In this article Ruth Fergusson, an educational pyschologist for Wiltshire County Council discusses autism and attachment and explores if there is a connection.
Autistic spectrum condition and attachment – what’s the connection?
What is ‘attachment’?
The term attachment can be described as a deep and supportive bond between a child and caregiver that creates a sense of safety and stability through meeting the physical and emotional needs of the child. Ideally, this bond creates a secure attachment, which gives a child a safe base from which to explore the world around them and return to when in need of comfort and safety.
Attachment patterns begin to form as the brain develops, approximately three months before birth and throughout infancy. Secure attachment is essential for healthy neurological development. When an infant cries/gurgles/tracks with their eyes, they are putting out a signal to ensure that their carers respond to them and their needs are met. When a consistent and significant adult reacts by soothing and meeting the baby’s needs, the stimulus from baby is managed and her feelings are regulated. It is this process, which peaks at around 2-8 months, through which the foundations of attachment behaviours are laid down. Babies go on to develop related beliefs and expectations about caregivers, primarily that relationships exist and that adults are predictable, thus creating the foundations for a set of communicative strategies which evolve over time to permit healthy and meaningful social interactions.
If the baby’s signal (crying/gurgling/ eye tracking) is met with little, irregular or no response as a result of limited parental emotional or physical availability (for whatever reason), the baby learns over time that her needs may not be met through communication with others, and a different set of responses evolve. These may include limited communication, or conversely, overt and relentless communication; impulsive behaviour; poor empathy; and stalled development in areas such as physical and sensory skills, emotional and social communication, and the capacity to develop meaningful relationships.
Attachment and Autism?
It must be emphasised that there is no scientific body of evidence to indicate a relationship between attachment difficulties and autism. The notion that autism may be somehow caused by the influence of parenting practices is outdated and refuted by the vast majority of professionals. However, there is a wealth of anecdotal evidence that suggests that some of the presenting behaviours in children and young people can sometimes seem very similar. Research into autistic spectrum conditions (ASCs) and attachment difficulties asserts that one of the key areas affected by the presence of either condition is compromise to the brain’s executive function (EF). Executive functions are a set of mental processes that help us to learn and to solve problems. We use them to remember, manage time and space, plan, organise, start and change activities, set goals and stay on task long enough to achieve them. They also help us to control impulses and regulate feelings, and they allow us to reflect on situations and consider a range of options as opposed to responding impulsively. Normally, children navigate their worlds with a basic set of skills that enables them to follow rules, understand what comes next, see other people’s points of view, and predict outcomes. It is often a number of the skills which are attributed to executive functioning that are reported as absent or undeveloped in children with both ASCs and attachment difficulties.
As a result of some difficulties with executive functioning being shared by both groups, a number of the interventions that enable children with either condition to manage more successfully are similar.
Examples of such interventions include:
- Setting one task at a time and demonstrating “here’s one I did earlier”
- Planning routines and using visual and verbal prompts
- Chunking information to improve learning and recall
- Planning and structuring times of change
- Breaking down tasks into simple steps
- Use of the goal, plan, do, review model to encourage task-setting and reflection
- Visual planners
It cannot be overstated however, that many of the difficulties arising in both conditions require significantly different approaches both in the nature of the intervention and in terms of delivery. The success, for example, of interventions for a child who experiences attachment difficulties will be heavily dependent on the work invested in the relationship with the person delivering them in a way that may not necessarily be the case for child with ASC.
This brief article has simply touched on some of the similar presenting behaviours in these two very different conditions and it is worthy of note that some of these similarities create the potential for misdiagnosis. It is useful to remain mindful of this potential in our interactions with children presenting with either condition; the issue raises important questions for further research.
Lavery, S. Let’s Learn Together: Adoption UK
Zelato, P.D.Executive Function Part Five: What happens when the development of executive function goes awry? http://www.aboutkidshealth.ca/En/News/Series/ExecutiveFunction/Pages/Executive-Function-Part-Five-What-happens-when-the-development-of-executive-function-goes-awry.aspx:
Author: Ruth Fergusson, Educational Psychologist for Wiltshire Council
Date added: 21st January 2014