Peculiarities of attachment behavior in children with autism. Interaction problems as a signaling disorder between people

The "DMM" according to Crittenden

Bachelor Thesis , 2014 , 53 Pages , Grade: 1,0

Pedagogy - Orthopaedagogy and Special Education

The phenomenon of autism seems to fascinate society as it becomes more widely known, but unfortunately its significance is often completely misunderstood. Reactions to the topic are often monosyllabic. Along with the symptoms come interesting ideas: people with autistic disability live in their "own world," they have no feelings or social interest, and they are also geniuses. This work is concerned, among other things, with clearing up these false "facts".

The main part of this thesis can be divided into three parts: first the topic of autism is dealt with, then that of attachment and finally attachment behavior in people with autism. This bachelor thesis does not only serve to enlighten about autism, i.e. to describe the development of autism research and the symptomatology, but also to dedicate a special aspect: the assumption that people with autistic disabilities have no social interest and do not develop emotions.

In order to examine this aspect more closely, the time of early childhood will be addressed, the age at which the person forms his first attachments. It will be attempted to get to the bottom of the cause and purpose of attachment, the theory of attachment, the phases and forms that attachment goes through and takes on, as well as which factors promote stable attachment behavior.

However, the questions that this bachelor thesis ultimately addresses are: Can all people form attachments in principle? If so, how do they manifest themselves in disabled children, especially in children with autistic disabilities? Are there any special features and if so, what are they due to? A special role in answering these questions will be played by the "Dynamic Maturation Model of Attachment and Adaptation" according to Dr. Patricia Crittenden.

Table of contents

Table of contents

1. Introduction

2. Autism
2.1. The pioneers of autism research
2.1.1. Hans Asperger
2.1.2. Leo Kanner
2.2. Autism today – the symptomatology
2.3. Perceptual peculiarities
2.3.1. Seeing
2.3.2. Listening

3. First binding
3.1. The bonding theory according to John Bowlby
3.2. The "Foreign Situation" according to Ainsworth and Wittig
3.2.1. The 4 binding types
3.2.2. Cause and purpose of the development of a binding system
3.2.3. Attachment behaviour in disabled children
3.2.3.1. Resilience and vulnerability in children at risk
3.2.4. Mother-child bonding in interaction with a disabled child
3.3. Initial conclusions

4. Autistics and attachment - explained at the "DMM" according to Crittenden
4.1. Definition of the DMM
4.2. Autistic children and "signal disturbances" of negative base effects
4.3. Resulting interaction in mother and child

5. Conclusion

List of references

Internet sources

Appendix:

1. Introduction

Although the phenomenon of autism seems to fascinate society with increasing popularity, its importance is often, unfortunately, completely misunderstood. Reactions to the topic are often monosyllabic: "Oh yes, I saw âRain Manâ." No, not every person with autism is a "Rain Man". But the American film, in which the highly talented autistic Raymond and his brother Charlie embark on a long journey across the USA, certainly ensured with the help of the media that the autism disorder reached more people, but also for a distorted clinical picture. The symptoms are accompanied by interesting ideas: People with autistic disabilities live in their "own world", they have no feelings or social interest and geniuses they are too. This work deals, among other things, with cleaning up these false "facts".

Recently, the autism disorder was in the media, as the software company SAP announced in 2013 that it wanted to train and hire hundreds of autistic people by 2020, so that 1% of employees would then be autistic.¹ But not all people with autism are highly gifted or even geniuses, there is a wide spectrum of clinical pictures and their manifestation. In Germany a few years ago, figures were circulating according to which out of 10,000 children about 4-5 have an autistic disability. However, these numbers are rising steadily, currently these are estimated at about 15-40 children out of 10,000. It is striking that the probability of boys being born with an autism disorder is four times as high as for girls.²

The main part of the present work can be divided into three parts: first the topic of autism is dealt with, then that of attachment and finally the attachment behavior in humans with autism.

This Bachelor's thesis not only serves to educate about autism, i.e. to describe the development of autism research and the symptoms, but also to dedicate a special aspect: the assumption that people with autistic disabilities have no social interest and do not develop emotions. In order to examine this aspect in more detail, the time of early childhood is thematized, the age in which man enters into the first bonds.

