ABSTRACT
In 1943, Leo Kanner published his seminal paper delineating the syndrome of infantile autism, in which he emphasised the children’s “extreme autistic aloneness” and their lack of affective contact. Contemporary workers are widely assumed to share Bettelheim’s (1967) mistaken and damaging opinion that children develop autism because of their parents’ supposed death wishes, a misapprehension that does not seem to have been affected by many explicit refutations. Genetic endowment plays a central part, though extreme privation can lead to behaviour resembling autism in a small percentage of children. Technical adaptations of various kinds have been thought necessary by virtually all these authors, beginning with Klein, in view of the restricted relational and symbolic capacity of children with autism. In Anne Alvarez’s work, technical considerations occupy a central position. She has proposed a major integration of psychoanalytic and developmental approaches that involves differentiating the contribution of deficit, defence, deviance, and personality to the child’s presentation.
