We're dealing with the fine line as well. Two boys, DS4.5 PDD-NOS and DS3 High functioning Autism. I am more and more convinced that DS4.5 is NOT on the spectrum. At this point his only issues are sensory processing related (I had to deal with that all my childhood and still do), being overly sensitive at times and fighting boredom. A lot of things he used to do (rituals, etc.) went away as he learned to cope better. But we now have this diagnosis that the school is going by (unfortunately that is what we originally wanted :() and the school (special ed preschool class) is dead set on trying to correct something that in my mind does not need correcting. He's extremely verbal and always asking questions and always explaining something or talking to himself because he doesn't have anyone else to talk to and always wanting to answer all the teacher's questions. And the school sees it as an issues and possibly might be recommending him to be held back from K in the fall and attend pre-school again. The teacher is very nice but she's so busy trying to teach the other 9 kids to count to 10 that she doesn't see how under challenged DS4.5 is. She never in those 4 months he's been there realized how much of what she says he is taking in (pretty much all of it). And there are things she's said the he now understands are the law because he's teacher said that and we're working hard at home to reverse that. We had a parent teacher conference last week where I mentioned some of the issues that arose from this and the OT (who seems to get him!) suggested to the teacher to have a normal "adult" conversation with him because that's how you need to speak with him and explain again the things we're having issues with. The preschool has been great in terms of getting him be with age peers but that's about it. Everything else has been a fail. His teacher has absolutely no idea what he actually knows academically, which means there is no way she could ever even try to accommodate him in the slightest possible way. Apparently his biggest problem at school is that it takes him 15 minutes to take off his coat in the morning because he's too busy thinking out loud and because of that misses the first part of their table time! lol ... NOT an issue at home. I explained to him a little while ago that if he stops talking, he can get things done a lot faster. So when he gets home, it's coat and shoes off first and THEN he can tell me all about his day

. But back to the "fine line" ... as soon as I mention getting more challenge for him (in my emails to the teacher or at the conference), it always comes down to them wanting to work on his "areas of weakness" and not one suggestion that would solve the boredom issue. His IEP is for speech with OT consult. Meaning he gets ST at school once a week and the OT just sits there with him and some other kids and just oversees their behavior. He has NOT needed any speech therapy in well over a year. If anything, he needs OT for fine motor skills. But his diagnoses called for ST and that's what he's getting. Because of this and because of health issues (allergies and being sick all the time), we'll be most likely homeschooling K and possibly 1st grade. In the meanwhile I am planning on getting him tested to see where he's at. We are pretty sure he is gifted just not sure where exactly on the scale. But as for the PDD-NOS diagnosis, I am 99% sure he does NOT have it.
DS3 is very different from his older brother. Most likely more gifted than his brother (doing most things 1.5-2 years ahead of his advanced brother) but he is also the one with more issues and for him the High Functioning Autism diagnosis will probably last, though for reasons other than what the evaluators initially saw in him. But we won't know for sure until he's fully verbal. At this point he acts autistic one day and "almost normal" the next day. I am saying "almost normal" because he doesn't do very many age-appropriate things so it's hard to call his behavior normal. But because of these switches in behavior, it really is a fine line as well. And once again, EVERYONE concentrates on his diagnosis and NOBODY pays any attention to the needs that his brain has even though a lot of the autistic behavior seems to be coming from his brain working so hard wanting to learn more.