An attempt will be made to get to the bottom of the cause and purpose of binding, the bond theory, the phases and forms which bond experiences and assumes, as well as which factors promote a stable bonding behavior.

But the questions that this Bachelor's thesis ultimately deals with are: Can in principle all people form bonds? If so, how do they manifest themselves in disabled children, especially children with autistic disabilities? Are there any special features and if so, what are they due to? A special role in answering these questions will be played by the "Dynamic maturation model of attachment and adaptation" according to Dr. Patricia Crittenden.

2. Autism

"Autistic people can love, at least that's what I do. How I show this, however, may not necessarily meet with the approval of society."

(by uppsdaneben, forum for autistics and interested contemporaries on the subject of love) ³

Au|tis|mus: from Greek ΑΥ̓ΤΌΣ ( "autós" ) - itself

The term "autism" existed before it was used in the context of autism as a disability as we know it today. Eugen Bleuler, a Swiss psychiatrist, used the term in his 1911 paper "Dementia Praecox" or "Group of Schizophrenias". Autism described one of the basic symptoms that occurs in schizophrenia.⁴ One characteristic here is the "interrelationship of internal life with the outside world. The inner life gets a morbid overweight (autism)."⁵ By this he means that autistic people withdraw strongly into their "own world" and lose contact with the environment in favor of their own world of thought. Bleuler, on the other hand, refers in his writing to the concept of "autoerotism", which Sigmund Freud already used. However, this was misleading, since Freud dealt strongly with the sexual aspect of schizophrenia, which Bleuler did not want to go into here. For this reason, a new term had to be introduced.⁶

If you look back in the history of autism, it has experienced a wide variety of developments. An autistoid behavior of people triggered in the course of time various ideas, where the origin of this could come from.

During the period of Tsardom in the years 1547 to 1721, it was believed that this behavior was the origin of a special religiosity of man, which had detached itself from social conventions and did not care about law and order. Since this behavior was considered strange, autistic people were probably also referred to as "holy fools". They are chosen to transmit coded divine messages to humanity.⁷

But in addition to these rather loose superstitious solutions, there were also early concrete records with descriptions of autistic behavior. Over 200 years ago, in 1799, the French doctor and deaf-mute teacher Jean Itard made Records of Victor of Aveyron, also "the savage of Aveyron" called. This had been found by chance as a so-called "wolf boy" completely feral in 1797 in a forest in southern France. The boy, who was estimated to be about ten years old at the time, had symptoms at the time that would be called autism today. Itard described that victor, to his dissatisfaction, made little progress towards "civilization" after a very short time and handed him over to an outbuilding of the deaf-mute institution, where he worked as chief physician. Victor died there at the age of about 40.⁸

In 1908, the Austrian pedagogue Theodor Heller as head of the "Educational Institution for Mentally Abnormal and Nervous Children" on rare developmental peculiarities, which occurred between the third and fourth year of life. These were accompanied by a loss of already acquired skills, in particular language, as well as the development of a severe intellectual disability. Heller referred to this disorder as "Dementia infantilis", or "Hellerâsche Dementia", which is similar to autism.⁹

2.1. The pioneers of autism research

All these observations about autistic behaviors collected so far in history have in common that they were written from the outside perspective.

In recent autism research, intra-perspective statements by those affected are becoming more and more common and are now not only increasingly perceived, but also included in ongoing research. However, in many cases only observations from the outside perspective are possible, since those affected are often not able to tell about their experiences or to writing them down. This mainly affects diagnosed autistic people with a severe degree of disability or early childhood.

Those who are regarded as pioneers of autism research Hans Asperger and Leo Kanner in the 1930s to 1940s, they approached the topic with the help of the outside perspective, as they worked with children. They both contributed to the fact that from this point on it became possible to describe a first disorder picture of "autistic" valid children through case presentations.¹⁰

2.1.1. Hans Asperger

The Austrian pediatrician and curative educator Hans Asperger was born in 1906 in Hausbrunn, near Vienna. He studied medicine at the University Hospital of Vienna, where he received his doctorate in 1931 and from then on worked as an assistant at the children's hospital. A year later, he took over the management of the curative education department there.

