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DSM-5 is likely to provide a dimensional approach to ASD with two main dimensions: social communication disorder, and repetitiveness. ID/ language impairment adds a further dimension. I shall start my talk with a consideration of how a psychotherapeutic orientation can be relevant to these neurodevelopmental dimensions as well as associated neurodevelopmental disorders, particularly ADHD. However, the main value of a psychotherapeutic approach is in relation to the emotional difficulties associated with ASD and ID, and I shall consider particularly the consequences of bullying, exploitation, and marginalization with special attention on the management of anxiety and of seeking to make an impact on others.