another Is this the right DX question

[aine]

My daughter is 4 1/2 now.  I am not in denial but I frequently get contrasting opinions on her.  She was DX w/ Autism after I took her to MD after MD to get two to agree on a DX.  The first said NO NO NO she isn't autistic. (Neurologist) The DEV Peds said not in a million years.  We switched ins. the new neuro said severe autism. and a neuro psych said the same so I went w/ it.  She is social, very happy and playful, likes interaction, touching, eats great, sleeps great makes great eye contact.  She is dev delayed globally probably 18mo-2yr scattered, before meds showed little fear, difficult time playing w/ toys just went from object to object and mouthed things .   She developed ADHD symptoms about 3yrs old.  We just medicated w/ Ritalin and she has stopped all "crazy behaviors" hyperactivity, is attending and playing appropriatly w/ toys and peers (at dev. age level and above)  She has limited speech but is speaking in appropriate sentences for her level of speech.  She still has some speech abnormalities like saying "hockey" when she means other things or at an inappropriate time (like school)  One set of clinicians feels if you look at her cognitive level she isn't all that abnormal but w/ obvious mental retardation of course.  The other group says she is hard to engage in age appropriate activites so she is in "her own world" and is autistic mod/severe.  My question is if the meds worked doesn't it figure she might have ADHD w/ severe learning disorders?  (not that it makes anything better)  I just feel no one can agree.  PS Her teacher (an autism specialist 20 yrs) doesn't feel she is autistic but she also doesn't know exactly what it is either.  Her special day class teacher also felt she did not meet the criteria for autism.  Should I get a psychiatrists opinion now that she's on meds and things are different?  We currently see a neurologist that specializes in Autism, as does our Pediatrician.  Thanks

[Kevin Kennedy, Ph.D.]

Except in the more extreme situations, one of the chief difficulties in diagnosing developmentally-related problems or conditions in very young children is that we haven't had the opportunity to witness how development will actually proceed with those children. Consequently, it's not unusual to observe the different sorts of professional opinions you have received. Professionals who now evaluate your daughter have a major benefit that those who evaluated her earlier did not have - i.e., the current perspective benefits from knowledge of how your daughter's situation has evolved over the past couple of years.When she was two years old, people were trying to project how she might look at the age of four or five. Now the clinicians have the opportunity to actually see how she looks at the age of four-five. It is looking like a diagnosis of autism, at least to any great degree of severity, is doubtful. But the spectrum of Pervasive Developmental Disorders is quite broad - from children with very severe Autistic Disorder to quite high-functioning Asperger's Disorder children. It's not likely you're looking at ADHD + learning disorder; it's more likely that some aspect of developmental disorder is present. But I would certainly endorse the plan to seek the opinion of child psychiatry and include it with what you already know.