I agree with you that ADOS is the best test that exists, what I was diasagreeing with is the fact that once diagnosed by ADOS means always diagnosed.
I think ASD can be divided unevenly into groups. One would be a broad group with some deep genetic involvement - CNVs in nuclear DNA, mitochondrial issues etc, when recovery from ASD is as likely as from Down syndrome. Another group is when the ASD is a result of some epigenetic problem during prenatal or perinatal stage of development, that introduces a delay in the development rather than a permanent impairment. All environmental causes, maternal causes, immune disorders, prematurity etc would fall here.
I know for a fact what caused my son's delays. I have PCOS and very very likely had high fetal testosterone levels, that have been shown to produce some autistic traits, lateralization changes (hyperlexia?) and speech delays. Yet, the exposure to FT was limited (only nine months) and given child's brain plasticity, was reversible through intense postnatal therapies, life experiences etc. Was it not a real ASD then if it can be reversed? If a child can recover from a brain trauma, why can't we accept that a child like mine can recover from ASD?
He may not have a typical outcome, but there are hundreds of boys like him. Whether you call this hyperlexia III or PDD-NOS or something else, it is certain to me after dealing with this firsthand, that with a lot of effort, ASD presentation can change over time and no test given at the age of 2.5 can accurately predict where the child will be at age of 16. It is true for all intelligence tests and it is true for ADOS.
