Background: Children with autism spectrum disorder show a deficit in neurobiological processes. This deficit
hinders the development of intentional behavior and appropriate problem-solving, leading the child to implement
repetitive and stereotyped behaviors and to have difficulties in reciprocal interactions, empathy and in the
development of a theory of mind. The objective of this research is to verify the effectiveness of a relationship-based
approach on the positive evolution of autistic symptoms.
Method: A sample of 80 children with autism spectrum disorder was monitored during the first four years of
therapy, through a clinical diagnostic assessment at the time of intake and then in two follow-up.
Results: The results showed that through the Autism Diagnostic Observation Schedule it is possible to
assess the socio-relational key elements on which the therapy is based. There was evidence, in fact, of significant
improvements after two and four years of therapy, both for children with severe autistic symptoms and for those in
autistic spectrum.
Conclusions: Socio-relational aspects represent the primary element on which work in therapy with autistic
children and can be considered as indicators of a positive evolution and prognosis that will produce improvements
even in the cognitive are