Is this just autism? Or more?

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I'm a mom of a 14 year old boy diagnosed with ASD and AD/HD. He's always kept to himself and never spoke about his feelings or experiences. When I would ask him a question he would just shrug his shoulders and say, "I don't know". Recently he's been opening up to me. And the things he is saying is startling. I'm so confused about his diagnosis because yes I see autism is there, but at the same time I don't... and I also see something else entirely. But I don't know what is going on in his head or how to help him because I can't feel his emotions or thoughts. Here is what I do know, and if anyone can relate please respond..
1. Definite social skills problems, but only at times. It's like he can turn it on or off.
2. He is able to read body language and facial expressions. He understands theory of mind. And he's sensitive to energy. He can especially feel what I'm feeling... and at times it's nothing but worry. I don't want him knowing that but somehow he does...
3. Extremely picky eater. Only wants carbs and fried food. It's to a point he's in serious physical trouble.
This is where things get worrisome for me......
1. He has extreme paranoia. He is afraid to drink out of the water fountain at school because he doesn't trust the water supply. He believes that trying new foods (because we've been trying in ABA therapy) will poison him. He doesn't trust others intentions and sometimes believes even me is out to get him in some way.
2. He hears a VOICE in his head talking to him. But apparently, from what he says, it's been there as long as he can remember. He has an excellent memory, and he remembers exactly how old he was when he started talking (it was 4 and a half) and he said the voice was there from the beginning. It's a "good" voice, we call it his conscience so he isn't afraid to talk about it. He will shut down if he feels something about what he said is abnormal.
3. He is emotionally flat. His eyes change sometimes. He looks at me with a weird expression with dead, lifeless, eyes. I hate to say that about my son, but it's true. Sometimes it's like he turns into someone else. But only briefly.
4. He wants to know what it's like to kill animals, but not pets.
5. He thinks he's insane. Literally. He said that. For years he said, "something is wrong with me mentally and I don't know what it is". Typing that makes me cry...
6. I believe he hallucinates. I've heard him talking on the playstation network telling kids about a pony with multi colored hair standing in his room. He tells me it was his imagination that made it real.
7. He's completely aware while he's asleep. He is able to wake himself up out of dreams because they scare him. He literally is conscious of his dreams while they are happening. He also dreams about the same things constantly, and believes that he lives two lives. One here, and one while his physical body is sleeping.
-he has an above average IQ and is musically talented. He's gifted and talented and loved more than he'll ever know. I just need to know...... is this something else other than autism?

Am not a shrink. But yes, that sounds like a lot more than autism and ADHD.

To be blunt its sounds like his own assessment of himself is right: that he is kinda insane( ie psychotic). Get him checked out again.

Again, not a shrink but visual and auditory hallucinations are not ASD/ ADHD symptoms.

An emotionless 'flat affect' is associated with ASD but also with other psychological conditions such as schizophrenia. Same goes for magical beliefs and confusing fantasy and reality.

Social symptoms can vary to the extent that some days a person might find it easier to socialise compared to others for a number of reasons .

You can be able to interpret body language, facial expressions, and understand ToM and still be on the spectrum.

Some of the paranoia could be OCD which is a common ASD comorbid but it could also be related to the other psychotic symptoms you've described.

Definitely seek a clinical opinion asap.

Sounds like evidence of OCD and schizophrenia. Some people with OCD get thoughts in their heads about killing.

I read that ASD and schizophrenia have some overlapping symptoms (including little facial expression) and can co occur or are linked in some way, autism also used to be lumped under schizophrenia way back when. But yeah hallucinations are not part of autism, but also can be caused by other things.

I feel very much like your boy...
Before I was diagnosed with asperger's I was told that I have mild schizophrenia and/or schizotypal personality disorder for exactly the same symptoms you were describing. Hallucination, sleep awareness and lucid dreams, voices talking in my head, images of killing things, severe picky eating, paranoid thoughts and actions, sensitivity to energy etc. Later by another doctor the diagnosis changed into severe obsessive compulsive disorder. I don't know which one is true (and the doctor also says he still can't be sure and it's more important to treat them than to name them) But since i'm on antidepressants many of the symptoms have decreased, especially the delusions and the paranoid and obsessive thoughts.

In certain cultures he would be taken out of the community and be trained to become a shaman, a highly respected individual.
We have learnt to dismiss these kind of beliefs, sadly enough.

Maybe get him tested for epilepsy?

I have autism but never any illusions or visions that aren't there. So I think it's more than just autism that's with your son.

Agree with others that you should get him evaluated for schizophrenia. Paranoia and hallucinations (especially hearing voices) are typical symptoms of that. My understanding is that teens and twenties is when that tends to start manifesting, or at least when it gets diagnosed.

My guess is a likely misdiagnosis.