Attachment behaviours and parent-child interaction in pre-school autism

Background: Children with autism suffer from significant social impairments that affect social interactions and relationships with others, yet evidence suggests they are still capable of forming secure attachments to their caregivers. The origins and consequences of this paradox have been insufficiently studied. In non-autistic populations, parental sensitivity, mutuality and affect have been identified as key factors associated with attachment security. Few studies have directly examined these constructs in children with autism.

Objectives:

1) To examine the relationship between attachment security in autism and parent-child interaction in areas of: parental sensitivity, mutuality, parent affect, and child affect.

2) To compare children with autism and a group of typically-developing controls on these constructs.

Methods: Baseline data from 27 children with autism (mean age = 46 months, SD = 7.83) participating in the Pre-school Autism Communication Trial (PACT, www.manchester.ac.uk/medicine/pact) were examined and compared with data from a group of 24 typically-developing children (mean age = 23 months, SD = 6.50) group-matched on non-verbal ability. Both groups participated in a video-recorded free-play session with their parents. A ten minute sample of the play session was coded using a modified version of Coding of Attachment-Related Parenting. Attachment security was measured using the Brief Attachment Screening Questionnaire.

Results: In the autism group, attachment security was significantly associated with high mutuality and low child negative affect. Compared to typically-developing controls, the autism group showed significantly lower parental sensitivity, mutuality, parent positive affect and child positive affect.

Conclusions:

Attachment security in autism is, in part, associated with key features of parent-child interaction in expected ways. However, parent-child interactions differ in autism compared to typical development in ways that may affect the development of attachment security. To fully understand the origins and consequences of attachment security in autism, longitudinal studies that examine these effects across time are required.