Bonding (Attachment) Therapies

Description: Interventions intended to facilitate attachment or bonding between individuals with autism spectrum disorder (ASD) and their caregivers. In Holding Therapy, the mother forcibly holds the child close to her in order to prevent the child from distancing him/herself. “Gentle Teaching” focuses on providing unconditional support and encouragement to individuals with ASD (McGee & Gonzales, 1990).

Examples: Holding Therapy, Gentle Teaching, Son-Rise

Research Summary: Bonding therapies have not been evaluated in well-designed scientific studies on children with ASD, although one study suggests that Gentle Teaching may be non-beneficial for children with other developmental disabilities (Mudford, 1995). Because most children with autism have strong attachments toward their caregivers (Rutgers et al., 2004), the theoretical rationale for bonding therapies is suspect. Therapies that involve forcibly restraining the child or covering up the child with objects such as blankets are potentially dangerous and should be avoided (Chafin et al., 2009).

Recommendations: Researchers may wish to conduct studies with strong scientific designs to evaluate bonding therapies. Professionals should present bonding therapies as untested and encourage families who are considering this intervention to evaluate it carefully. Therapies that involve forcibly restraining or covering up the child are not recommended.

Selected References:

Systematic reviews of scientific studies:

Mudford, O. C. (1995). Review of the Gentle Teaching data. American Journal on Mental Retardation, 99, 345-355.

Rutgers, A., Bakermans-Kranenburg, M.J., Van IJzendoorn, M.H., Van Berckelaer-Onnes (2004). Autism and attachment: a meta-analytic review. Journal of Child Psychology and Psychiatry, 45, 1123-1134.

Recommendations of expert panels and government task forces:

Chafin, M., Hanson, R., Saunders, R., Nichols, T., Barnett, D., Zeanah, C., et al. (2009). Report of the APSAC task force on attachment therapy, Reactive Attachment Disorder, and attachment problems. Child Maltreatment, 1, 76-89.