This paper proposes that psychoanalytic psychotherapy can be a helpful form of treatment for certain autistic children. Some of the misconceptions surrounding this kind of treatment are discussed. The literature identifying a particular sub-group of autistic children is then reviewed and the characteristics of this group, and the relationship of their difficulties to early trauma, are described. Using clinical material from work with a child who probably fell within this sub-group, and who had very marked autistic features, the paper illustrates the importance of the therapist taking an active role in the therapy and how this helped the child to emerge from his withdrawn state. Particular emphasis is placed on the importance of introducing themes of aggression, and of this being done in a playful way. The impact of trauma on children's development, with particular reference to the acquisition of language, is considered. The role of sibling rivalry as a factor is emphasised.