This article describes a psychoanalytically informed dyadic approach to treatment of children with autism spectrum disorder that both engages the child on a psychodynamic level and works toward addressing the impact on the mother and the mother–child relationship resulting from the child's diagnosis and developmental differences. The treatment of Johnny, a 2.5- to 6-year-old boy on the autism spectrum, is used to illustrate the methodology implemented in this approach and explores and elucidates the developmental themes as they unfold in the course of treatment.