Should I seek a second opinion?

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Hello, everyone. I just created an account here to hopefully get some perspective on my 28-month-old, who was just evaluated for autism last month by a child psychologist. It was recommended because of his strong sensory issues with food (largely will only eat crunchy things). He has always seemed different from the day we took him home, but he is our first child, and the first male grandchild in our family, and so it has been easy to blame the differences through the years on 1) being a boy, 2) not having raised children before, and 3) that men in our family are "difficult". Long story short: I am a stay-at-home mother and I believe my son has Asperger's, but we received a "neurotypical" diagnosis from the psychologist, who instead believes that all of my son's odd behaviors are just to get a reaction out of me (I fought this, as I feel very strongly about the importance of "unruffled" parenting).

The psychologist is aware that I am offended and in disagreement. My response to him was, "You tested him for cognitive and speech skills only. You are aware that those are his strengths, and that the issues lie everywhere else." That didn't change anything. We took a break from seeing him for a few weeks, but eventually as I cooled down I decided to email him some questions, trying to gauge why the diagnosis had to be either classic autism or neurotypical. I have never received a response. I am fully aware, and always have been, that my child does not have classic autism. But, as a mother who is with my son almost always and works very hard to intuit things from his perspective, I will question anyone who tells me that he is neurotypical, or, as my in-laws like to tell themselves, "king of the house". I am hoping those of you who are either parents of children with Asperger's or who have it themselves can read these descriptions of my son and tell me whether I should seek a second opinion or whether I should believe the psychologist and stop chasing a diagnosis that just isn't correct. (To clarify, I'm not chasing a diagnosis for any personal reasons other than the fact that, the better I know and understand my kid, the better I can raise him in an uplifting way that supports his spirit AND his differences from me, rather than in a frustrated way that builds a negative self-image of himself in these sensitive toddler years).