Here Hans Asperger gave a lecture in 1938, in which he first discussed so-called "autistic psychopaths" Lectured. In this lecture, which for a long time was unfairly little noticed, he presented the symptoms of these autistic psychopaths, which are today called the Asperger's syndrome knows. It was originally assumed that Asperger's described these symptoms in his habilitation thesis only in 1944.

His presentation is also of particular importance because it was aimed at protecting the children concerned. In the same year, Austria was reunited with the German Reich. Austria now also threatened to enforce the "Law for the prevention of hereditary diseased offspring", of which Hans Asperger was aware. He noted that a "Wiener Gesellschaft für Rassenpflege" had already been founded in 1924 at the University of Vienna, which was closely linked to the National Socialist Network.

Here, after reunification, became official "hereditary and racial biological teachings" in research and teaching.¹¹ In order to keep the fascist ideologies of the "unworthy of life" existence away from his protégés, he tried to make the doctors, who would in future become active for the not yet passed law on racial hygiene, to observe all abilities, as well as the personality of the child. He first cautiously tried to point out the social upheaval with its consequences in psychiatry. But then he changed the view of "Public health point of view" into a "Viewpoint of abnormal children" ¹²A bold and rather unusual step by Asperger's:

"How much can we do for these people? is supposed to be the question. And if we help them with all our devotion, we are also doing our people the best service; not only by preventing them from burdening the national community through their dissocial and criminal acts, but also by seeking to ensure that they, as working people, fill their place in the living organism of the people".¹³

He thus calls for the children to be helped instead of condemned, since they could also "fill their place as working people in the living organism of the people" – a counter-argument for the welfare costs that people with disabilities bring about according to the National Socialist ideologies and thus burden the "healthy people". Asperger's appealed that "abnormal" should not be equated with "inferior" and tried with this decisive argument to avert the imminent danger that approached the children with the adoption of the law on the prevention of hereditary disease.¹⁴. On 01.01.1940 the law actually came into force in Austria. It is known that the sterilization of these "hereditary patients" was one of the first crimes introduced under the National Socialist regime.¹⁵ Not only to fight preventively for the well-being of children is what makes Asperger's lecture of 1938 so important, he also described the first pedagogical approaches for working with the "autistic psychopaths", who are still considered universally valid even today. This includes "the primary response of the mind before emotions" and "the need for reliable rules in the daily routine and thus its predictability."¹⁶ In 1944 Hans Asperger's habilitation thesis "Die âAutistischen Psychopathenâ im Kindesalter" was published. On the basis of four case presentations, he concretized seven symptoms of such "autstic psychopathy" with the help of his previous research:

1. The disorder is congenital.
2. Relations with the environment are constricted in all areas.
3. From the second year of life, the abnormalities are recognizable and persist throughout life.
4. Verbal and non-verbal communication has special features.
5. Special features in learning are striking, as the children are absorbed in their own interests, but are limited if they have no interest in the topic or if they are to learn something by heart.
6. Learning everyday work is difficult.
7. The emotional level of these people can be described as qualitatively different. ¹⁷

Hans Asperger died on 21.10.1980 in Vienna.¹⁸

2.1.2. Leo Kanner

Leo Kanner was an Austrian-American child psychiatrist and was born in 1896 in Klekotow in Austria-Hungary (today's Ukraine). In 1913 he began studying medicine at the University of Berlin, where he received his doctorate six years later. In 1924, he emigrated to the United States, where he occupied an assistant position in psychiatry at yankton county hospital in South Dakota. In 1930 he founded a child and adolescent psychiatric clinic, the John Hopkins Children's Psychiatric Clinic in Baltimore, Maryland. Kanner first described in 1943 the signs of what we now call "early childhood autism" (Kanner syndrome) know.

