How are autism and attachment related?

Research shows a connection between attachment disorders and autism spectrum disorder (ASD), or autism. For example, one study found that approximately 20% of children with reactive attachment disorder (RAD) also showed symptoms of autism. In addition to this symptom overlap, these conditions can also co-occur. Sometimes, this can make it difficult to tell whether a person is living with autism, an attachment disorder, or both. 

But regardless of a person’s diagnosis, it’s important to know that having autism doesn’t necessarily prevent a child from forming secure attachments with their caregivers. While autism is a lifelong condition, attachment bonds can be strengthened with the right support.

How does autism affect attachment?

The relationship between autism and attachment isn’t yet fully understood. We don’t know whether autism makes it more difficult for children to form secure bonds with caregivers. Similarly, we don’t have clear evidence that insecure attachment increases a child’s risk of autism. 

However, it appears that children with autism are at greater risk of being insecurely attached. In this context, the term “attachment” describes the bond between an infant or child and their primary caregiver(s). 

When a child is securely attached, they trust their caregivers to keep them safe. This dynamic provides a secure base for them to go out and explore the world and develop the resilience they need to manage stress. In contrast, when a child has an insecure attachment, they don’t trust their caregivers to keep them safe. This may increase their risk for mental health problems, relationship difficulties, and other challenges later in life. 

Can autism cause an attachment disorder?

Autism isn’t caused by attachment disorders like reactive attachment disorder or disinhibited social engagement disorder (DSED). While there appears to be a correlation between autism and attachment disorders, they don’t directly cause one another. 

Are autism and attachment styles related?

People with autism may be more likely to develop an insecure attachment style. But, fortunately, attachment bonds between children and parents can be improved, and this may improve developmental and relational outcomes overall in those with autism.

It’s also important to note that early autism research placed undue blame on parents. It was incorrectly assumed that if a child developed autism, it was, at least in part, because their parents harmed them or did something wrong. 

Today, we understand that autism is a complex neurodevelopmental condition caused by a wide range of factors. While adverse childhood experiences can impact mental and physical health, autism isn’t the result of attachment difficulties or a particular parenting style.

Are attachment issues part of autism or a sign of another condition?

On their own, attachment issues aren’t a part of autism. A person can meet the diagnostic criteria for an attachment disorder without having autism (and vice versa). While these conditions can create similar symptoms, there are also some notable differences between them:

• Attachment disorders are associated with child maltreatment, while autism isn’t.
• Children with insecure attachments may struggle with physical affection due to experiencing abuse or neglect. Children with autism may feel uncomfortable with affection due to sensory sensitivities.
• Attachment disorders can lead to hypervigilance due to a belief that one isn’t safe. But children with autism may be completely unaware of others’ thoughts and feelings.
• Children with attachment disorders may lie or attempt to manipulate others to produce a desired outcome. But children with autism tend to tell the truth and may be incapable of deception.  

Can an attachment disorder look like autism?

Autism and insecure attachment can create similar symptoms. Both can lead to:

• Communication challenges
• Difficulty developing social skills
• Emotional dysregulation
• Repetitive behaviors
• Social isolation
• Discomfort with eye contact
• Discomfort with affection 
• Sensory challenges
• Difficulty showing empathy

Anyone can experience attachment difficulties without meeting the full diagnostic criteria for an attachment disorder. However, a child might be more likely to develop an attachment disorder if they experience:

• Severe problems in early relationships
• Physical or emotional abuse or neglect
• Inadequate care at home or in an institution
• Time in an out-of-home setting, like an orphanage, foster care home, or residential facility
• A traumatic loss or event
• Changes in their primary caregiver 

Overcoming attachment challenges with autism

With the right support, people with autism can develop more secure bonds with the people they love. However, some traditional attachment therapies may need to be modified for them. For example, some approaches involve having people physically hold one another as a means of strengthening their connection. Providers who are experienced in supporting autistic people can modify these interventions for people with sensory sensitivities.

In addition, other types of therapy, like relationship development intervention (RDI), have been developed specifically to help people with autism form meaningful relationships. The goal of RDI is to foster “dynamic intelligence,” which supports perspective taking, integrating information, and coping with change. These skills can help improve social connection, self-awareness, and flexibility — all core aspects of secure attachment.

In addition to therapy, self-care has also been shown to encourage secure attachment by increasing resilience. So try to make time each day to invest in your physical and emotional well-being. This can include getting adequate rest, eating a balanced diet, and doing things that bring you joy.   

Find care with Rula

Autism and attachment disorders are different diagnoses that are sometimes mistaken for one another. These conditions typically manifest in early childhood and can lead to similar social, emotional, and developmental challenges. 

However, it’s important to remember that while attachment disorders can result from childhood maltreatment, that’s not the case with autism. While this can lead to some diagnostic confusion, the good news is that people with autism can strengthen their attachments with the right support.   

When you need mental health support that honors neurodiversity in all forms, we invite you to explore Rula. With a network of over 10,000 providers to choose from, you can find the right support for your needs in just a few clicks. To begin, head over to our therapist-matching program to find a provider who takes your insurance and begin receiving the specialty care you deserve as soon as tomorrow.

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