So, here goes (and feel free to ask for clarifications if something doesn't make sense):
1. The crunchy foods. He WILL NOT eat fresh fruit, veggies, anything with the consistency of yogurt, purees, sauces, puddings, frosting/icing, soup,he won't eat cheese or other dairy products other than milk, etc. His preferred foods are trail mix, granola bars, dried or freeze-dried fruit, crackers, cereal, toast with spreads, buttered noodles, and that's about it. He LOVES beverages, and I think if he could, he would subsist on them without eating anything ever. He was in food therapy, but we quit after realizing that he manipulates the whole situation to do the minimum amount of work to receive the preferred food.
2. He seems to be incapable of handling other children. He has very few problems with adults. I tried to start nannying another girl his age in our home. It lasted two weeks before we had to quit because he would spend the entire day, in lieu of doing anything enjoyable, following her around and touching her, usually in a violent way. He would poke at her, hit her, pull her hair out, kick her, and bite her. It was never angrily, though... It was obsessive and deadpan in its delivery. If I would redirect/scold/put him in time-out, instead of not touching her, he would try to hug her, but then couldn't resist biting her, so would often bite her in the shoulder during the hug. If I would go to take him out of time-out, I would typically ask him one form of a number of different rhetorical questions trying to gauge if he was ready to stop touching her. His answer was always honest: no, he was not going to stop. Again, none of this is angry. It has all been point-blank. It is the same at parks and indoor play areas. If we are at a play group with acquaintances, he will play in a corner and swat at any other child who walks by him. There is a neighbor girl that he tends to mesh with a little better because she is quiet and independent, but he is still obsessed with his desire to "eat" or bite her belly button because she has an outie, and will talk about this at least once every day even if we haven't seen her lately.
3. He frequently talks about how much he does NOT like other children or people ("No people!" was one of his first 2-word sentences). He will talk about wanting to eat them and pinch them. If we read books, he gives kisses to the animals but will pretend to eat or pinch human characters. If the animals talk to humans, he will yell that he wants the humans to go away and that he doesn't LIKE them.
4. He seems to have a preoccupation with defending himself. He spends a lot of the day babbling on about how he doesn't like things, certain people, or a number of places we go for errands. When he has to do/see/go to those places, he will either talk about the violent things he wants to do to them/there, or he will get into a hyper fit where he spins and flaps, makes these yodeling noises and "deedle deedle" noises, and hits himself. Lately during those spells he will say, "I KILL me, Mama." He doesn't even know what that means. I think he picked it up when I talked once about how he kills the ants outside when he presses down on them, and put two and two together.
5. For as long as he's been able to speak in sentences (10 months), he's had obsessive interests and fears that he needs to talk about constantly. The topics have changed, but the frequency with which he talks about them and thinks about them hasn't. I would say the interest lasts about two months per topic, and we need to talk about the topic probably 20-25 times a day. When we talk about those topics, he wants the same sentences repeated in the same order over and over again, and he will correct me if I go out of order.
6. He has a different way of talking. It's not hugely obvious, but it's there enough that we joke about it as a family when my son isn't around. Not in a mean way, but more just because it is unique to him and different; in a loving way. We kind of compare it to a mix of Dracula and Doc Martin, if you have ever seen the BBC show. It is crisp, with clear consonants that aren't typical of our midwestern dialect, and with great emphasis on the verb: "I'm RUNNING, Mama." "I don't WANT to, Mama."
7. For as much as he wants to talk about his interests and thoughts throughout the day, and for as well-developed as his vocabulary and sentence structure is, he is not a good reciprocal communicator. If he is asked a question that doesn't have to do with an interest or whatever he is thinking about at the time, he answers "Yep", no matter what the questions is or how you re-phrase it. He seems to do best when questions are in A or B format or yes/no format. Anything else that is deeper than that, we tend to get "Yep", or he will finally get it and answer after an unusual amount of time has passed.
8. This will sounds biased because I have read about it out of confusion and frustation, but he has TONS of sensory-seeking behaviors combined with sensory-revulsion behaviors. They have changed over the years. Some of his sensory-seeking behaviors currently are: body slamming into me, biting and chewing on things that aren't food, licking my skin (which often ends in biting), picking scabs, jumping on the bed and the trampoline for ridicuous amounts of time (45 min), rubbing his face up against me like in The Lion King (he has never seen it), being intensely hyper all day long (seriously... he never stops moving, other than to read books, which are a fixed interest for him), biting breasts and stomach fat, and others. Some sensory-revulsion behaviors are: he can't stand being wet, dirty, or sticky, he hates my hair, he doesn't like his clothes or his diaper, any cuts or scabs on his own body, anything on anyone's skin (moles, acne, freckles, tattoos, bug bites, etc.), men who look feminine or women who look masculine, when people wear hats, scarves, or jewelry, sudden noises, blankets, etc.
9. He has recently stopped pretending and instead has started lining up the toys he used to pretend with.
10. He goes through half-week phases of being what we consider to be mean to his father, which hurts his father. We think they are routine-based. Luckily my husband has learned to try to conceal his hurt and doesn't make a big deal about it. Our son is very attached to me, my husband would say too attached. When my husband comes home from work, at first our son seems happy to see him, but then after a minute or two seems to sense that now his dad will be taking care of him also, and rejects him. He won't do activities with him, will get angry if his dad tries to do care-tasks that I would do during the day, won't hug him or show him affection, and gets angry at me if I talk to his dad or if his dad shows me affection. Then the weekend comes and he gets used to it and is fine. Then when his father goes back to work on Monday, he is upset all day that he is gone and struggles the whole day. Eventually he goes back to rejecting him, and the cycle starts over again.

I'll stop at 10 : ) Our son does have a lot of strenghts. He is VERY happy at home for the most part and loves his home and his things. He is attached to the adult members of our family (not the cousins). He is an unbelievable pattern-matcher, in life and in objects. It is charming that he is so interested in the things he likes. Adults who can spend easy time with him love his company. He finds things funny, usually the sounds of certain words. He loves to sing songs and recite rhymes. He is athletic, although I think his run looks funny. He is affectionate, at least to me, though not as much to his father. People find his unique personality refreshing. His psychologist described him as having "strong social skills", and I can see why, because the psychologist is an adult.