He also determined the disorder on the basis of a case presentation of eight conspicuous children and described 4 symptoms:

1. The building of a relationship with man and situation is denied to the children from birth, while a relationship with things is quite possible.
2. Verbal communication is striking, as some children do not learn to speak at all and others do not use it for a long time to convey information.
3. Uniformity is essential for the children, spontaneous activities are rare
4. The families are intelligent. ^[19]

For a long time, Kanner seemed to be one step ahead of Hans Asperger, as his habilitation thesis had taken up the topic of autism a year earlier. However, this was only true until the relevance of Asperger's lecture of 1938 was emphasized, which had thus overtaken Kanner again. The aspect that the two psychiatrists are said to have written about the symptoms of autism in their writings at the same time and yet independently of each other seems curious.

Especially since Leo Kanner in "Autistic Disturbances of Affective Contact" the year 1938, i.e. the year of Asperger's lecture, stands out as a year in which he noticed some children whose behavioral characteristics differed greatly from those of the others.²⁰

Since Leo Kanner and Hans Asperger both came from Austria, there is a high probability that Kanner closely followed all child psychiatric developments in his home country and thus Asperger's lecture on autistic psychopaths did not pass him by. However, all accusations of plagiarism are unfounded and have never been confirmed.²¹ Leo Kanner died on 03.04.1981 in Syskeville, Maryland.²²

2.2. Autism today – the symptomatology

Today, autism is classified by the WHO according to the diagnostic classification system ICD-10 to the "profound developmental disorders" counted. He is considered innate and incurable. Autism is described by researchers, doctors and those affected as a perceptual and information processing disorder of the brain.²³

In German-speaking countries, a distinction is made between 3 forms of diagnosis of autism:

- Asperger's syndrome,
- early childhood autism
- and atypical autism.

The boundaries from "normality" to a strongly pronounced autistic disorder are very fluid and an exact classification is not easy due to the diverse symptoms. For this reason, summarizing a "Autism Spectrum" in which the severity of the autistic disability of the person concerned is classified. That's why autism is also common "Autism Spectrum Disorder" called.²⁴

that Asperger's syndrome is only noticeable from about the age of 4 of a child who is not developmentally delayed. Since the intelligence of these children ranges from an average intelligence quotient to giftedness, autistic disability is not very obvious, which is why it is considered more of a "nerd" by the environment.

It is striking that they are severely limited in their patterns of action, which also affects their social interaction. These children usually pursue special interests with a special intensity.²⁵

If one of these special interests meets a giftedness, it can in very rare cases become a so-called "Inselbegabung" or the "Savant syndrome" which also affected Kim Peek, for example, who provided the model for Raymond in the film "Rain Man". 50% of these "Savants" are autistic. With such a gift for the same, it is possible for man to perform extraordinary and individual achievements in a sub-area.²⁶ Another well-known example is the Briton Stephen Wiltshire. The autistic artist had attracted the attention of the media because, after a unique helicopter flight, he was able to draw the city panorama of various cities such as London, Frankfurt am Main, Hong Kong and Rome completely from memory. In addition to an artistic one, there are also musical, computational, linguistic and visual talents as well as an extraordinary memory.²⁷

However, such a similarization is the absolute exception and should not be too closely associated with the symptoms of autism spectrum disorder.

According to current estimates, there are only about 100 people worldwide with such a talent. It doesn't always have to be Asperger's autism.²⁸

People with the Asperger's syndrome usually have weaknesses in motor dexterity. But the linguistic level is very high. They have a large vocabulary and can be described as eloquent. However, they have problems understanding non-verbal signals and sending them themselves, especially in relation to eye contact. For example, there are strong reaction delays and difficulties of interpretation of the other person. These clumsy and "strange" behaviors underline the status of the oddball.²⁹

Early childhood autism (Kanner syndrome), also called "infantile autism" is known to be the most noticeable disorder within the autism spectrum. It occurs within the first three years of a child's life. This is usually referred to as an intellectual disability classified, but what can not be must.

