Autism and attachment: a meta-analytic review.

METHOD Sixteen studies on attachment in children with autism were reviewed, and ten studies with data on observed attachment security (N = 287) were included in a quantitative meta-analysis. RESULTS Despite the impairments of children with autism in reciprocal social interaction, the majority of the studies found evidence for attachment behaviours in these children. In four samples using the Strange Situation procedure the average percentage of secure attachments amounted to 53% (n = 72). Meta-analytic results showed that children with autism were significantly less securely attached to their parents than comparison children, and the combined effect size for this difference was moderate (r =.24). Children with autism displayed less attachment security than comparisons without autism, but this difference disappeared in samples with children with higher mental development, and in samples in which autism was mixed with less severe symptoms of autistic spectrum disorders. CONCLUSIONS It is concluded that attachment security is compatible with autism, and can be assessed with Strange Situation type of procedures. The co-morbidity of autism and mental retardation appears to be associated with attachment insecurity.

[1]  S. Koller,et al.  Between- or within-culture variation? Culture group as a moderator of the relations between individual differences and resource allocation preferences , 2001 .

[2]  J. Buitelaar,et al.  Insecure and disorganised attachment in children with a pervasive developmental disorder: relationship with social interaction and heart rate. , 2000, Journal of child psychology and psychiatry, and allied disciplines.

[3]  S. Pipp-Siegel,et al.  Chapter II. Neurological Aspects of the Disorganized/disoriented Attachment Classification System: Differentiating Quality of the Attachment Relationship from Neurological Impairment , 1999 .

[4]  M. Bakermans-Kranenburg,et al.  Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae , 1999, Development and Psychopathology.

[5]  G. Levi,et al.  An Evaluation of Early Development in Children with Autism and Pervasive Developmental Disorders from Home Movies: Preliminary Findings , 1998 .

[6]  Marinus H. van IJzendoorn,et al.  Sensitivity and Attachment: A Meta‐Analysis on Parental Antecedents of Infant Attachment , 1997 .

[7]  C. Dissanayake,et al.  Autistic Children's Responses to Separation and Reunion with Their Mothers , 1997, Journal of autism and developmental disorders.

[8]  S. Crossley,et al.  Proximity and sociable behaviours in autism: evidence for attachment. , 1996, Journal of child psychology and psychiatry, and allied disciplines.

[9]  Robert Rosenthal,et al.  Progress in Clinical Psychology: Is There Any? , 1995 .

[10]  P. Mundy,et al.  Attachment security in children with autism , 1994, Development and Psychopathology.

[11]  D. MacGregor,et al.  Quality of toddler-mother attachment in children with Down syndrome: limits to interpretation of strange situation behavior. , 1994, Child development.

[12]  S. Rogers,et al.  Developmental aspects of attachment behavior in young children with pervasive developmental disorders. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[13]  K. Grossmann,et al.  Biobehavioral organization in securely and insecurely attached infants. , 1993, Child development.

[14]  P. Kroonenberg,et al.  The relative effects of maternal and child problems on the quality of attachment: a meta-analysis of attachment in clinical samples. , 1992, Child development.

[15]  S. Rogers,et al.  A comparative study of attachment behavior in young children with autism or other psychiatric disorders. , 1991, Journal of the American Academy of Child and Adolescent Psychiatry.

[16]  S. Harris,et al.  Perceptions of Child Attachment and Maternal Gratification in Mothers of Children With Autism and Down Syndrome , 1990 .

[17]  S. Rogers,et al.  Age of symptom onset in young children with pervasive developmental disorders. , 1990, Journal of the American Academy of Child and Adolescent Psychiatry.

[18]  P. Kroonenberg,et al.  Cross-cultural consistency of coding the strange situation , 1990 .

[19]  T. Shapiro,et al.  Attachment in autism and other developmental disorders. , 1987, Journal of the American Academy of Child and Adolescent Psychiatry.

[20]  P. Mundy,et al.  Social interactions of autistic, mentally retarded and normal children and their caregivers. , 1986, Journal of child psychology and psychiatry, and allied disciplines.

[21]  M. Sigman,et al.  Attachment behaviors in autistic children , 1984, Journal of autism and developmental disorders.

[22]  J. Bowlby.  Attachment and loss: retrospect and prospect. , 1982, The American journal of orthopsychiatry.

[23]  E. Schopler,et al.  Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS) , 1980, Journal of autism and developmental disorders.

[24]  M. Ainsworth.  Infant--mother attachment. , 1979, The American psychologist.

[25]  L. Wing,et al.  Severe impairments of social interaction and associated abnormalities in children: Epidemiology and classification , 1979, Journal of autism and developmental disorders.

[26]  M. Sigman,et al.  Attachment and emotional responsiveness in children with autism , 2000 .

[27]  J. Buitelaar,et al.  Attachment and Social Withdrawal in Autism: Hypotheses and Findings , 1995 .

[28]  P. Mundy,et al.  Social attachments in autistic children. , 1989, Journal of the American Academy of Child and Adolescent Psychiatry.

[29]  L. Wing,et al.  Cognitive Impairments Affecting Social Behavior in Autism , 1986 .

[30]  L. Kanner.  Autistic disturbances of affective contact. , 1968, Acta paedopsychiatrica.