This article describes the deliberate therapeutic construction of a transitional object for a 10-year-old autistic girl in an integrated psychoanalytic and neuropsychologically oriented play therapy. Treatment was initially directed to the regulation of excitement levels, the focusing of attention, and the recognition of orderly sequencing of events. Significant development in symbolic functioning led to a marked interest in sign language instruction in school.

Two major events, the coming birth of a sibling and the long summer separation, led the therapy team to present her with a teddy bear in such a way that it became internalized as a transitional object. The article provides a brief case history of this child, describes the treatment context, and traces the process of constructing the transitional object and its outcome. This process and its outcome is discussed for its treatment and theoretical implications.