Our understanding of autism and PDD’s (“ASD”) has leapt forward over the last two decades, but it still confounds the most experienced clinicians. Research is beginning to provide some scientific data on ASD, but much remains unknown.
There is solid research to refute Bettelheim’s “Refrigerator Mother” hypothesis. Studies also report that most ASD children do not differ in early attachment behaviours from their typical counterparts. Although a subset may display “disorganized attachment”, even this may be more attributable to associated intellectual disabilities. The literature on the interactions between ASD and co-morbid mental health conditions is scarce. We know these children suffer a markedly higher risk for psychiatric disorders (often presenting in atypical patterns). Yet, the manifestation and impact of a psychiatric syndrome in a child with ASD remains largely speculative.
The best clinical research into improving the outcomes for children with ASD remains flawed, but points to the importance of early and meaningful support for child and parent development. Though informed pharmacological treatment can sometimes be very helpful, it does not replace adequate attention to the support needs of families. The case history of J.D. reflects the remarkable resilience of parents in spite of daunting childhood disorders, and how appropriate supports promote better outcomes for all.