So, I don't know what you see when you read this, but his psychologist described him as a"completely normal two-year-old boy", and also made comparisons between toddler girls and toddler boys. Am I completely missing the point?? I adore my child, but I don't think he is a "completely normal" person. And I don't mean that in a negative way. My son is very special and different and I want to raise him in a way that will capitalize on those differences rather than in a way that teaches him that his differences are a barrier to being healthy and happy. He is very sensitive and I think he is beginning to be able to tell that the way he is confuses and frustrates people, and that is painful for me to watch as a parent. I am at fault for that, as well- there are behaviors he has that seriously frustrate me (the body slamming, for one). If I could learn more about where these thing are coming from and what they feel like to him inside his body and mind, I could learn a better way to parent. I'm very dedicated to him, but it is hard to shepherd a person who doesn't seem to work the same way you do. I told the psychologist all this in the email I sent as I thought he'd be able to hear my need for help, but like I said, no reply all week. Which is why I'm turning to you. What do you think? And should I find a new psychologist, or do you think our current guy was right?

Thanks so much in advance, I know this was a terribly long one.

I was thinking and thought I would include this exchange for context. He has these insighful moments here and there: We have always struggled with taking him to church, and so we've been trying lately just to go at the end to try to have it end on a positive note rather than taking him out. We've still had to take him out- even with snacks, books, and occasionally the phone. He said to us last week after leaving, "Sad, Daddy." When my husband asked why, our son said, "Church. Behavior." We were shocked, and it was hard to hear. We know him well enough to know what that meant- "I'm sad because at church I get in trouble for my behavior." So we talked to him about how we know church is hard for him, and that we have been trying to find ways to make it easier for him, and that we don't want him to be sad. He said, "Want to go to church, Mama." So there's the rest of the information- he wants to go to church, but it makes him sad because it doesn't work out for him. What I want to emphasize here is that the diagnosis that "all of his behaviors are just to get a reaction from you" doesn't make sense to me. My kid wants to be successful and feel good. He's basically communicated that to us. So ignoring whatever his behaviors are trying to tell, to avoid "showing a reaction", is the opposite of what I feel I should be doing. And my in-laws saying that he's just "king of the house" and that he needs to be spanked is just as ridiculous- that will only make him feel more disconnected than he already does.

I wish I had more information for you, but if nothing more I do think you need a second opinion.

I'm no expert in how behaviours display in young boys, but I would personally be thinking the same as you here.

I can say that I know a lot of children roughly his age, and this is not typical behaviour. In fact, I only know of one child that even remotely stands out from the crowd, and he is a boy the same age as your son. He cannot follow instructions, pushes and bites other children, and doesn't seem to do it out of malice. It seems that he simply can't help himself. He's particularly attached to my daughter because she's the only other toddler that isn't terrified of him, and as a result she's the one he targets the most. He likes her, so he will literally run across the room to push her over or hit her, then hug her, then tackle her to the floor and hit her again. I've explained to her that it's just his way of being affectionate and friendly, he doesn't mean to hurt her and he just says hello in a different way to most. She gets that, and when he goes over to bite or hit her, she remains calm and doesn't react to it, then gives him a hug or comes to me calmly if she's feeling like she can't quite handle him at that time. This child's behaviour is just one aspect of the many that you've listed - as far as I know, he doesn't have a long list of things that make him different, he's just incapable of listening/following instruction and being around people without getting 'violent', but even still it is INCREDIBLY clear that what he does is not typical. The other kids avoid him, parents are uncomfortable around him, his own parents are struggling to know how to react to his behaviour and have any control over it, and I know he's certainly getting the reputation of being spoiled but I can see that it's not intentional - you can just tell from looking at him, that this isn't bad behaviour for the sake of being rebellious.

