What is ‘secure emotional attachment’?

I was sitting at the doctor’s office when a mother walked in with her three year old girl. She had curly hair, rosy cheeks, and wore a fluffy pink dress with white laces. She caught my eye as she was moving away from her mum towards the toy box.

I winked at her with a smile and a little wave. She stopped, looked at me with a puzzled face, moved back slowly towards her mother and hid her face in her mum’s lap. She waited a few seconds, then attempted her adventure again. She moved quickly towards the toys, pulled out a raggedy doll from the box, ran and grabbed her mother’s jacket. She glanced at me with a cheeky grin then looked at her mother with a sense of achievement saying: “It’s a baby!”

This little girl’s typical behavior illustrates “the secure emotional attachment theory” where a young child displays proximity-seeking behaviour towards her caregiver in the presence of a stranger. She is relying on her mother’s presence for safety and protection. Researchers have questioned whether this theory applies to the world of an autistic child. After all, clinical and popular definitions of autism both mention emotional detachment as a part of the condition.

Emotional Attachment and Autism

The available research on the subject of attachment and autism contains some confusion about the interpretation of social skills and the definition of ’emotional attachment.’ There is a lack of differentiation between the behaviour in social skills such as smiling, pointing, sharing a toy with an adult, and the behaviour in attachment such as clinging, fretting and proximity-seeking to the caregiver.

In the 1990s OTARC Director Prof. Cheryl Dissanayake developed an interest in the subject and did not find any empirical data proving the existence of attachment in autistic children or the lack of it. Using the Ainsworth Strange Situation approach to record modified behaviour, she created a scenario to maximise the observation of the behaviour of 16 autistic children aged 3-6 interacting with their caregiver. She observed each child with her/his parent alone, the child with the parent and a stranger who walked into the room, the child with the stranger while the parent walked out of the room, and the child’s reunion with the parent.

Prof. Dissanayake discovered that compared to their typical developing peers, children with autism did chose to be selective in their behavior to demonstrate a secure form of emotional attachment. The fretting, clinging, vocalising, and moving towards the parent were all behaviours exhibited by children with autism but varied from one child to the other in frequency and intensity depending on their developmental level. She was able to provide strong evidence that children with autism did clearly show a preference towards their caregiver as well as awareness of strangers.

Taking the next step

Prof. Dissanayake took her research a step further to investigate if children with autism continue to develop their security of caregiver attachment during the middle childhood phase. A typical child between the age of eight and twelve is cognitively able to internalise her relationship with her parents. She can anticipate and interpret her parents’ response or behaviour and act upon it. A sample of 17 typical children from that age group and 21 peers with high functioning autism were asked to complete the Kerns Security Scale (KSS) questionnaire to measure their perception of attachment security in the caregiver. The questions on the KSS are designed to measure the degree to which children believe a caregiver is available and responsive and how easy it is to talk to her.

Prof. Dissanayake concluded that there were no marked differences between the two groups. Children with high functioning autism know that when they are struggling with social and emotional issues, their parents will be available and responsive to their concerns.

What does this mean for your child?

“It’s a baby! Look mummy!” the little girl at the doctor’s office climbed up and sat on her mum’s lap. The mother cuddled her and they exchanged smiles and a lengthy conversation about the doll. If this girl’s attachment continues to be nurtured she will grow up with confidence and positive self-esteem. However if that is taken away from her, she will develop an insecure-ambivalent attachment which will impact further relationships and may lead to behavioral problems and self unworthiness. Prof. Dissanayake’s research findings show that autistic children do exhibit a secure attachment towards their caregiver, from which we can infer that “nurturing the secure attachment relationship may represent a protective factor for these children.”

Prof. Dissanayake’s work has impacted the views and perspectives of parents and clinicians.  “It is important for parents to understand attachment and know that their child is emotionally attached to them. It is not about looking for the social interactions and saying my child needs me but does not want me. It is about how your child behaves when you leave him and how he greets you when you come back.” The child with autism does not perceive the caregiver as an object that is interchangeable but as a secure emotional anchor in a relationship that needs nurturing. Consequently it is that relationship that can become the catalyst for social interaction and joint attention.

This piece was originally published in OpenForum.

Published April 2013