Early diagnosis and interventions are the standard in the field of Autism Spectrum Disorders, however ascertainment of these diagnoses is unreliable, in a large minority of high functioning cases given the ambiguity of diagnostic criteria of the Pervasive Developmental Disorders; Not Otherwise Specified, and the lack of clear boundaries with other developmental disorders. A “Difficult to Diagnose” clinic was developed 6 years ago to rapidly develop a consensual diagnosis to expedite treatment. The factors that cause diagnostic confusion will be outlined and a brief observational tool adapted from the Children's Autism Scale for Children will be described utilizing a videotaped presentation. The clinical diagnosis was compared to the “gold standard”, the previously validated Autism Diagnostic Observational Scale (ADOS). To bypass long waiting lists for interventions and provide immediate direction to help parents stimulate social engagement, a brief intervention called “Let's Get Started” was developed and will be described.

The consensual clinical diagnoses of two physicians and the findings on the ADOS will be correlated.

The ADOS does not consistently diagnose the “Difficult to Diagnose” children. By utilizing a collaborative clinical method focusing on the child's social interactive skills, the child on the Autism Spectrum can be differentiated from other developmental disorders. Those on the Autism Spectrum can receive a social interactive training program administered by their parents, who have been trained in the “Let's Get Started” program, taught to them when they felt most helpless and disempowered, and in mourning after being given the diagnosis of Autism.