spectrum... and over the years I have been told that she couldn't be because "her eye contact is fine" or "but she speaks very well"... In 2nd grade she was evaluation'd by a child psychologist who diagnosed (among others) NonVerbal Learning Disorder (NVLD). As far as what to do about NonVerbal Learning Disorder (NVLD)? Well, there didn't seem to be a lot of info or supports available, but we dutifully took the report to the school to implement a 504, which consisted of social groups - "lunch buddies", preferential seating and written cues to supplement verbal lessons. difficult child was so darn stubborn about everything! Refused anything "extra" the teachers tried to do for "support". Refused to bring her notebook back and forth. Would make up stories to get out of homework. Bullied other kids. Stole from other kids. By the time difficult child reached middle school it was determined (by the school) that all of her issues were largely behavioral. 504 was dropped. Psychologist's tests were ruled "out of date" for school purposes and since difficult child had been non-cooperative with everything the school had done for her previously....it seemed pointless to pursue it. The the behavior issues really exploded. In addition to bullying and stealing we were now dealing with running away, cutting, sex, and violence. New evaluations (though not as thorough as years before) now found "ODD", depression, anxiety, and possible "conduct disorder" and probably an emerging personality disorder. Now here we sit waiting to (hopefully) get additional services from the state to help difficult child based on the current diagnoses... and yesterday, I get in the mail a newsletter from the local hospital with an article on the warning signs of autism in young children. difficult child had at least two of them - possibly three. The biggest red flag? The list included 'Child does not engage in imaginative play by 18 mos' difficult child had no "imaginative play" - ever. EVER! I remember asking about it when she was little and I was brushed off... OK - so does that mean that difficult child is, indeed, on the spectrum? And because difficult child has never had any supports or therapies to address autism issues - are all these problem "behaviors" learned coping skills? And - my biggest concern - at this point, does it matter what the technical, actual diagnosis is? difficult child has been through so many years of "therapy" that she knows all the right answers, all the right things to say...does the treatment just need to deal with difficult child's current issues as they present? Has it really become an emerging personality disorder because of all the years of incorrect treatment (think "behavior charts") and should be now treated as such? Or should I be pushing for a re-consideration of possible autism, even thought hat has been "ruled out" by various specialists over and over for the same non-reasons as listed above? I'm confused... and frustrated... and feel like I just keep going over and over and over through the same circles. autism/behavioral....autism/behavioral....autism/behavioral... And the first thing the caseworker is doing is sending us somebody to help design a new Behavior Chart... I don't know.... What do you think?