One-year psychoanalytic treatment of a nonverbal child with ASD: a clinical case report

Background. This paper describes a year of psychoanalytic therapy with a 4.5-year-old boy with autism spectrum disorder who did not speak. The patient (nickname «Noah») showed minimal eye contact, no speech, and stereotypical behaviors common in severe autism. Purpose – is to illustrate and analyze a clinical case in which an original psychoanalytic approach was applied to a nonverbal child with autism Materials and Methods. A single clinical study was conducted following the CARE Guidelines; it described a 12-month course of psychoanalytic play therapy, gradually introducing techniques to reflect the childʼs emotional states, expand their spontaneous actions, and support symbol formation through play. The therapeutic process included adapting the sensory environment to meet the childʼs specific needs. Results. By the end of the year, the child had acquired a few words and expressive gestures, developed basic pretend play skills (feeding and dressing a doll), and showed a marked improvement in social interaction: the boy began making eye contact, initiating joint play, and exhibiting less anxiety in response to changes. Conclusions. Individually tailored psychoanalytic therapy that emphasizes the childʼs ability to symbolize can foster the development of communication skills even in severe autism. This case highlights the importance of the therapeutic alliance, clinician creativity, and addressing the childʼs sensory needs for successful work with children with autism spectrum disorder.