Parental Sensitivity and Attachment in Children With Autism Spectrum Disorder: Comparison With Children With Mental Retardation, With Language Delays, and With Typical Development

Abstract

This study on sensitivity and attachment included 55 toddlers and their parents. Samples included children with autism spectrum disorder (ASD), mental retardation, language delay, and typical development. Children were diagnosed at 4 years of age. Two years before diagnosis, attachment was assessed with the Strange Situation procedure, and parental sensitivity and child involvement during free play were assessed with the Emotional Availability Scale. Parents of children with ASD were equally sensitive as parents of children without ASD, but their children showed more attachment disorganization and less child involvement. More sensitive parents had more secure children, but only in the group without ASD. Less severe autistic symptoms in the social domain predicted more attachment security. Autism challenges the validity of attachment theory.

A short-term longitudinal study of correlates and sequelae of attachment security in autism

“…These findings were subsequently replicated in a toddler sample by Naber et al (2007a). These findings suggest that when autistic stereotypies are excluded from consideration, the disorganized attachment classification can nonetheless be assigned for children with autism, with expectable correlates (see also Koren-Karie et al, 2009; Van IJzendoorn et al, 2007). …”

“…Studies using the Ainsworth Strange Situation procedure (Ainsworth & Wittig, 1969) find that 40–60% of preschool-age children with autism are classified as securely attached, based on Mary Ainsworth’s original secure/avoidant/resistant classification system (Capps et al, 1994; Koren-Karie et al, 2009; Shapiro et al, 1987; Van IJzendoorn et al, 2007; Willemsen-Swinkles et al, 2000). In the first Strange Situation study conducted with toddlers, Naber et al (2007a) found that 35% of toddlers with a diagnosis of Autistic Disorder and 43% of toddlers with a diagnosis of Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) were classified as securely attached (see also Naber et al, 2008).…”

“…As has been demonstrated for the mothers of typically developing children, mothers of securely attached preschoolers with autism have been rated as more sensitively responsive than mothers of insecurely attached children (Capps et al, 1994; Koren-Karie et al, 2009). One study did not find a link between sensitivity and attachment security in a sample of toddlers with autism (Van IJzendoorn et al, 2007). This study utilized a median split on maternal sensitivity and compared continuous ratings of child attachment security between mothers rated as high versus low in sensitivity (rather than comparing continuous ratings of maternal sensitivity between securely vs. insecurely attached children, as the other studies had done).…”

“…Links between severity of autism symptoms and attachment security have been equivocal. Studies utilizing total scores on the Autism Diagnostic Observation Schedule (ADOS) diagnostic assessment reported significant differences in total scores between securely and insecurely attached children (Naber et al, 2007a; Van IJzendoorn et al, 2007). In contrast, studies comparing children with strictly defined autism to children with diagnoses of PDD-NOS reported similar rates of security in the two groups (Oppenheim et al, 2009; Willemsen-Swinkels et al, 2000).…”

“…Though there is an emerging literature on the social and cognitive correlates of attachment in autism (e.g. Capps, Sigman, & Mundy, 1994; Koren-Karie Oppenheim, Dolev, & Yirmiya, 2009, 2007b; Naber et al, 2007a; Oppenheim, Koren-Karie, Dolev & Yirmiya, 2009; Van IJzendoorn et al, 2007; Willemsen-Swinkles, Bakermans-Kranenburg, Buitelaar, van IJzendoorn, & van Engeland, 2000), the implications of secure attachment for subsequent development in children with autism remains an understudied topic (Kahane & El-Tahir, 2015). To that end, the goals of the present study were to (1) investigate the correlates of individual differences in the quality of attachment organization in children with autism, including maternal sensitivity as well as child cognitive and social skills, and, (2) for the first time, examine the implications of attachment security for subsequent development of these children.…”