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Sociocultural influences are seen as pre‐eminent in the development of community child psychiatry, with special emphasis given to issues of social reform, race and poverty. Current status of the field is discussed within the framework of a typology that identifies programs as being clinically‐adapted, socially‐adapted, or community‐adapted.

Ordinal diagnostic criteria were developed and used to assess the clinical characteristics of 20 autistic children. Subgroups of autistic children were identified and, on the basis of rankings on behavioral measures and performance on standardized tests and indices of school achievement, found to differ with respect to general level of functioning and educational placement. Developmental changes, expected in autistic children over a 12•year period, were reflected in higher rankings, especially for those in less restricted educational placements. Although the ordinal classification of autistic behavior is preliminary and the present results are based on the observation of only 20 children, the inclusion of ordinal criteria was found to promote high levels of diagnostic agreement among therapists and to facilitate the clinical monitoring of autistic children. Beginning with the observations of Kanner (1943) and including the classification schemes of DSM I through DSM Ill-R, the autism diagnosis has been defined dichotomously through the presence or absence of symptoms. Autism, within the first and second DSM editions, was categorized as concurrent with childhood schizophrenia. Significant improvements have since been made in diagnostic criteria, and, in the DSM Ill-R, autism is now classified under the general rubric of pervasive developmental disorder (PDD). Fifty years of clinical research and practice have added substantially to the identification of salient symptomatology and behavioral indicators, relevant family history, and the course and prognosis of autism (Dahl, Cohen,