Autism and Attachment Theory: Can Autism Influence Attachment and How?

The study of Autism Spectrum Disorder (ASD) has often proven to be a challenge throughout the ages – no less because the disorder looks different for everyone who has it, but also because it shares symptoms with other imbalances, such as attachment difficulties. 

The complex relationship between the communication and socializing difficulties associated with autism, and its concurrent disruptions to the caregiver-child bond, makes it difficult to determine how much autism impacts the development of a secure attachment style. And also how the formation of an attachment style affects the symptoms of autism. Moreover, research in the area is somewhat limited and conflicting. 

Yet, there is a clear relationship between ASD and attachment theory, and an awareness of this association may help caregivers, adults with ASD, and professionals in the area understand how to best manage symptoms and facilitate the development of a secure attachment style. 

Therefore, we have done our best to outline this relationship in light of the information that is available. This article will discuss:

  • What autism is
  • Similarities between autism and insecure attachment
  • Differences between autism and insecure attachment
  • The relationship between autism and attachment
  • How caregiver attachment style may impact ASD symptoms
  • Overall thoughts on autism and insecure attachment

What Is Autism?

Autism is a lasting developmental disorder that affects how people with it interact and communicate with the world. It is characterized by challenges around speech and non-verbal communication, social skills, and repetitive actions. The Centers for Disease Control recently reported that approximately 2.21% of people in the United States are on the spectrum of autism.

As autism is a spectrum disorder, each person with it is affected differently and thus presents with a distinct set of difficulties and strengths. For this reason, the skillset of people with autism can range from high functioning to severely challenged. Some autistic individuals require very little support in order to lead a fulfilled life, but others may need a great deal of help. Although the severity of peoples’ symptoms varies massively, the common traits of autism are:

  • Difficulties interacting and communicating with others
  • Problems understanding others’ feelings or thoughts
  • Anxiety about unfamiliar events or social situations
  • Finding loud noises and bright lights uncomfortable and stress-inducing
  • Repeating the same actions/thoughts 
  • Processing information at a slower pace

The Similarities Between Autism and Insecure Attachment

The symptoms of insecure attachment and autism often overlap to such a degree that clinicians express difficulties with diagnosis. Although there needs to be more consistent research into the area, a common finding from studies, in general, is that children with autism are at high risk of developing an insecure attachment style. However, a number of variables – which we will discuss subsequently – affect this relationship. 

There are evident similarities between the traits of autism and those of an insecure attachment style, including:

  • Troubles with social skills and communication
  • Emotion regulation difficulties
  • Repetitive, self-stimulating behaviors (also known as stimming)
  • A preference for being alone
  • Difficulties with maintaining eye-contact
  • Avoidance of affection from loved ones
  • Sensory difficulties
  • Problems with empathy 

How Autism and Insecure Attachment Differ

The most prevalent difference between the development of an insecure attachment style and the presence of autism is that with the proper guidance and effort, an insecure attachment style can be healed. People with autism can benefit from support, learn skills, and lead a fulfilled life. Still, autism is nevertheless a lifelong condition. Some other notable differences between autism and insecure attachment include:

  • Boundaries around trust and affection – many autistic individuals don’t necessarily have an issue with trust and affection, but rather with the sensory elements involved in demonstrating endearment, such as hugging and kissing. 
  • Attunement to others – people with autism tend to be unaware of the thoughts and feelings of others. In contrast, some of us with an insecure attachment style tend to be hypervigilant towards what we perceive to be other peoples’ feelings, thoughts, and actions. 
  • Bending the truth – insecure attachers may attempt to impress others or shift the focus of blame in order to come across favorably. However, people with autism struggle to deceive others or tell anything less than the truth. 
  • Issues with eating – some individuals with attachment difficulties may struggle with food, particularly the social aspect of eating. Autistic individuals tend to also have issues with food. These concerns, however, are more to do with the texture of the food itself, the timing of the meal, and also how it is presented to them. 

The Relationship Between Autism and Insecure Attachment

The relationship between autism and insecure attachment is complex. Much of this may be due to the fact that early leaders in the field of ASD regularly claimed that caregiver actions led to the formation of autism. Therefore, before we continue, we wish to clarify that autism is not caused by poor parenting. The exact reason why it develops in some people is unknown. Nevertheless, it is thought to have genetic and biological factors. 

