My son is both gifted and on the spectrum. We lucked out with a diagnosis and the Dr. told us so. We had two things going for us. 1. my middle son had previously been diagnosed by the same Dr. leaving a family history and 2. Just days before our appointment the Dr. had seen a child he had misdiagnosed years before. The child presented just like my son and was originally diagnosed as mixed conduct/mood disorder just like your daughter. After many years of therapy our Dr. said it became obvious that he had misdiagnosed the child. With this being fresh in the Dr.s mind he wasn't about to make the same mistake twice.

My son makes friends easily but has trouble keeping friends. He is better with adults or children much younger than he is. He is able to mask his problems/differences when out in public 95% of the time but that leads to full blown melt-downs once we are home. He presents like a very intelligent adult and a toddler all at the same time. He uses his high IQ and memorizes routines that make him appear normal but when these routines are deviated he doesn't know what to do. At times I think it's actually easier on my middle son (classic Autism) because he is different and totally unaware that he is different yet my older son is different and strives to be normal to fit in.

@A MyAutismTeam Member Both my sons were diagnosed by Dr. Frank Kirchner. He works with Hampton Roads Behavioral Health ( http://www.hrbhgroup.com/ ) and is a pediatric psychiatrist. The testing started with an 1 1/2 hour interview of the entire family. Although most questions were directed at my husband and I (developmental history including prenatal and birth) you could tell Dr. Kirchner was taking in Logan's every move. He would occasionally ask Logan questions. He also consulted Logan's IQ (160) and academic scores (at the time he was up for retention.) At that time my son received a PDD-NOS diagnosis with highly suspected Aspergers. Dr. Kirchner immediately scheduled the ADOS to be done the following week and after that was when he received the Aspergers label. At the time of testing my son had received speech therapy from the age of 3 and play therapy from the age of 4. He received other unofficial therapies as need arised from my husband and myself as we are both teachers of children with autism. We are a very social/ active family. My son has always made friends easily but always had trouble keeping friends. He does not read social cues and never has. He presents as an adult and toddler all wrapped into one. He has always thrown major tantrums/melt downs. He doesn't stick out in a crowd like my middle son does but if you closely observe him he is very different and always has been. He has always been very aggressive but can control it in public.

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A MyAutis...

I was told for years my daughter was to smart to be on the spectrum ummm sorry but that is why a child is on the spectrum they use more of their brain then we do.

Have you seen this article about diagnosis in girls? http://asperkids.com/seeing-the-pink-on-the-spe... Perhaps it has some helpful points.

I think you are right on that strong intellectual skills offset and mask autistic traits. People can use strengths to compensate for weaknesses. Which is a good thing!

But public schools don't usually do much for these kids I don't think. They don't care whether a kid has friends, only whether they can do reading and math. At least that's what we've found with our son.

With our son a tricky diagnostic thing is that he's much better at interacting with adults than peers - which is very typical - and this can make it hard for a psychologist to get an accurate picture if they just talk to the child 1-on-1.

What you might be able to do is document the case for diagnosis in writing point-by-point (maybe lining up with the diagnostic criteria - here's how each criterion is met) and discuss with your psychologist and/or find a different psychologist or autism center for a second opinion. You could also try to go back and think about when she was younger, when issues may have been more obvious, and document that.

To get private insurance coverage we had to have a PhD psychologist or developmental pediatrician. Diagnosis from a school, therapist, etc. was not acceptable to them.

@A MyAutismTeam Member... My son sounds like a mixture of both because he does go into these full melt down moments at home but you will never see that in public.

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A MyAutis...