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Clinical data, including five case histories, are adduced to support the hypothesis that autism is a syndrome of multiple origins. It occurs when one or any combination of a series of etiological gradients affect the child during a particularly vulnerable period of ego development, namely, six months to three years of age. The first stage of the syndrome is conceptualized as a paranoid rejection of mother by the child based on his reaction to her as persecutor. The second stage is the mother's counter-rejection or withdrawal. In the third stage, there is chronic, severe pathology which is characterized by the consolidation of paranoid attitudes and the appearance of restitutional behavior such as compulsive, magical attempts to reconstitute external reality. Interrupting the process before it becomes irreversible depends primarily on prompt identification of etiologic factors, classified as follows: 1, family psychodynamics specifically promoting autism (the 'tone-deaf' mother who is unable to empathize with the child or the mother whose unconscious needs provoke autistic responses); 2, family psychodynamics enabling autism to occur (such as the mother's prolonged illness); 3, environmental circumstances (such as the father being drafted); 4, assaults on the child (such as the child's serious physical illness, congenital or constitutional sensory impairments, temporal lobe disease, understimulation or overstimulation). These fundamental etiologic factors are often obscured by massive secondary symptom developments and complicated family interactions.