If his behaviour is relatively mild compared to your son's, and is already affecting him and how everyone else treats him (and I suspect it'll only get worse as he grows up), then I truly believe that your son needs more done for him ASAP.

Life isn't easy on 'different' kids. And yes, there are 'different kids' who are neurotypical and do not need or warrant any kind of diagnosis, but from what you are saying there are so many behaviours that will negatively impact your son's life and will deserve some kind of support.

I don't believe that your son's behaviour is typical. I do believe (as a mum of a toddler myself) that you know him better than anyone and that if alarm bells are ringing for you to this extent then something needs to be looked into more thoroughly.

Good luck to you with whatever your next step is.

You probably know as much as anyone what your son exhibits.

No apparent delay in speech. Various displays of anxiety and obsessive compulsions. Some obvious sensory sensitivities. Maybe minor anger. Preferred association with primary caretaker.

These examples might be because your son is 28 months of age. But, they might also be part of a set of autistic behaviors and characteristics; especially when we include his choice of solitude instead of playmates, his expressed descriptions of anxiety, his possible hyperlexic speech and pronunciation patterns, his lack of reciprocity in conversations, his singular focus on his side of a discussion, and his persistent and repetitive categorizing of toys.

These behaviors and characteristics appear to support the Autism Triad of Impairments (social impairment; verbal and non-verbal language impairment; and repetitive/stereotyped activities). It would seem to me that there is something that a diagnostician with experience in childhood autism should recognize.

I would pursue a second opinion from a diagnostician with experience in diagnosing childhood autism. But, the caveat with any childhood autism diagnosis is that it is easy to mistake a diagnosis when the child is too young to play a meaningful role in his own diagnosis (describing his behaviors, explaining context behind his characteristics, recognizing his actions).

Good luck.

I am going to say to go for a second opinion as well. It won't hurt anything. I would try to go through the county where you live and seek out the 0-3yr childhood developmental delay diagnostic team. They probably have more experience with these kinds of issues than a neurologist who is not comfortable acknowledging anything between classic autism and NTism. Also, it is free, so if you don't agree with what they say, at least it won't cost you anything It also gives you time to research private resources in your area. There is an alarming number of medical professionals who don't understand even the basic things about the autism spectrum.

Often there is a "wait and see" approach when the child does not have verbal/cognitive delay, but that is not what I am sensing is going on with your neurologist. He seems to be out and out denying the existence of these other types of autism.

If in doubt, seek a second opinion.

The difficult thing with milder autism at that age is that it can look similar to NT toddler behaviours, especially if one hasn't spent a lot of time with a child. Many of the more 'obvious' signs will only appear when the child reaches an age where children are expected to use more complex social communication.

Particularly as child development charts are over clusters of charts and a child of 28 months could have a delay putting them at a lower developmental band but that they might catch up by 4/5 years old. Or they may simply be towards the back end of the band. A lot of those behaviours aren't too far out for a two year old.

The charts we use at work for EYFS ("development matters" - http://www.foundationyears.org.uk/files/2012/03/Development-Matters-FINAL-PRINT-AMENDED.pdf) don't look for children interacting with other children ("confident to talk to other children when playing, and will communicate freely about home and community") until 30-50 months. Though the tail end for playing alongside others is 26 months. (For example, two children using the same sand pit but ignoring each other.)

Similarly, I would also expect at 28 month old to have 'single-channeled' attention which means that they can only focus on one thing unless attention is fully attained, for example using their name. Though, it would have to be something sufficiently interesting to change focus.

All that said, it doesn't mean that there isn't something different about your child just that it can be more easily masked, not yet possible to diagnose or simply in need of someone more experienced at differentiating the degree. Even if your second opinion comes back null, I would do watchful waiting and not be afraid to seek another evaluation at a later stage.

sarag,

I would agree that second opinion would be in order. There definitely seems to be a strong need for sensory regulation. I know prior to my sons diagnosis of ASD he had a diagnosis of SPD (Sensory Processing Disorder) and a lot of what he displayed is consistent with what you are describing in your own son. OT (Occupational Therapy) can help with better defining his sensory needs and then it can help develop a "sensory diet" for your child. Regardless of the NT diagnosis, or any other one that receive as a second opinion, based on what you have described SPD sounds like it might be a big factor.

