Family and medical histories, autistic and dysmorphic features, and neurological status of 5 children with autism and hyperlexia and 5 sex and IQ-matched children with autism and no hyperlexia were compared. Results showed that the children with hyperlexia displayed more persistent echolalia, superior visual motor performance, and more favorable response to vestibular stimulation. These children performed better than did their matched controls in the physical and neurological assessment. Two of these children, one of whom had a sibling with hyperlexia, presented with macrocephaly. Both groups had a similar incidence of dysmorphic features, computerized tomographic and EEG abnormalities, and family morbidity. Results suggest that children with autism and hyperlexia probably represent part of the continuum of autism rather than a specific syndrome.