The boy is 5 years old. When someone speaks to him, he turns his head away, and sometimes he mumbles unintelligibly. He dislikes sounds and does not communicate. In addition, he cannot relate to others and avoids looking anyone in the eye. He cannot use the toilet nor feed himself, and he actively resists others touching him. He often engages in routine manipulative activities, such as dropping an object, picking it up, and dropping it again. He repetitively plays with the same toys for months, lining items in rows; collecting objects such as bottle tops; and insisting on having two of all items, one in each hand. He shows a pathological need for sameness. While seated, he often rocks back and forth in a rhythmic motion for hours. Any change in routine greatly upsets him.
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