A philosophy for understanding and handling autistic children is presented. The multiplicity of etiologic factors, both hereditary and environmental, is emphasized. These

factors are seen as overwhelming at a vulnerable early developmental stage. The consequent stress is construed by the child as caused by mother who is persecuting him. This results in a basic paranoid position, which is seen as the core of the autistic reaction and the reason for the need for psychological treatment. The authors argue against separating the evaluation process from treatment. On-going treatment planning furnishes the best information and opportunity for investigating such things as organic features if they are found to be important. Flexibility is essential in the therapeutic approach to each child except that the therapist must always side with reality. Informative case histories are presented.