Kanner's syndrome is further referred to in English in a "Low (LFA)", "Intermediate (IFA)" and "High Functioning Autism (HFA)" subdivided . Here, the LFA is classified as an intellectual disability, the HFA describes a normal to above-average intelligence. The distinction between "High Functioning Autism" and Asperger's Autism has not yet been regulated at this point. Early childhood autism can be expressed in a variety of disabilities. In addition to the most impaired intelligence, the most noticeable is a retarded speech development, but also difficulties in eye contact. Children with this autism spectrum disorder can become conspicuous in the first months of life, in other cases only between the first and third year of life. If the second case occurs, a loss of the language skills learned so far can often be observed. Icd-10 states that other nonspecific disorders such as anxiety, sleep and eating disorders as well as aggressive and self-injurious behavior can be associated with Kanner's syndrome.³⁰

from atypical autism is spoken when not all diagnostic criteria for early childhood autism are met or the abnormalities do not occur within the first three years of life. It is differentially and diagnostically distinguished from Asperger's autism, but is considered a subtype of Kanner's syndrome.³¹ Here again the symptoms of Asperger's syndrome and early childhood autism in direct comparison:

Asperger's syndrome

Early childhood autism

first occurrence

From the age of 3

Within the first 3 years of life from approx.dem 10th month of life

intelligence

Normal to above-average IQ, up to giftedness

Usually classified as mental retardation with impaired intelligence (LFA), sometimes normal (IFA) to above average (HFA) IQ

communication

Early development of an eloquent language style with large vocabulary; difficulties of interpretation in the case of metaphorical/ironic statements of the other person; Problems with maintaining eye contact

Frequently retarded and/or delayed speech development, also due to loss of already learned skills; Problems with maintaining eye contact

Motor

Often motor disorders

No motor abnormalities, unless there is a corresponding disability

Although autism spectrum disorder is considered congenital, the exact cause of its development remains unclear. In research, it is sometimes assumed that a variety of factors play a role on which there are different opinions. Researchers largely agree on the significance of biological genetic factors, in addition to the influence of the Epigenetics. This is regarded as bridging the field of tension between the genetic make-up and the influence of the environment. Humans are not completely pre-programmed, not all our genes are activated. Our genetic make-up is to be understood as a library, whereby it depends on which books are read. This "switching on and off" of the genes is also called "gene regulation". In epigenetics, an attempt is made to determine the external factors responsible for this.³²

In addition to many other factors, risk factors in pregnancy and childbirth are also mentioned, as well as neurological abnormalities. Even the parental age at birth is said to have a possible influence.

Since this work deals, among other things, with the peculiarities of attachment behavior in autistic children, one speaks here, due to the relevant age up to three years, about an early childhood autism.³³

2.3. Perceptual peculiarities

Within the first 3 years of life, the most important developmental steps for the bond between child and caregiver take place. It is precisely the aspect of communication that is absolutely necessary for building a bond between two people. But especially in this area, people with autism are enormously restricted. According to many statements of those affected, they have a different perception than non-autistic people, especially with regard to hearing and seeing. The German graduate pedagogue Brita Schirmer has, above all with the help of such internal perspective reports from those affected, dealt in detail with these "Perceptual peculiarities" employed by autistic people.

2.3.1. Seeing

Think and act as a next step. As simple and ordinary as this process may seem to a healthy developed person, people with autism are faced with a difficult task. The thoughts and the actions differ so much from each other that one could speak of a kind of "transmission error". This leads to difficulties of interpretation on the part of the environment.

The lack or only very fleeting eye contact is considered one of the most striking symptoms of autism. The search for the origin of this phenomenon has always led to controversial discussions. Do the children lack interest in contacting us and thus also human relationships in general? Or does it avoid eye contact out of fear? Asperger's time also dealt with similar questions. In his habilitation thesis, he writes that the disturbance becomes clear above all in the conversation, since one not only answers with words, but also "with the gaze, with the tone of the speech, with the expression of his expression and his gestures; it is precisely the thymic relationships, i.e. that which binds above all other people to people, that take place in these latter phenomena.."³⁴

[...]

