Editorial

A diagnosis of a complex learning disability, including autism or Asperger's, can have a profound impact on the individual and their family. Autistic Spectrum Disorders (ASD) are complex and varied conditions nowadays regarded as being multiply determined. The early psychogenic accounts of autism have been replaced by far more sophisticated models that integrate genetic and environmental determinants so as to understand what is regarded by some as a disorder of intersubjectivity (Hobson, 1993 and this issue). By their very nature ASDs present the clinician with a profound challenge: how to communicate with an individual who appears to lack curiosity and a desire for interaction with other people (Alvarez & Reid, 1999).

The three papers on ASDs in this special issue are written by clinicians working at the Tavistock Clinic (Hobson, Rhode, Urwin), which has a long and distinguished history of approaching autistic states from both psychoanalytic and developmental perspectives and of providing multidisciplinary services for this group of patients and their families. The Autism Workshop at the Tavistock Clinic, founded by Sue Reid in 1986 and later co-convened with Anne Alvarez, has originated a great deal of thinking in this area (Alvarez, 1992; Alvarez & Reid, 1999). The papers in this issue draw from these rich foundations, but also evidence recent developments in theory and clinical applications.

Peter Hobson sets the scene in a clear and thought-provoking overview of psychoanalytic contributions to autism, inviting us to engage in interdisciplinary dialogues, which he regards as essential to understanding ASDs and to developing effective interventions. The papers by Cathy Urwin and Maria Rhode ease us into the consulting room, with vivid and moving illustrations of work with children with ASDs, which remind us of the way clinicians have to struggle to stay connected with the ‘limited or distorted intersubjective experience’ (Hobson, this issue) of the autistic child