How does one get an early diagnosis?

My grandson is now four, and my daughter and her husband have been seeking professional help for him for the past year.  He is defiant, has one on one moments when he does okay.  He is obsessive, he remembers where he has put everything and if someone moves it, goes ballistic.  He hordes food.  But worst of all, he engages in very risky behavior!  After burning himself on the stove twice and looking me straight in the eye while I was caught behind a sewing machine, and laying the flat of his hand on an iron, I'd say he doesn't learn from experience quickly.  My daughter and son-in-law finally ran for help with him after he'd climbed up the old TV tower of the neighbor's, jumped across to his own roof and then tried to hook the dog leash onto the electric wires, just when his dad reached him.  Since then he managed to climb out his second story window, somehow hang on with fingers and toes while he shut the window on a retractable measuring tape, hung onto the box of the tape, and repelled off the house landing on the air conditioning unit at ground level.  They got locks for the windows.  My daughter has taken him to a developmental pediatrician who put him on drugs that just made him worse.  She is seeing a behavioral psychologist, now, who told her today that her son is beyond his kind of help and will refer her to a pediatrician who can in turn refer her to our teaching children's hospital for diagnosis.

Everything we read stresses the importance of early interventions to avoid becoming another bad statistic.  How can we develope an intervention plan if we can't get a diagnosis?

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Sorry your grandson is having such a hard time. If he's seen a developmental pediatrician (who tried him on medication) and a behavioral psychologist, he definitely has a working or provisional diagnosis or diagnoses. Make sure to have their records sent or in hand prior to him being seen next so you don't have to "repeat history" with them. He sounds like a complex kid. His parents really have been doing early intervention. This is a situation where you need to focus on safety and containment while awaiting further comprehensive evaluation, As scary as it may sound, if he can't be safely contained, he might need to be evaluated on a children's psychiatric inpatient unit until the nature of his problems are better understood and treated to the point of stabilizing him. Good luck.