A Comparative Study of Attachment Behavior in Young Children with Autism or Other Psychiatric Disorders

doi:10.1097/00004583-199105000-00021

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 30, Issue 3, May 1991, Pages 483-488

https://doi.org/10.1097/00004583-199105000-00021 Get rights and content

Abstract

The present study examined attachment behavior in children with autism and children with other developmental or psychiatric disorders. The groups were matched on chronological and mental age, IQ, and socioeconomic status. When a modified Strange Situation paradigm was used, no group differences were found in proximity seeking, contact maintenance, proximity avoidance, or contact resistance; the groups also did not differ in their overall security ratings. Attachment security was related to several developmental variables in the autistic group but not in the nonautistic comparison group. This suggests that attachment formation may involve different processes in autistic children than in nonautistic children of equivalent intellectual level.

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Cited by (86)

Does child-mother attachment predict and mediate language and cognitive outcomes? A series of meta-analyses
2023, Developmental Review
A programmatic set of meta-analyses by Groh et al. (e.g., Groh et al., 2017a) and Madigan et al. (e.g., Madigan et al., 2023) demonstrated that secure child-caregiver attachments are positively associated with children’s social and emotional development, with somewhat stronger associations identified in relation to social competence and (lower) externalizing behaviors than for (lower) internalizing symptoms (Groh et al., 2017a). The association of attachment security with children’s cognitive and language outcomes, however, is relatively less well established. Moreover, it is unknown whether attachment is associated with these outcomes through direct links, indirect links (i.e., as a mediator of the association between caregiver sensitivity and child cognition and language processes), or both. Empirical tests of these hypotheses have not yet been conducted. The current study had two main objectives: 1) provide a meta-analytic update for the association between attachment security and cognition and language (k = 125 studies [107 samples]; N = 9,213 children; 52.5% boys; 100% mothers; 93% from North America/Europe), and 2) test this association within a larger mediation model that accounts for the roles of sensitivity and attachment through a meta-analytic structural equation model (sensitivity → attachment → cognitive and language outcomes). Results showed that child-mother attachment security was significantly associated with child cognition (r = 0.17, 95% CI [0.14, 0.20]) and language outcomes (r = 0.16, 95% CI [0.12, 0.20]). The MASEM model revealed a small, but significant, indirect effect of sensitivity on cognitive and language outcomes through attachment security. The discussion considers the theoretical and practical implications of these findings.
Parenting behavior and the development of children with autism spectrum disorder
2019, Comprehensive Psychiatry
Citation Excerpt :
Wing & Gould [29] identified three groups of children with ASD: 1) those who were aloof and socially remote, 2) those who moved away from social overtures but could be engaged, and 3) those who engaged in interactions in unusual or odd ways. In the 1980s, a number of studies reported that children with ASD showed the hallmarks of secure attachment relationships, that is, they were more oriented to their caregivers than other adults and sought proximity after separation [23,30,31]. Subsequently, studies using the Strange Situation procedure (SSP) have shown that approximately 50% of young children with autism are securely attached to their mothers, that is, they show proximity seeking when stressed by the separation, controlling for difficulties with eye contact and stereotypies such as hand flapping and rocking [22,32,33].
Autism spectrum disorders (ASD) are neurodevelopmental disorders in which multiple genetic and environmental factors play roles. Symptoms of deficits in social communication and restrictive, repetitive behavioral patterns emerge early in a child's development. While parents do not cause these difficulties, impairments in social relatedness can strain parent child interactions and parental stress can have negative transactional effects that impede children development. Conversely, as with typically developing children, parental behavior can also enhance development in ASD and parents play a role in many interventions. In this review we examine parental contributions to the development of children with ASD, focusing on social communication and emotion regulation. We address parent and family characteristics that may impede development so they can be identified in families and interventions developed to target them.
Autism, attachment, and social learning: Three challenges and a way forward
2017, Behavioural Brain Research
Citation Excerpt :