My youngest (4yrs) is showing signs of being on the spectrum and we talked with my older sons therapist about a formal evaluation. She said that at that age what Dr's will do some time because of the young age is evaluate to rule things out or give a preliminary diagnosis with the intent of revisiting the evaluation process a year or so later to see how the child has progress, stayed the same, or even regressed.

I know at a young age it can be hard to differentiate what is age appropriate and what is not normal. It sounds like you are being pro-active, and that is fantastic. All the best with this process and I hope you find the answers you seek. Kind Regards. Shark

I haven't had time too read the whole post and responses, but I thought our experience might be helpful.

My son had a minor speech delay -- he put two words together at 25 months, then got stuck. At 30 months he was still only doing 2-3 word combinations. Our neighbor's daughter had gotten therapy for speech through Early Intervention, so I thought it was worth a try. The screeners came out to our house and did about half an hour of simple tests. They said his speech was not far enough behind to warrant further testing, but they were worried about some of the other behaviors they observed, so they referred him for an evaluation with the Early Intervention developmental psychologist.

The psychologist did the ADOS -- the gold standard test for diagnosing autism. She noted that he was extremely insistent about leaving the room, but told us he did not have autism. Case closed. We paid out of pocket for 7 months of private speech therapy, his speech seemed to catch up, end of story, right?

Wrong. At age 4 and 4.5 he was kicked out of two preschools. The second one recommended we call the school district for an IEP evaluation. We took him to a psychologist who told us, "It's not ADHD, and it's not autism, he just needs an extra year at home to mature." We decided to delay kindergarten to figure out what was going on. At age 5, we finally saw another developmental psychologist, who did the ADOS again and diagnosed him with Aspergers Syndrome. A year later, a developmental pediatrician added the ADHD label.

Long story short, a child who does not meet the autism criteria at 28 months may turn out to test autistic after all a few years later. The test has different modules for different ages, and the gap between the child and his same age peers may be more obvious then.

While reading your description I heard myself thinking "He is 2 years old, what do you expect?".
He certainly seems to have some sensory issues and behavioral problems but there is no need to suspect Asperger just jet. Kids his age are picky eaters and sensory seekers, don't listen to questions and answer "Yes" almost all the time or "No" almost all the time. They will also try to "eat" people. And generally misbehave. And do stuff over and over again. And set routines they will refuse to change. Because they are 2 years olds. That's the age. In our country the phase is called "Rebellion of a 2 years old", for English it would probably be "terrible twos".

All kids I know went through something like that, some more some less - around 2-3 year of age.
Just recently I had to tell my 3 year old Godsister to stop biting me because she constantly tried to "eat" the hand I was holding her with, but fortunatelly she is out of "No" stage now so she agreed when I explained I don't like it.
And my cousin(boy) at age 2 used to kick me a lot and say "No" when I was telling him to stop and he could watch Shrek 24/7.
The only exception is my cousins son, which I found utterly weird. He is just too obedient. It felt awkward when he was doing every single thing his parents or any other adult told him to - he was like a trained animal, not a 2 year old kid. But he on the other hand s the only kid with language delay I know. He is 3 year old now and still can only say stuff like "Aga bum-bum" (to drive with any aunt in a car he points at, or perhaps just to show it's a car - Aga is the name of one of his aunts but he uses this word to call it any woman except for his "mama" and "baba") - despite understanding pretty much everything.

