As parents maybe we all just want to ask "will my child be OK?" I would guess the answer is simply YES. Every person has struggles in their life, but you've listed many wonderful things about your son, and it sounds like he's going to be fine.

When you ask "are there other conditions where unusual play is a symptom," I'd urge you to question the premise of that question because it assumes we (as the human race) have answers that we don't have. Autism is not a single condition; it's a whole family of unknown conditions with unknown cause. Some do still argue it's one condition, but in my opinion research points to it being at least dozens if not hundreds of distinct conditions.

The medical/educational worlds have no idea how to distinguish the many conditions. Therefore: it's all lumped as "ASD" - and the exact diagnostic criteria are open to debate.

Here's a book review that relates: http://intellectualizing.net/2013/12/17/book-re...

This is all even more true at age 2; kids that young are hard to diagnose.

It sounds like I'm just being pedantic (maybe I am) but this has practical consequences.

One is that the diagnosis doesn't tell you about appropriate intervention because it's so broad. The specifics are key. If you go to a diagnostic session, most parents get tons of details on speech, IQ, behavior, etc. and they overlook those details because "IS IT AUTISM" crowds the details out of their brain. But in fact the details are where you can find what matters - that is, what help your child might need and not need. You'll get the details whether they decide on autism or not.

If you are concerned about the play or the speech delay, then you may WANT it to be autism, to get access to more school and insurance resources.

Remember, a diagnosis doesn't change your child, nor is it a condition/explanation. It's a description.

The unusual play and speech delay definitely don't have to add up to ASD; by themselves, those two things probably aren't enough to fill out the whole autism checklist. But if "autism" means you checked 5 things and your child only has 2 things, you still have the 2 things. And the same interventions that would help those 2 for someone who met the full autism checklist, would also help someone with only the 2. And your child may have more boxes to check in a year, or fewer.

There are very different experiences of autism out there. When people talk about what worked for their child, or if you read a study about autism in the paper, you have to remember that it may not apply to your child at all. Or it might.

Long-term outcomes vary a lot. Sometimes autism is pretty hard, sometimes it's no big deal, most often it's somewhere in between. I guess we could say that about any kid (or adult) though... again, autism diagnosis doesn't say your child will or won't be OK.

There is enough red flags to warrant an evaluation as pointed out earlier. It could very well not be ASD - need a professional evaluation.

Since you had asked same question before, I will try to answer differently this time.

When my son was 2 yrs old, my wife thought speech delay and I was sure it was ASD. We got diagnosis of ASD from a professional but my wife was in denial for over a year even after diagnosis and didn't agree. In any event, I am glad that I started all interventions right away despite my wife (and her side of the family) objections and desire to wait for him to "grow out of it". The logic was simple - even it is a speech delay or something else, early intervention is only going to help him catchup developmentally. We are simply doing what is best for our child. Time was the scarce resource, not money or hope. A year later, she realized diagnosis was indeed correct but it was quite tough not having both parents on the same page. However I am glad that at least our son didn't lose a year.

So whatever the diagnosis may or may not be (it may very well not be ASD) start early interventions now. Don't need diagnosis for that in most places. I know it is going to be a tough selling this to the wife but it is the right thing to do.

I had originally thought my DD was "too social" to have autism. She is sweet, affectionate, loves hugs and snuggling, and is highly motivated to interact with people. She did struggle with appropriate social interactions, but I'd chalked that up to being a factor of her speech & language delay (which *IS* her biggest challenge). It seriously took having 4 different evaluations and all 4 agreeing on the diagnosis of HFA for me to accept it. That was 3 years ago this month, and while DD's functioning has improved (and she has improved from being in the <1st percentile to now in the 8th-14th percentile), the gap between her and NT peers has become much more obvious.

I know where you are at. It was all out war of hope against reality. But I had to place my son first over my wife's hope.

Don't get too fixated on what is or is not a symptom. There is no doubt that the child is delayed. Why would be impossible to answer. ASD is simply a "I don't know what's wrong" diagnosis and subjective. Some kids are able to lose ASD diagnosis as well on their own as they grow up and become indistinguishable from peers. We don't know why.

Another way to look at it. The old stat is that 1 in 6 kids will have some kind of neurological damage. The stat might be 1 in 3 now. The levels of impairments will vary. Even with autism, it is a huge spectrum of impairments. One needs to work on the specific impairments regardless of the cause.

Autism is a symptom (rather collection of common symptoms) that is also common in some 30 different known medical or genetic conditions that can cause neurological impairment (some of these can be reversed if caught early). There might be very well be over 100 different medical conditions that may have autism as one of the symptom. But for most, it remains unexplained. A lots of different medical hypothesis (dozens) and many are being tested and researched further.

Regardless of the cause or level of impairment in any given child, the recommended interventions are the same and these should be targeted towards the specific individual as much as possible.

We also had the fixation and repetitive behaviour of spinning, rotating objects as well as unusual / inappropriate play when our son was 2 yrs old but few years later, it is gone now. That doesn't mean whatever was causing ASD symptom is gone yet. Just that the challenges and symptoms are slightly different now.