There is, however, a correlation between parenting style and the type of attachment style that a child with autism develops. 

Children With Autism Are Capable of Forming Secure Attachments

One of the more common traits of autism is difficulty with reciprocal social interactions. And yet, studies have found that a sizable group of autistic individuals form secure attachments. However, bear in mind that the studies demonstrate somewhat mixed and inconclusive findings.

Attachment theory and autism correlation

Early research illustrated that infants with autism showed attachment responses to their caregivers. For instance, such children used social actions like looks, touches, vocal cues, and distress when separated. What’s more, children with autism may also use their caregiver as a safe base to explore their environment and return to when they feel startled or afraid. Essentially, according to these early studies, children with autism seemingly have similar attachment needs to those without. However, despite what might appear to be typical attachment-related behaviors, there are still clear individual differences in the overall quality of the bond that children with autism form with their caregivers. 

The disruption to this bond can come from difficulties with social actions associated with ASD, such as eye contact, stereotyped and repetitive behaviors, and difficulties relating to or understanding others. These issues can be challenging for a caregiver to manage. They may also result in problems meeting an ASD child’s needs in the way they require. 

Autistic Children May Be at Higher Risk of Forming an Insecure Attachment 

Analysis of the overall findings of recent studies showed that children on the ASD spectrum were significantly less securely attached to their caregivers than children without autism. In fact, children on the ASD spectrum were more likely to have a disorganized attachment style than their counterparts. 

Furthermore, these findings also suggest that the stronger the child’s autism traits, the more likely the child is to be insecurely attached. Moreover, lower levels of developmental ability are more highly associated with disorganized attachment. 

However, this lack of attachment security may only be found in children who fall on the more severe dimensions of the autism spectrum. The ASD children with milder symptoms seemed to show more secure attachment traits. In fact, studies that examined attachment in high-functioning older children with ASD found no differences between levels of secure attachment between ASD children and children considered to be typically functioning. This effect may come down to a caregiver’s ability to understand their child’s needs based on the child’s ability to communicate them clearly to them. 

The Benefits of Secure Attachment for Autism

Just like anyone else with a secure attachment style, securely attached people with autism tend to be more socially skilled, empathetic, and popular, in general. What’s more, autistic children that were found to be securely attached had greater language abilities. They also initiated more interactions with their caregivers during play times than their insecure counterparts. 

Also, in line with attachment theory, autistic children who have their emotional needs met through consistent and responsive caregiving are more aware of and better able to respond to the emotional needs of others. What’s more, their actions towards others during times of distress demonstrate empathy. However, these traits were not found in insecurely attached children with autism.  

Insecure Attachment Traits Could Lead to Early ASD Diagnosis 

As problems with social relationships are a key element of ASD, it may be the case that early traits of insecure attachment may be a tell-tale sign of the existence of autism.

Attachment and autism

A study of young children (approximately fifteen months old) found that the children who were at high risk of developing autism were significantly more likely to display the traits of an insecure attachment style – specifically the anxious attachment style – than children classified as low risk. 

Overall, research suggests that high-risk children who show signs of insecure attachment are actually nine times more likely to receive an ASD diagnosis in comparison to high-risk children with secure attachments. 

What’s more, an insecure attachment style may contribute to the difficulties experienced by children with autism and their families. This is because the traits of an insecure attachment style may further harm the child-parent bond during stressful times. 

How Caregiver Attachment Style May Impact the Severity of ASD Symptoms

Attachment styles tend to be passed down through generations. Basically, we tend to parent in the manner in which we are parented, unless we actively attempt to change our behaviors. Yet, autism disrupts both a child’s ability and motivation to signal their needs effectively to their caregiver. Therefore, we shouldn’t judge a caregiver’s ability to be sensitive to their child’s needs without these communication difficulties in mind. 

As previously suggested, the presence of more severe symptoms of autism may be a determinant of whether children with autism develop a secure or insecure attachment style. Therefore, it might be a child’s language ability and communication skills that affect caregivers’ sensitivity towards their child rather than the presence of autism in general. 

