This paper, together with the author's recent one, ‘Une théorie de l'autisme infantile’, is the fullest account Fordham has as yet given of his work and research with autism in children, and is an important addition to the literature on the subject. The earlier paper, unfortunately not yet available in English, concentrated on his theoretical explanation of the syndromes of primary and secondary autism. In this one he discusses again the three cases used there to illustrate his theory, but this time in such a way as to lay out clearly and in detail his understanding of these autistic states and their mechanisms, his method of approach to such children, and his experiments in technique and management both of the child and of the mother-child unit. He concludes, and demonstrates, that mental growth can occur in such children but often not sufficiently to satisfy the environment. It is this, he thinks, that leads often to the judgment that therapy of such children is useless. The paper is full of valuable insights and original technical suggestions.