Changing Autistic Behavior

THIS ARTICLE reports the relative effectiveness of three contrasting milieus in changing the behavior of autistic children as measured by a behavior rating scale. The first setting (I) is a large, long established state institution which primarily offers custodial care; the second (II) is a large, modern state institution with both a school and a therapeutic program involving a variety of planned activities; the third (III) is a small, psychoanalytically oriented day-care unit which emphasizes the emotional relationship between staff and children. The evaluation of autism and of therapeutic milieus will be discussed first; then the finding concerning the relative therapeutic effectiveness of the three settings will be presented; and, finally, the results will be used to make some general inferences concerning the nature of change in autim. Evaluation of Autism To date there is no published report of psychotherapy with autistic children which is objective in its evaluation, which comprehensively assesses the multiple pathologies which comprise autism, and which systematically compares different psychotherapeutic approaches. The clinical literature contains detailed descriptive accounts of special psychotherapeutic techniques usually involving only a small number of children.¹⁻⁴