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OVER THE PAST 20 YEARS we have formulated a model of early ego development that integrates biological differences, developmental stages, interaction patterns and wishes and affects. Our approach to assessing and intervening with children with autistic spectrum disorders is based on this model, which emerged from work with infants, young children, and their families. Understanding early ego development served as a foundation for a therapeutic program that has enabled a subgroup of children with autistic spectrum diagnoses to become engaging, communicative, verbal, creative, and empathetic (Greenspan and Wieder, 1977, 1998; Greenspan, 1992a). Applying developmental concepts in clinical work has also suggested a core psychological deficit in autistic spectrum disorder and the components of a comprehensive approach to intervention.
Before we describe our work with children with autistic spectrum diagnoses, it is necessary to provide a brief discussion of the basic concepts that inform this work. Observations, clinical work, and