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A retrospective study of 131 autistic children was made in which 2 groups, Natal and Acquired, were defined on the bases of age at onset and type of onset. Prenatal and perinatal variables were found to be significantly related to Natal onset, whereas in the Acquired group the significant variables were those occurring in early childhood, between years 1 and 3. Follow-up data on intellectual functioning and language development indicated a better prognosis for the Acquired group. An inability to cope with stress is postulated as an underlying feature in both instances, present from birth in the Natal group and occurring in the face of developmental stresses in the Acquired group.

Life story work has long been established as a highly effective means of helping children separated from their birth families to come to terms with a history of abandonment, rejection and loss. However, the traditional method of using photos, drawings, writings and memorabilia from the child's past to create a life story book may not always be possible or appropriate. Juliet Harper presents four case studies in which, for various reasons, it was necessary to pursue alternative methods of life story work, for instance through play and the exploration of dreams. She underlines the importance of truthfulness, sensitivity and flexibility on the part of the therapist, and the need to constantly watch out for clues from the child. In following their lead, she asserts, the most constructive path towards rebuilding their sense of self will be found.

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