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¹ SPIEGEL ONLINE: Software-Konzern: SAP stellt Hunderte Autisten ein. URL http://www.spiegel.de/wirtschaft/unternehmen/sap-stellt-bis-2020-hunderte-autisten-ein-a-900882.html Stand 21.01.2014

² AUTISMUS1.de: Häufigkeit von Autismus.URL http://www.autismus1.de/autismus-glossar-a-z/143-haeufigkeit-von-autismus-in-deutschland.html Stand 21.01.2014

³ UPPSDANEBEN: Autismus und Liebe. Forum für Autisten und interessierte Zeitgenossen. Vom 01.06.2006. URL http://376277.forumromanum.com/member/forum/forum.php?action=ubb_show&entryid=1095521225&mainid=1095521225&USER=user_376277&threadid=1147912167 Stand 27.11.2013

⁴ vgl. SCHIRMER, Brita: Autismus von der Außen- zur Innenperspektive. Erschienen in: Behinderte in Familie, Schule und Gesellschaft Nr. 3/2003. Thema: Autismus von innen, p.5

⁵ BLEULER, Eugen: Dementia Praecox. 1Aufl. Leipzig 1911, p.51

⁶ (Cf., ibid., p.52)

⁷ cf. SINZIG, Judith: Frühkindlicher Autismus. Springer-Verlag, Berlin Heidelberg 2011, p.1

⁸ cf. ITARD, Jean: Victor, das Wildkind vom Aveyron. Rotapfel, Stuttgart 1965 , p. 12-32

⁹ cf. SINZIG, Autismus, a.a.O., p.1

¹⁰ vgl. SCHIRMER, Innen- Außenperpektive, a.a.O., p.1

¹¹ cf. SCHIRMER, Brita: Autimsus und NS-Rassengesetze in Österreich 1938: Hans Aspergers Verteidigung der "autistischen Psychopathen" gegen die NS-Eugenik. In: Die neue Sonderschule Jg. 47 Heft 6, 2002, p.460-.464

¹² ASPERGER, Hans: Das psychisch abnorme Kind. In: Wiener Klinische Wochenzeitschrift 51, 1938, p.1314-1317

¹³ Ibid.

¹⁴ Ibid.

¹⁵ cf. SCHIRMER, NS-Rassengesetze, a.a.O., p.460-464-464

¹⁶ SCHIRMER, Innen- Außenperpektive, loc. cit., p.3

¹⁷ ASPERGER, Hans: Die ,Autistischen Psychopathenâ im Kindesalter. In: Archive of Psychiatry and Nervous Diseases, 7,1944, pp.76-136

¹⁸ cf. SCHIRMER, Innen- Außenperpektive, loc. cit., p.4

¹⁹ Cf. ibid.

²⁰ (Cf., ibid., p.77)

²¹ Cf. ibid.

²² (Cf., ibid., p.77)

²³ ATTWOOD, Tony: Ein ganzes Leben mit dem Asperger-Syndrom. Alle Fragen – alle Antworten. TRIAS, Stuttgart 2008, p.27-30

²⁴ ICD-10 see Annex

²⁵ cf. ROY, Mandy; DILLO, Wolfgang; HINDERK M., Emrich & OHLMEIER, Martin D.: Das Asperger-Syndrom im Erwachsenenalter. In: Dtsch Arztebl Int. Nr. 106(5), 2009, pp. 59–64

²⁶ cf. TREFFERT, Darold.: Extraordinary People. Understanding "Idiot Savants", New York 1989

²⁷ STEPHEN WILTSHIRE MBE. URL http://www.stephenwiltshire.co.uk/ Status 11.01.2014

²⁸ cf. JACOBS, Angelika: Geheimnisvolle Genialität. URL http://www.wissenschaft-online.de/alias/inselbegabung/geheimnisvolle-genialitaet/959093 Status 12.01.2014

²⁹ ICD-10 see Annex

³⁰ Ibid.

³¹ Ibid.

³² cf. Portal epigenetischer Forschung: Einführung. URL http://epigenetics.uni-saarland.de/de/home/ Status 20.01.2014

³³ ICD-10 see Annex

³⁴ ASPERGER, Hans: Heilpädagogik. Einführung in die Psychopathologie des Kindes für Ärzte, Lehrer, Psychologen, Richter und Fürsorgerinnen. Springer, 3rd ed., Wien 1961, p.178f.

• College: University of Frankfurt (Main)
• Course: Erziehungswissenschaften
• Grade: 1,0
• Author: Lisanne Hilker (Author)
• Publication Year: 2014
• Pages: 53
• Catalog Number: V1175609
• ISBN (PDF): 9783346587152
• Language: English
• Tags: peculiarities, interaction, crittenden