Can a child be diagnosed as on the ASD spectrum if they meet almost all the criteria?

[Aliceinboots]

My 3 yr old has severe speech delay, appears oblivious to other children, appears a lot of the time to be in a "world of her own" and is emotionally aloof.
She does not however have any issues with routines or rituals. In fact you can take her anywhere surrounded by anyone and she just does her own thing. There are no sensory problems or tantrums either.
Could it be that she still fits somewhere on the ASD spectrum or is it more likely she to have a more non-specific learning difficulty?
I realise only a paed can only answer this but ours seems clueless.
Can ASD present as just a communication and social disorder?
Any thoughts, theories, comparisions gratefully accepted.

BigBoobiedBertha

Neuroimaging will as you say provide one of the diagnostic test options along with genetic analysis to identify the various individual deficits / disorders / disabilities which combine to cause the various behavior symptoms that currently have to be observed to from an ASD diagnosis.
Untangling the various multiple causes of the ASD behavior symptoms has been part of recent ASD research but there is still a long way to go.

So an EEG (presumably) couldn't diagnosis ASD but could identify one or more symptoms of it?

Aliceinboots - an MRI scan wouldn't identify symtoms as such, it would identify an area of brain differences/deficit/damage that is specific to those with ASDs and it is that difference that leads to the symptoms of ASD. Behaviour can be caused by many things potentially but the scan would hopefully show whether the cause in an individuals case was autism or something else.

Hi. Your DD sounds just like my DS who was dx'ed ASD at 3.0 years old. ASD is a spectrum so there's no one checklist or symptom. The triad of autistic impairments are lack social interaction, speech and (imaginative) play. We waited and waited to get a diagnosis and really regret it now. Our son has done 40 hours per week of ABA for the last two years and can function nearly independently in MS education. However, I think if we had started sooner when we first saw that he was struggling he'd be much further along. The sooner you start intensive intervention, the better prognosis for your child. With the benefit of hindsight, I would have started ABA immediately whilst waiting for more conclusive dx. I wish you all the best and hope you and your family will get the help you need. A good resource for ABA information is PEACH. We do not get services from them but they were really helpful in answering our questions. They are very helpful. I found the National Autistic Society too wishy-washy and wouldn't commit to saying which were the best treatments/courses of action. However, they may be able to give you information about getting a diagnosis privately, which is actually fairly tricky we found. (Got our dx through NHS but had to wait 7 months.) All my best to you.

I'm confused as to what constitutes imaginative play. DD likes to play with her teddies and dolls a lot and will hug, kiss them, put them to bed and say "night night". If you ask her if teddy wants a drink she'll offer him her cup and make slurping noises.
She makes her dolls dance and fall down then says "uh uh" and gives them a hug.
She doesn't do this all the time and also likes to look at books (very limited selection) and to play ring-a-ring-a-roses and physical songs like that with her sister.
I am concerned however that she can be quite restricted in her play rather than it lacks imagination.

Bertha, so an MRI scan could indicate brain changes associated with ASD? Could a clear scan rul it out?

Aliceinboots

Neuroimaging has many processes including fMRI, EEG, and many more, and each of these processes measure different types of brain activity, and how the brain reacts to various sensory stimuli.
ASD has a multiple set of underlying causes each of which can have different patterns of brain activity, the areas of no activity, areas of little activity areas of high activity, etc. And as yet they have not been able to identify all of these issues in relation to ASD mainly due to the highly complex nature of ASD, and the sensitivities of those who have ASD, which cause laboratory investigation to be difficult due to the invasive nature of the technology currently in use. Researchers are trying to improve the technology to be less invasive, to help them study children and infants who have ASD.

So in the long term future neuroimaging and genetic analysis will be the scientific method of diagnosing the various differences / deficits / disabilities which combine to cause the various forms of ASD.

Currently because they have not identified all of the areas of brain activity or inactivity which contribute to causing ASD, they are not able to identify what you term a "clear scan" which could be used to rule out ASD either.

As much as it would be ideal to be able to have such clear cut diagnostic processes, the current scientific technology and resulting understanding of the full nature of these issues is still some way in the future.

As One leading UK researcher in a related area, says the more intensely we research these issues, the more we realise that we actually understand less than we previously thought.