When you say, "autism was ruled out," do you mean that the evaluator said, "This kid definitely does not appear to be on the autism spectrum at all?" or that autism / Asperger's / PDD-NOS was listed as a rule-out diagnosis (often written "R/O"). That second meaning is actually the *opposite* of the first -- "I think this child may very well be on the spectrum but it's really hard to tell right now." From a developmental-milestones and social-interaction perspective, you're describing a kid where a lot of folks would be likely to use "rule out PDD" in the sense of, "I think there's a problem here but I'm not quite ready to make the diagnosis yet."
It's really quite difficult to be certain of a PDD diagnosis in a GT 4yo, either to say for sure, "Yes, this kid is definitely on the spectrum," or "No, this kid is quirky but is definitely not on the spectrum." Hence the use of a rule-out -- it's a way to tell another professional down the line that this professional was concerned about this possibility.
