Attachment and autism: Parental attachment representations and relational behaviors in the parent -child dyad

Until attachment and autism researchers provided empirical support for attachment-seeking behaviors in children diagnosed with autism and associated disorders (Rutgers, Bakermans-Kranenburg, Van IJzendoorn, & Van Berckelaer-Onnes, 2004), they were too often considered incapable of forming attachments with their primary caregivers. Yet, constitutionally based shortfalls in joint attention (Charman, 2003), theory of mind, empathy, affective reciprocity (Baron-Cohen, 1989, 1991), reflective functioning (Fonagy & Target, 1997), and mirror neuron functions (Dapretto, Davies, Pfeifer, Scott, Sigman, Bookheimer et al., 2006) in the children place great demands on their parents in cultivating secure attachments and engaging them emotionally and socially to facilitate their development. Attachment research has demonstrated that parents\u27 internal working models of attachment relationships tend to be transmitted to their children, affecting their developmental trajectories (Main & Hesse, 1991; Sroufe, 1983), yet this is the first known study that examines associations between adult attachment status and observable parent, child, and dyadic behaviors among children with autism. Specifically, parental internal working models of attachment relationships and internal states of mind regarding unresolved loss or trauma are derived employing the Adult Attachment Interview (AAI); George, Kaplan, & Main, 1985), and the quality of relational and functional behaviors in parents and their children are determined employing the Functional Emotional Assessment Scale (FEAS; Greenspan, DeGangi, & Wieder, 2001). The present sample includes parents and their 4- to 16 year-old children with autism and associated disorders. Though hypotheses were not all supported, significant correlations were found between AAI classification and four FEAS subscales, indicating that children of parents demonstrating secure attachment representations were better able than children of parents demonstrating insecure attachment representations to initiate and respond in two-way pre-symbolic gestural communication; organize two-way social problem-solving communication with pre-representational awareness of self and other; and create and use ideas for imaginative thinking, symbolic play, and verbal communication. In addition, parents demonstrating secure attachment representations were better able than parents demonstrating insecure attachment representations to facilitate their children\u27s imaginative thinking, symbolic play, and verbal communication. No significant correlations were found between organized-unresolved states of mind and relational and functional levels in the parent-child dyad. These findings lend support to the relevance of the parent\u27s state of mind pertaining to attachment status to child and parent relational behavior in cases wherein the child has been diagnosed with autism and associated autism spectrum disorders. Further research is urged to better understand relationships between parental internal models of attachment relationships and parent-child relational and functional levels to aid in differentiating interventions