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Two clinically and dynamically distinct groups of childhood psychoses are described. Intrinsic factors predisposing to arrested ego-development are considered to be the main determinants, and defective maternal attitudes, while contributory in some cases, are far from invariable. Autistic children are described who seem incapable from the outset of responding with special feeling and awareness to the mother as an outside person. She remains as a part object without specific value. This autism would seem to be based on an inherently defective tension-regulating apparatus in the child which heightens the need to ward off stimulation in a negative hallucinatory fashion and to a degree which can be almost completely destructive of contact. In contrast the symbiotic type has an inherent need to maintain the earliest narcissistic relationship with the mother, in the form of a delusional parasitic fusion with the mother image. The course of ego development is typical for each type. The psychobiological rapport between nursing mother and baby normally results in a progressive displacement of the child's libido from awareness of its own organic states, to a differentiated sensory awareness of the outer world. Through contact with the mother's body, the child effects a differentiation of its own body image which is the core of its ego-development. This development sequence precedes the critical step in the growth of the sense of reality when the mother is finally left outside the omnipotent orbit of the child's self. In the autistic type, ego-development tends to be arrested at the stage of awareness of inner organic states, and awareness of the body surfaces as well as of outer reality is partial and defective. The synthetic functions therefore achieve only minimal development and instinctual forces persist mainly in unneutralized forms. In symbiotic psychosis on the other hand, where there is an inordinate need for parasitic fusion with the mother, her mental re