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Six children were studied, ranging in age from 22 to 39 months. All belonged to the autistic or symbiotic types of deviant (Mahler), and showed gross disturbance in human contact and absence or near-absence of speech, with general features which had led to a diagnosis of mental defect. Two features of their test performance are used as corroborative evidence for Mahler's formulations and for advancing suggestions for early diagnostic criteria of the symbiotic type.
All children of both types achieved age-adequate or superior performance on form board items. All moreover showed poor imitation of the examiner in tests where the imitation of drawings, vocal sounds, and movements was a feature. The poor imitation of these children is said to reflect the tenuous nature of their object relations, and the insufficient differentiation of the self from the not-self. In imitation the transformation of the self is carried out according to an image of the object and appears to be a part process of identification. Mahler stresses that these children have difficulty in cathecting the periphery of the organism with consequent defect in the body image and difficulty in establishing ego boundaries. The high performance on the form board presupposes a strong interest in and ability to perceive boundaries of shapes experienced through the hands, an aptitude which, it is suggested, stems from the forcing value of anxiety in their special area of conflict.
Early diagnosis of the symbiotic child might find some help in the study of nascent identificatory processes as manifested in the earliest imitative elements. It would seem likely that symbiotic cases would show disturbances in this area.