This chapter is drawn from a retrospective qualitative study based on psychotherapy sessions with children presenting autistic features who use language in atypical ways. The purpose of this research was to explore what factors could hinder or enhance the development of communicative language and symbolic thinking. The study was based mainly on the detailed investigation of two cases. Two child patients (6 and 8 years old at the beginning of the study), in the range of autistic spectrum disorders (ASDs) and presenting idiosyncratic language use, were seen once weekly in 50-minute sessions of individual psychoanalytic psychotherapy for a period of two years. Although this was not the ideal frequency, it was difficult for their parents to commit to bringing the child to the clinic more than once weekly. Both families were also supported by parent work.