
evaluation and treatment planning
for autistic children
infantile autism is considered to be a re-
action on the part of an immature organism
at a primitive and undifferentiated stage of
ego development.  little choice of defensive
reactions is available; the possibility of sub-
limation does not exist and, even though
other object relationships are gradually
developing, the mother is still the child's
primary object.  at this vulnerable develop-
mental stage, a wide range of pathological
circumstances, ranging from the most severe
family psychopathology to the most adventi-
tious physiological traumata or the most un-
fortunately malignant circumstances, may
constitute an acute or cumulative cata-
strophic stress.  the primitive organism
tends to respond to this overwhelming stress
with a paranoid reaction which is directed at
the mother (regardless of the actual etiologi-
cal variables) because the mother is still the
child's primary object.  we believe that the
child then responds with an autistic reaction
and shows varying degrees of simple with-
drawal, obsessional behavior, magical or de-
lusional thought processes, and consequent
disruption of developmental skills, speech,
and relationships with others.
many families can and do make every
effort to counter the paranoid reaction of the
child and do not respond to his rejection with
counterrejection and counterwithdrawal.
some of the child's autistic symptoms may
abate without formal treatment.  yet, since
the mother (and family) are the primary
objects of the child's paranoid attitude, it is
felt that formal therapeutic intervention is
necessary to modify the paranoid core of
the autistic reaction.