Your boy might need some therapy if his sensory seeking behavior is so severe. His anger towards humans needs a look into too. - so look for a second opinion if they bother you.
But don't jump the Asperger diagnosis yet. Any 2 year old could fit autism criteria from the point of view of someone who has little experience with 2 year olds - because they do have communication difficulties, odd body language, get obsessive, use repetitive play, show adherence to routines and have a lot of sensory seeking behavior. Because that's how toddlers learn the world!
Let someone specializing in children his age take a look - they will be able to tell if and how different from norm your boy really is. It would be good to take him to a daycare, so people taking care of young kids can watch it play and interact for at elats a few hours. I don't know about daycares in your country but in Poland they evaluate kids and if they feel something isn't right they suggest taking the child to child psychiatrist.

I was sent to one at age 3 - because I just gave nursery caregivers a feeling "There is something wrong with her" (from what I know the first thing I did when entering daycare was making 6 kids fall down before caregivers realized what I am doing - it looked like I thought other kids are dolls - and after caregivers stopped me I went to toys, threw all of them on floor and started tiding up - by lining toys back on shelves, I didn't show any interest in other kids during all that time and I seemed unaware my mom is gone).
Child psychiatrist I was sent to said I am highly intelligent, my motor skills are within norm but my social development is delayed - but I will catch up because I am smart. Asperger wasn't a known diagnosis back then yet.

BTW. Take a look: https://www.zerotothree.org/resources/2 ... t-response Biting is a common toddler behavior.

Thanks so much for your input, everyone. I'm definitely hearing that the young age is a tricky thing. I suppose that is mostly what the problem is. We did do the ADOS, along with two other forms that I can't remember the names of; he was given a test that seemed to be a lot of logic puzzles, and then they began the speech evaluation but only got through a few questions before his behavior was too difficult to continue (they tried to do the the logic/cognitive test and the speech test back to back). I don't remember if I mentioned this, but there were a few other parts of conversations that stuck out to me but that I don't remember enough about the context/other important information to describe clearly. One thing I remember being frustrated by was the fact that, in every appointment until the diagnosis appointment, the psychologist often said things like, "There are a lot of red flags, but there are a lot of strengths, too", and "If you're worried about the diagnosis because you're worried he won't qualify for services, don't- he will get services", but then in the diagnosis appointment all he had to say (other than what I already told you) was, "The tests don't show autism. We recommend you take a ______ parenting class to learn some more positive parenting skills." The blank was something like Child-Led Initiative maybe. Perhaps some of you will have heard of it? The other thing I can't remember as well as I'd like is a rating scale for the level of severity they saw. I don't remember what the names of the categories were, just the levels. There was 0-7, 8-14, and 14+. My son, cumulatively between all their data, scored a 7. Can anyone give some perspective as to what that might have meant? Typically I would have retained more from the meeting, but it was a contentious meeting and I was pretty upset, and that was something they said in passing and didn't address directly.

One of the things I remember being most frustrated about was the psychologist saying to me before I left, "You know, my daughter bit someone on the playground yesterday. Toddlers do these things." I think what people in our life aren't hearing us saying is that we understand as much as anyone who has siblings/cousins/nieces and nephews/children of their own does about the basics of toddler behaviors. For us, the difference is the frequency, intensity, and specificity of the environments when the problems occur. At home, our son is happy, but not "content"- ever- he displays strange obsessive habits, goes around looking for things/people to chew on or bounce off of, and doesn't "play"- in fact, rather than being all that different from what the last poster said about her own behaviors with toys (I realize she would arrange them, but), our son also mostly dumps his toys out and goes around taking our adult things down and apart (which personally is a behavior I see in most one-year-olds, not 2+). (He lines things up, but doesn't put them away/clean up.) That feels "different" to us. In public, our son is for the most part anxious, aggressive toward people who walk past us, and consistently makes strange, loud stress noises, unless it is the most ideal of situations that involve no waiting, plenty of distraction, our entire attention, and absolutely no attention from strangers (even being looked at)- how often can that scenario happen when running errands or meeting up with other moms? All that feels "different". Consistently when around other children, he either avoids them and wants them nowhere near him, or if he can't get away from them, follows them around touching and hurting them. The only scenario that seems to work okay is if he is with one other child and that child is independent themselves and doesn't seek him out much, and even still he will obsess over wanting to bite/eat parts of their body. This all feels "different". There is a reason he was put into Food Therapy- not by us, but by his doctors. Because they see kids all day, and this one's palate and preferences seemed too concerning for them to not do anything. That means they see something "different". So you see, we feel like yes, of course all toddlers exhibit this stuff, but with this frequency and intensity? We, personally, have not ever experienced that. Yes, he is our first child, and the first male grandchild; however, our parents are parents of 5 and 3, and grandparents of combined 4 girls and 2 boys (my nephew is only a month old and so we can't really compare other than he is an "easy" baby, whereas my son was considered amazingly difficult by our family members as an infant). The only difference is the divided opinion, which is what we tend to experience with anyone who we are close enough with to talk to about our concerns- the in-laws think he is spoiled, the great-grandparents who rarely see him think he is just fine, and my own parents believe there is something going on with him. So, I don't know. Things don't feel right, but who knows.

