DS *might* eventually get diagnosed with this. Before he turned three (and over the last five months) he had three complete evaluations. So far he has "no diagnosis" from our local regional center, developmental delay (primarily based on his prematurity) through the school district, and PDD-NOS (somewhat provisional, the diagnosing psych was on the fence and wanted to wait a few more years, but went ahead and gave it to him so our insurance would cover ST and OT for him). The consistent agreement between all three evaluations is that he isn't using language functionally the way he should. His receptive language is 97th percentile and his expressive language is 50th percentile. But, he doesn't seem to intuit HOW to use language to interact with others. It's a frustrating puzzle. He doesn't seem to fit the criteria for ASD (no stereotypic movements or special interests, little rigidity, seeks out interaction with others, etc), but his ability to use language functionally is delayed.
His play skills appear to be emerging on time according to his pre-school teachers (he's in an inclusion pre-school and play skills with peers are what they primarily focus on). He's pretty firmly in the parallel play developmental stage (they say he pays a lot of attention to what his peers are doing) and collaborative play skills are starting to emerge - which is still in the typical development range for a young three. The teachers in his district inclusion pre-school are very aware of ASD in pre-schoolers and they aren't seeing typical signs of a child on the spectrum other than possibly his difficulty using language functionally. It's difficult to tell whether this is a developmental delay and that it will come in eventually or if it is a true language disorder that he will continually need support with.
I hoped to have an answer by now - is it autism or isn't it? But, we're still in a wait and see. I guess the new social communication delay is a possibility, but most of the therapy for it seems to be similar to therapy for autism spectrum disorders. All three evaluations we've had gave recommendations that he should NOT be in an autism class room or have any of the ABA therapy protocols. Other than supporting him in a class room setting with communication with typically developing peers, what can be done to help him at age 3?