Poster #148 - Maternal Sensitivity and Attachment in Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis

• In Event: 3-106 - Poster Session 11
  In Poster Session: PS 11 Section - Parenting & Parent-Child Relationships

Integrative Statement

Evidence shows that maternal sensitivity, i.e. the mother’s ability to perceive, interpret, and respond promptly and adequately to her child’s needs, is moderately associated with attachment security in neurotypical infants (De Wolff et van IJzendoorn, 1997). The impairment in the capacity of signaling discomfort in children with Autism Spectrum Disorder (ASD) may complexify the task for the mother to stay attuned to her child’s internal states, which may, in turn, affect the development of a secure mother-child relationship (Esposito et al., 2012; 2014). Nevertheless, most of studies observed a significant association between maternal sensitivity and attachment security in preschool children with ASD (e.g. Capps et al., 1994, Koren-Karie et al., 2009) except one that failed to show such an association (van IJzendoorn et al., 2007). The main purpose of this systematic review and meta-analysis is to clarify the magnitude of the association between maternal sensitivity and attachment security in a population of children with ASD (aged 0 to 6 years). A second objective is to explore the moderating role of children chronological age, percentage of boys included in the sample and publication year on effect sizes.
The systematic review was conducted using the following databases: PsychInfo, Medline and ProQuest Dissertations & Theses Global and the reference list of articles with the following key-words: (autism* or ASD) AND attachment AND («maternal sensitivity» or «parental sensitivity» or «caregiv* sensitivity»). Studies were retained if they included: (a) a sample of children with ASD (aged 0 to 6 years); (b) a measuring instrument assessing maternal sensitivity; (c) a measuring instrument assessing attachment security in children; (d) an association between both measures or the report data allowing to calculate an effect size of the association between attachment and sensitivity.
From the 940 articles identified, 7 articles, including 172 dyads of children with ASD and their mothers, met criteria and were included for quantitative analysis. According to Cohen’s conventions (1988), a moderate significant effect size was observed between maternal sensitivity and security of attachment in children in the sample (r = .45, 95% CI [.25 - .61], I2 = 45%). A significant difference was found between effect sizes according to child gender. In boys with ASD, the effect size was significantly slightly higher than in girls with ASD (b = .02, 95% CI [< .01 - .03], p = .02, I2 = 16%). Analyzes did not show any significant effect of children chronological age (b = .01, 95 CI [< -.01 - .02], p = .16, I2 = 53%) nor publication year (b = - .02, 95% CI [- .06 - .01], p = .20, I2 = 57%) on the effect size estimate.
Discussion will focus on the conceptual and clinical implications of these results for attachment theory and interventions with dyads including children with ASD. Considering the limited number of studies, more research is needed to evaluate the influence of various moderators such as mental retardation and severity of ASD on the association between maternal sensitivity and attachment in children with ASD.

Authors

• Flavie Cossette-Côté, Université du Québec à Trois-Rivìères
  Presenting Author

• Ève-Line Bussières, Université du Québec à Trois-Rivìères
  Non-Presenting Author

• Karine Dubois-Comtois, Universite du Quebec a Trois-Rivieres
  Non-Presenting Author