1, DEFINITIONS AND CHARACTERISTICS 7 TABLE 1.2 DSM-IV Diagnostic Criteria for Autistic Disorder A. Atoul of sx (or more) items from (1), (2), and (3), with at leas two from (1), and one each from (2) and (3) (1) Qualitative impairmentin social interaction, as manifested by at least wo of the following (a) Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facal expression, body postures, and gestures to regulate socal interaction (b) Failure to develop peer relationships appropriate 19 developmental level (c) A lack ofspontaneous secking to share enjoyment, interests, or achievements with, other people (e.g., bya lack af showing, bringing, or pointing out objects of interest) (4) Lack of social or emotional reciprocity (2) Quatitauve impai ‘couumunicaton, as manifested byat leas ewo of the following (2) Dekay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as © or mime) juals with adequate speech, inarked impairment in the ability o initiate or sustain a conversation with others {c) Stereotyped and repetitive use of language or idiosyncratic language (4) Lack of varied spontaneous make-believe play or social imitative play appropriate 10 developmental level (8) Rewricted repetitive and stereotyped patterns of behavior, interests, and activities at manifested by at least one of the following (a) Encompassing preoccupation with one or more stereotyped and restricced patterns ‘of interest that are abnormal either in intensity or in focus (b) Apparently inflexible adherence to specific nonfunctional routines or rituals (] Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements) (4) Persistent preoccupation with parts of objects 1B, Delajs or abnormal functioning in atleast ane of the following areas, with onset prior to age 3 years: (a) social interaction, (b) language as used in social communication, or (©) symbolic or imaginative play . Disturbance is not better accounted for by Ret's disorder or by childhood disintegrative disorder