I too find these behaviors a little "off". I have had MANY kids come through my door that seem to have delays, issues, or down right ODD behaviors. I have racked my brains over questions of delay, learning disabilities, autism or other syndromes. Some of the kids have grown out of the funny habits/quirks and some still behave strangely at the age of 4 and 5. I do think that any diagnosis is tricky to say the least....especially something like autism because there can be such a variance on the "spectrum".....I had a child I took care of from 1 year to 5 and he is off to school now, intelligent and seems to get along well enough with others around him (making for a normal enough life)...but I have always questioned a slight issue, strange behavior over the years, repetitive movements, uncontrolled emotions, (he was the puker...one day just decided to puke every day at lunch all over the table) That to me is far from normal......somethin g def off in that little brain! can he function well enough to make it through life? YES! will he at times be the outcast in school and other social functions? definately! if his parents had brought him in to be tested, I gaurentee they would find something....would it help? maybe. This is just one of many kids I have questioned over the years....are the parents on board with your concerns or are any comments falling on deaf ears? If she is in danger, I would say or do something, if she just seems "off"? take note of her "off" behaviors and have them on hand for future ref but other than that, just provide quality care. That's about all you can do.