o features, autistic aloneness and an obsessive insistence on sameness. Autistic aloneness is characterized by the child's state of mental separation from others. Obsessive insistence on sameness is a "densely formulated concept [suggesting] several factors at once: repetitiveness, rigidity, single-mindedness, pedantry, and inability to judge the significance of subtle differences" (Frith, 1989, p. 11).
The DSM-IV (1994) outlines a series of criteria for the formal diagnosis of autistic disorder. The first set of criteria, of which the patient must exhibit at least two, outlines impairments in the individual's social interactions. These include the absence of most of the complex nonverbal behaviors that individuals use to communicate and regulate social interaction (such as facial expressions and direct eye contact), the failure to develop age-appropriate peer relationships or even to demonstrate an understanding of social conventions, an absence of spontaneous sharing of interests and enjoyment with others, and an impaired awareness of the needs and feelings of others.
From the second set of criteria, communication impairments, the child must exhibit at least one symptom. These include impaired communications skills, either verbal or nonverbal, impaired conversational skills, unusual use of language, and an absence of imitative behavior appropriate to the individual's age and level of development. Autistic individuals often use unusual speech patterns or strange intonations, or they speak at an abnormal rate. They may employ immature grammar patterns and appear unable to understand questions, directions, or jokes.
From the third set of criteria, restrictions in behavior, interests, and activities, the patient must also exhibit at least one symptom. These include an abnormal intensity in or focus on specialized patterns of interest, an inflexible adherence to specific routines, repetitive motor mannerisms, and a pre...