Secure Caregivers May Result in Secure ASD Children

Just like with typically developing children, caregivers of securely attached autistic children have been reported to be more sensitive and responsive towards their childrens’ needs than the caregivers of insecurely attached autistic children.

avoidant attachment and autism spectrum disorders

And although children with autism may respond differently to parenting styles than typically developing children, overall, they nevertheless have been shown to react positively to caregivers who model the actions of a secure attachment style. As a result of these secure actions, these children tend to have greater problem-solving skills. They also communicate better and engage more in imaginative thinking and play. 

However, these findings are mixed. Some studies suggest that no relationship exists between secure caregiver behaviors and secure attachment in autistic children. Therefore, it may be the case that the wide range in symptom severity and needs of children with ASD may uniquely impact the bond between a child and their caregiver. 

Furthermore, it may also be the case that children with autism require different factors than typical children to establish a secure attachment with their caregivers. This may be due to autistic childrens’ difficulties with social interaction. They may, in fact, respond to their caregivers’ attempts at forging closeness in highly individual ways. 

So, in essence, a caregiver’s ability to be sensitive to their child’s needs should be considered within the context of the specific relationship – including the child’s ability to respond to their caregivers’ actions sensitively. 

But We Cannot Assume Causality

It’s important to consider the fact that any studies that assessed caregiver sensitivity and severity of an autistic child’s symptoms always did so at the same time. For this reason, we cannot assume that a caregiver’s lack of sensitivity to their child’s needs resulted in more severe autistic symptoms. Or that a lack of caregiver sensitivity resulted from the presence of more severe autistic symptoms in the first place. The relationship between both is complicated, and more work is needed in the area to reach more confident conclusions.

Nevertheless, caregiver attachment style may play a significant role in both a child’s severity of symptoms and ability to relate to others – so an awareness of this and attempts towards acting more sensitive and responsive may have an incredibly positive impact on a child’s symptoms overall.

Overall Thoughts on Autism and Insecure Attachment

In all, the findings from research suggest that children with autism are capable of forming secure attachments with their caregivers. However, it also suggests that autistic children may be more prone to developing an insecure attachment than typically developing children. This is explained by the traits of their disorder and subsequent blockages to the child-caregiver bond. 

Nevertheless, the symptoms of autism may possibly improve by establishing more secure, stable, and interactive relationships with caregivers. Yet, caregivers of children with autism may struggle to understand how to meet the often complex needs of their children. Therefore, interventions designed to improve caregiver sensitivity may help them to understand how to interact with their children in mutually beneficial ways. 

Moreover, for a more detailed understanding of how autism and attachment interrelate, research in the home setting may be needed to obtain more definitive information regarding the development of autism and the specific attachment styles.

References 

Seskin, L., Feliciano, E., & Tippy, G. (2010). Attachment and Autism: Parental Attachment Representations and Relational Behaviors in the Parent-Child Dyad. Journal of Abnormal Child Psychology, 38, 949–960.

McKenzie, R., & Dallos, R. (2017). Autism and attachment difficulties: Overlap of symptoms, implications and innovative solutions. Clinical Child Psychology and Psychiatry, 22(4), 632–648.

Naber, F., Swinkels, S., & Buitelaar, J. (2007) Attachment in Toddlers with Autism and Other Developmental Disorders. Journal of Autism and Developmental Disorders, 37, 1123–1138. 

Capps, L., Sigman, M., & Mundy, P. (1994). Attachment security in children with autism. Development and Psychopathology, 6(2), 249-261.

Giannotti, M., & de Falco, S. (2021). Attachment and Autism Spectrum Disorder (Without Intellectual Disability) During Middle Childhood: In Search of the Missing Piece. Frontiers in Psychology, 12.

Rutgers, A., Bakermans-Kranenburg, M., van Ijzendoorn, M., & van Berckelaer-Onnes, I. (2004). Autism and attachment: a meta-analytic review. The Journal of Child Psychiatry and Psychology, 45(6), 1123-1132.

Martin, K.,Haltigan, J., Ekas, N., Prince, E., & Messinger, D. (2020). Attachment security differs by later autism spectrum disorder: A prospective study. Developmental Science, 23(5).

Rozga, A., Hesse, E., Main, M., Duschinsky, R., Beckwith, L., & Sigman, M. (2018) A short-term longitudinal study of correlates and sequelae of attachment security in autism. Attachment & Human Development, 20(2), 160-180.

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