Maternal Resolution of the Child's ASD Diagnosis: Relationship with Maternal Emotional Availability and Child Attachment

Background: Receiving a diagnosis of ASD for one’s child is a painful experience for parents, one that requires that they realign their thoughts, feelings, and expectations regarding the child. Such realignment, also referred to as “resolution” of the diagnosis, is necessary in order to provide caregiving that is matched to the child’s needs and challenges. Resolution is therefore hypothesized to foster maternal emotionally-available behavior toward the child and secure child-parent attachment.

Objectives: To examine whether indeed mothers’ resolution of the ASD diagnosis of their children is related to their emotional availability during play interactions with their children and to secure child-mother attachments. 

Methods: 45 boys diagnosed with AD or PDD-NOS (ages 32-69 months) and their mothers participated in the study. Mothers’ resolution of their children's diagnoses was assessed using the Reaction to Diagnosis Interview. Mothers’ emotional availability was assessed using the Emotional Availability Scales applied to three play interactions. Finally, the attachment of the children to the mothers was assessed using the Strange Situation Procedure. 

Results:  Mothers who were resolved with regard to their children’s diagnosis were more sensitive to their children’s signals and structured their interactions better than mothers who were unresolved. Additionally, children of resolved mothers were more likely to be securely attached than children of unresolved mothers. These associations held over and above the effects of the severity of children’s diagnosis (AD vs. PDD-NOS) and level of functioning (low vs. high).

Conclusions: Maternal resolution of the child's diagnosis is associated with (a) more optimal caregiving behavior in mothers of young children with ASD and (b) secure child-mother attachment. These findings have important implications for our understanding of the socio-emotional development of young children with ASD. Clinically the findings stress the importance of helping parents come to terms with their children’s ASD diagnosis.