Tangled Roots and Ramifications: The Early Histories of Autism Spectrum Disorder and Reactive Attachment Disorder

Abstract

This chapter provides a historical context and overview of a burgeoning mental health service crisis and public health problem. The diagnostic confusion between Autism Spectrum Disorder (ASD) and Trauma and Stressor Related Disorder (TSRD), particularly Reactive Attachment Disorder (RAD) has undermined the credibility of professionals in the field, and contributes to challenges in professional-caregiver collaboration to meet the needs of children and youth with these conditions. We first compare and contrast the early histories of ASD and RAD and how those histories have overlapped and intertwined over time. Interestingly, as Bettelheim, Kanner, and others endeavored to understand autism and its causes, Rene Spitz and other investigators were simultaneously describing the impact of severe, institutional neglect on children’s development. We next discuss how perceived stigma associated with these conditions have waxed and waned, and more importantly, how perceived stigma seems to have influenced patterns of help-seeking behavior. The chapter is not a comprehensive history of ASD and TSRD, but an attempt to understand their confused and entwined histories. We hope that this understanding will put us in a better position to suggest some potential ways of dealing with this problem.