premature diagnosis for a 20 month old?

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I think it's too early to tell if he has an ASD at that age. For some toddlers it's so obvious at that age because they are so severe. Those who are milder or on the mild end, it will be impossible to tell because every toddler shows some signs and each toddler develops at their own pace and they grow out of their autistic characteristics because it's normal at that age.

Each doctor is going to have their own opinion so one doctor may say ASD while the other will disagree with that diagnoses. If many doctors don't think he has an ASD, you can safely say your kid doesn't have one. Just stick with what many doctors say and if the majority think he doesn't have autism, go with that.

It's true: a "normal" 2-year-old can seem "autistic" to an outside observer.

They play repetitively, they react adversely to change, they throw temper tantrums for seemingly no reason, they don't relate well to peers, they spin around....etc.

He actually exhibits none of those signs (at 20.5 months)... which is one of the reasons we were so confused by the way he laid it out there. It wasn't even a "I think we should monitor the situation" type deal - he seemed pretty confident.

We're going to get a third opinion, and fortunately we have a family member who is a pediatrician who we'll be seeing soon to spend a bit more time with him. I also have two family members who work with special needs children (one with 30 years of experience) and they don't seem to think he exhibits the signs either but are admittedly not specialists in diagnosis.

A bit of a follow up to anyone interested,

We talked to a family friend who is a pediatrician who said that nothing seemed unusual. Fast forward to 24 months and his expressive language caught up to the "normal" benchmarks (whereas previously it was a little behind), and now at 28 months he's speaking in 6-8 word sentences and has a vocabulary of more than 500 words. He's friendly with other children, plays tag, shares toys etc. Temper tantrums are infrequent. Doesn't spin anything, isn't obsessive about anything... only issue is clenching when excited.


We've heard from two sources that this guy has a reputation for making very liberal autism diagnoses. I get that it's good to err on the side of caution, but these types of things can really turn peoples lives upside down.

Great!

It seems your child is a perfect example of the infamous overdiagnosis of ASD.
Having just a few autistic traits like, say, a bit more intense interests, is within natural, healthy diversity of human minds.
The problem starts when autistic traits are so intense that they impair functioning - not earlier.

Enjoy your family life