A blinded comparison of parental and clinical observations of the behavior of 26 autistic children (23 boys and 3 girls) younger than age 48 months is reported from the Vanderbilt University School of Medicine, Nashville, TN, and The Children’s Mercy Hospital, Kansas City. Five most prevalent behavioral characteristics both reported by parents and observed by clinicians were as follows: 1) abnormal social play (eg. nonparticipation in peekaboo and itsy bitsy spider games); 2) lack of awareness of others (eg. noninteraction); 3) impaired imitation (eg. wave goodbye, patty-cake); 4) deficient nonverbal communication (eg. absent social smile or eye contact); and 5) absent imaginative play (eg. pretend games). Autistic behaviors rarely endorsed by parents and clinicians included: abnormal comfort seeking, abnormal speech, distress over change, and insistence on sameness and routines. Parents were more likely than clinicians to report absence of imaginative play and presence of stereotyped movements. 
COMMENT. Improved awareness of early signs of autism should help physicians recognize and refer patients for specialized intervention. Parents are better judges of a child’s imaginative play and peer friendships, whereas physicians may be more objective about a child’s social awareness, interactive play, imitation skills, and nonverbal communication.
Decreased plasma concentrations of the C4B complement protein are reported in a group of 42 autistic subjects examined at the Center for Persons with Disabilities and Department of Biology, Utah State University, Logan, UT.