Case Study of a Child with Autism John, an only child, was born after normal pregnancy and delivery. As an infant, he was easy to breast-feed, the transition to solid foods posed no difficulties, and he slept well. At first, his mother and father were delighted at how easy he was: he seemed happy and content to lie in his cot for hours. He sat unsupported at six months (this is within the normal range), and soon after he crawled energetically. His parents considered him independent and willful. However, his grandmother was puzzled by his independence. To her mind, he showed an undue preference for his own company: it was as if he lacked interest in people. John walked on his first birthday, much to the delight of his parents; yet during his second year, he did not progress as well as expected. At 3 years old. Although he made sounds, he did not use words indeed; his ability to communicate was so limited that even when he was three years old his mother still found herself trying to guess what he wanted. Often, she tried giving him a drink or some food in the hope that she had guessed his needs correctly. Occasionally he would grab hold of her wrist and drag her to the sink, yet he never said anything like drink, or he would just point to the tap. This was obviously a source of concern in itself: but at about this time his parents became concerned about the extreme of his independence. For example, even if he fell down, he would not come to his parents to show them he had hurt himself. At times, they even felt he was uninterested in them, because he never became upset when his mother had to go out and leave him with a friend or relative. In fact, he seemed to be more interested in playing with his bricks than spending time with people. He made long straight lines of bricks repeatedly. He spends an extraordinary number of hours lining them up in exactly the same way and in precisely the same sequence of colors. From time to time, his parents also worried about his hearing and wondered if he were deaf, particularly as he often showed no response when they called his name. At other times, however, his hearing seemed to be very acute, he would turn his head to the slightest sound of a plane or a fire engine in the distance. In the weeks following his birthday, they became increasingly concerned, despite reassurances from health professionals. He was not using any words to express himself, and he showed no interest in playing with other children. For example, he did not wave bye bye or show any real joy when they tried to play peek-a-boo. His mother agonized about her relationship with john, because he always wriggled away from her cuddles, and only seemed to like rough and tumble play with his father. She worried that she had done something wrong as a mother, and felt depressed, rejected and guilty. When he was three and a half years old, the family General Practitioner referred John to a specialist. The specialist, a child psychiatrist, told the p.