I guess time should tell more?

As for biting, I actually have read a lot about it. I totally agree that it is a reflection of not being able to effectively express himself, feeling overwhelmed, sensory-seeking, and hyperactivity. Again, the question I have is this: if he is biting/eating things (not food) and people to the degree that he is all day long, what does that mean about the amount of complicated feelings inside him, and is it "normal" for a child this age to have so many of those feelings so often?

I don’t know much about autism-related anger (except my own), but there are anecdotal reports about nonverbal autists who act in anger because, while they have average or above-average intelligence, they have no way to express themselves. After many of them received and started using an Augmentative and Alternative Communication (AAC) device, they became much calmer because they could then interact with their world. This is an example of probably many potential deficits which would cause angry behaviors and characteristics in autists, especially those who are young children. So, is it normal to be so angry? As an adult, I can only imagine what it would have been like to not have the skills to interact calmly with others. Perhaps, I, too, would have resorted to bad behaviors simply to express myself and hope for any attention, even negative attention, in return.

Makes total sense. And while my son is not non-verbal, whatever is happening inside himself that is causing some of these behaviors is exactly what I want to help him with. I just don't know how at the moment because I don't know what the underlying issue is. I suppose this is a universal problem with toddlers in general, it's just that mine seems so much more discontent in all these ways than most, at least in my opinion.

I know that you've had conflicting opinions even here.

I'm one of those that understood that this was about the frequency/intensity and didn't feel it was normal behaviour, based on everything you said, and (again) with lots of experience of children that age.

My concern with 'time will tell' is that this says 'we'll give up for now', when it sounds like you have a child that is struggling and that things are difficult for you. How long will you put it off? When do you decide it's still not normal enough behaviour?

Personally, I think a second opinion is the right way to go. You sound like this behaviour needs some extra support of some kind.

If a second opinion from an entirely separate party also agrees that he does not need additional support, then you can wait and see, but when so far you've only had one opinion and it's been from someone that doesn't seem to care that you, as his parent, really believe that something isn't right and have a long list of reasons why, I wouldn't say that's strong enough to use as a reason to give up.

Good point. It's hard. I get conflicting opinions from everywhere, and it's been from such an array of people who all have a perspective worth hearing from: doctors, parents, grandparents, teachers, and now even people who have an ASD condition or are the caretaker of one. You're right to point out that most people on here have encouraged a second opinion. And I suppose if the point of me being on here is to express that I feel we all need help (my husband and me, and our son) and to gauge whether others agree, then waiting it out is the opposite of that, isn't it?

To me, your son seems more aggressive than normal, which seems the biggest problem or is going to the biggest problem as he interacts more and more with other children in coming years.

I didn't get much asperger from your description, mostly the aggression stuck out in a socially-oriented, non-asperger way.

I think you should wait some time to see if he gets over this phase and maybe consult a professional about the aggression if it doesn't decrease over time.