As the body of experimental research on attachment in ASD grew, the intuitive idea that the unique social reciprocity deficits defining this disorder must interfere with attachment formation turned out to be unsupported. The seminal study by Sigman and Ungerer [111] and subsequent research documented that ASD can, and in most cases does co-exist with secure attachment [17,19,32,45,58,91,92,95,94,108,110,117,118]. Key-findings from this body of literature include the following: 1) children with ASD respond preferentially to familiar people versus strangers (e.g. [56], 2) they seek proximity with caregivers after a separation in a way that in most cases does not differ from mental-age matched peers (e.g. [110], 3) the presence of a stranger causes children with ASD to engage in more proximity-seeking and less explorative behavior (e.g. [32], 4) when the quality of child-caregiver attachment relationship is assessed using the Strange Situation Procedure, the majority of children with ASD can be classified as having a “secure attachment” [94], 5) the proportion of children with ASD classified as having a “disorganized” attachment is higher compared to the normal population, but similar to mental-age matched children without ASD who have other (non-social) delays (e.g. [76]).
We explore three challenges that Autism Spectrum Disorder (ASD) poses to our understanding of the processes underlying early attachment. First, while caregiver-infant attachment and later social-affiliative behavior share common biobehavioral mechanisms, individuals with ASD are able to form secure attachment relationships, despite reduced social-emotional reciprocity and motivation for social interaction. Therefore, disruptions in social affiliation mechanisms can co-exist with secure caregiver-infant bonding.
Second, while early attachment quality is associated with later social outcomes in typical development, interventions targeting caregiver-child interaction in ASD often show positive effects on parental responsivity and attachment quality, but not on child social behavior. Therefore, improvements in parent-child bonding do not necessarily result in improvements in social functioning in ASD.
Third, individuals with ASD show normative brain activity and selective social affiliative behaviors in response to people that they know but not to unfamiliar people.
We propose a conceptual framework to reformulate and address these three theoretical impasses posed by ASD, arguing that the dissociable pathways of child-parent bonding and social development in ASD are shaped by (1) a dissociation between externally-driven and internally-driven attachment responses and (2) atypical learning dynamics occurring during child-caregiver bonding episodes, which are governed by and influence social-affiliation motives and other operant contingencies.
Attachment in children with autism spectrum disorder: A systematic review
2017, Research in Autism Spectrum Disorders
Citation Excerpt :
Articles that compared the attachment security between groups of children consistently reported lower rates of attachment security in autism samples than both typically developing children and children with other developmental disabilities (Grzadzinski et al., 2014; Naber et al., 2007; Rutgers et al., 2007; Sotgiu et al., 2011). These articles contradict earlier reports of no differences in attachment security between children with ASD and matched clinical comparisons (e.g. Rogers et al., 1991). As well as lower rates of attachment security and higher rates of insecure attachments than typically developing children, children with ASD also demonstrated higher rates of disorganised attachment.
This paper aims to synthesise the literature on attachment in children with Autism Spectrum Disorder (ASD), highlighting gaps in current research and applications for clinical practice. The research databases PsycINFO, Ovid Medline, and the Cochrane Library were searched for the terms “autism” and “attachment”. Forty papers investigating attachment in children with ASD were identified and narratively reviewed. Seven samples were identified that reported attachment classifications using the Strange Situation Paradigm, with an average of 47% of children with ASD classified as secure (n = 186). With research to date concluding that children with ASD can form secure attachments, studies are now looking at risk and protective factors in the development of attachment, correlates of attachment, attachment disorders in children with ASD, and attachment-based interventions for children with ASD. Many of these studies are preliminary investigations with contradictory findings reported, highlighting important directions for future research.
Community-based Agency Delivery of Parent-Child Interaction Therapy: Comparing Outcomes for Children with and Without Autism Spectrum Disorder and/or Developmental Delays
2024, Journal of Autism and Developmental Disorders
Applying a Parent Training Program in a Naturalistic Behavior Analytic Context to Improve Attachment in Children with ASD
2023, Journal of Autism and Developmental Disorders

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: This research was supported in part by Grant #G008100247 to Dr. Rogers from the Office of Special Education and Rehabilitation, U.S. Dept. of Education.

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ARTICLESA Comparative Study of Attachment Behavior in Young Children with Autism or Other Psychiatric Disorders

Abstract

Infant Behavior and Development

J. Am. Acad. Child Adolesc. Psychiatry

J. Am. Acad. Child Adolesc. Psychiatry

J. Am. Acad. Child Adolesc. Psychiatry

J. Am. Acad. Child Adolesc. Psychiatry

J. Am. Acad. Child Adolesc. Psychiatry

J. Am. Acad. Child Adolesc. Psychiatry

Patterns of Attachment

Are autistic children behaviorists?

J. Autism Dev. Disord.

Bayley Scales of Infant Development

A review of attachment formation and disorder of handicapped children

Am. J. Ment. Defic.

The nature of the child's tie to his mother

Int. J. Psychoanal.

Clinical and multivariate approaches to the nosology of pervasive developmental disorders

J. Am. Acad. Child Adolesc. Psychiatry

ARTICLES
A Comparative Study of Attachment Behavior in Young Children with Autism or Other Psychiatric Disorders