Refrigerator mother theory

The term refrigerator mother was coined in the 1940s as a label for mothers of autistic children. These mothers were often blamed for their children's atypical behaviors, which included rigid rituals, speech difficulty, and self-isolation.

The 'refrigerator mother' label was based on the assumption, now discredited among a majority of medical professionals, that autistic behaviors stem from the emotional frigidity of the children's mothers. As a result, many mothers of autistic children suffered from blame, guilt, and self-doubt from the 1950s throughout the 1970s and beyond, when the prevailing medical belief that autism resulted from inadequate parenting was widely assumed to be correct.

Origins of 'refrigerator mother' theory
Psychologist Bruno Bettelheim and other mental health professionals championed the notion that autism was the product of mothers who were cold, distant and rejecting, thus deprived of the chance to 'bond properly'. The theory was embraced by the medical establishment and went largely unchallenged into the mid-1960s, but its effects have lingered into the 21st century.

As early as 1943, Leo Kanner, who first identified autism, called attention to what appeared to him as a lack of parental warmth and attachment among the mothers of autistic children. In a 1949 paper, he suggested autism may be related to a "genuine lack of maternal warmth." In a 1960 Time magazine interview, Kanner bluntly described such mothers as "just happening to defrost enough to produce a child."

Although Kanner was instrumental in framing the 'refrigerator mother' theory, it was Bruno Bettelheim, a University of Chicago professor and child development specialist, who facilitated its widespread acceptance by the public and the medical establishment cognoscenti in the 1950s and 1960s. Many articles and books published in that era blamed autism on a maternal lack of affection, but by 1964, Bernard Rimland, a psychologist with an autistic son, published a book that signaled the emergence of a rational counter to the established misconceptions about the causes of autism. His book, Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior, attacked the 'Refrigerator Mother' hypothesis directly.

Soon afterwards, Bettelheim wrote The Empty Fortress: Infantile Autism and the Birth of the Self, in which he compared autism to being a prisoner in a concentration camp, "The difference between the plight of prisoners in a concentration camp and the conditions which lead to autism and schizophrenia in children is, of course, that the child has never had a previous chance to develop much of a personality." Some authority was granted to this as well because Bettelheim had himself been interned at Dachau during World War II. The book was immensely popular and Bettelheim became a leading public figure on autism until his death, when it was revealed that his claims for success were greatly inflated if not wholly fabricated, and that Bettelheim himself had been involved in various cases of violent actions towards children in his clinic.

In 1969, Kanner addressed the 'refrigerator mother' issue at the first annual meeting of what is now the Autism Society of America, stating "From the very first publication until the last, I spoke of this condition in no uncertain terms as 'innate.' But because I described some of the characteristics of the parents as persons, I was misquoted often as having said that 'it is all the parents' fault'." In reality, this was somewhat a whitewashing of his own history&mdash;in many of his articles Kanner does explicitly and clearly blame autism on parental behavior&mdash;but the renunciation of the idea by the person who originated it was seen as a decisive blow in any event.

New explanations: filling a theoretical void
There are many contenders to replace the 'refrigerator mother' theory. After the 'refrigerator mother' theory gradually lost credibility within the medical community, autism research has focused primarily on establishing a genetic cause for autistic spectrum disorders. A twin study by Folstein and Rutter in 1977 found much higher concordance for autism in identical twins compared to fraternal twins.

However, one controversial new theory is bringing renewed life to Kanner's initial observations about the parents of autistic children. It derives from the observation that people with superior technical ability, but poor social skills, are meeting and mixing genes in high-tech enclaves, producing offspring susceptible to disorders whose traits mirror our computerized culture. Researchers have noted parents in fields such as engineering and computer science, with their particular talents and quirks, may have a greater chance of having children with autism or its high-intellect variant, Asperger's Syndrome. Now, this link is becoming a matter of public debate, resonating through the high tech corridors of Silicon Valley, New Jersey, Ottawa and the on- and off-line networks of Cambridge, Dublin and Boston's Route 128. This has been referred to as 'geek syndrome'. But there is no evidence that high incidence of autism among 'geeks' is due to their deficient parenting skills. A much more likely explanation is based on genetics; in fact, some 'geeks' clearly display a broader autistic phenotype, and many of them could even be undiagnosed high-functioning autistics.

Medical authorities, while continuing to focus on possible genetic vulnerabilities to autism since abandoning the long-held notion of refrigerator mothers, generally attribute the staggering increase of autism diagnoses to changes in diagnostic criteria and a growing awareness of the disorder.

Bernard Rimland was among the first healthcare professionals to articulate the premise that vaccines may have been the principle cause of autism, stirring controversy as a result. Critics of more recent environmental trigger theories have suggested widespread concerns about vaccines as the likely environmental triggers are simply hoaxes fostered by lawyers anxious to profit from litigation, and that such theories promote and prey upon feelings of guilt among parents, much as the discredited refrigerator mother theory fostered guilt among mothers decades ago.

Aftermath: escalating controversy
A growing number of parents, and a limited number of healthcare experts, reject the notion that autism is strictly an innate genetic disorder, noting there is no such thing as a genetic epidemic. Instead, parents seeking alternative explanations often link vaccines to the onset of autism, among a variety of other possible environmental causes.

Not satisfied with explanations offered by medical authorities, a number of parent led advocacy groups have sprung up seeking better explanations for the causes of autism. Some are loosely allied with the medical establishment, including the National Alliance for Autism Research and the M.I.N.D. Institute. Some advocacy groups, including Safe Minds, Generation Rescue and the Autism Research Institute (founded by Rimland), have stirred controversy by openly questioning the conclusions of medical authorities, calling for more extensive research examining possible environmental triggers, particularly vaccines and mercury exposure.

In response to demands for research into possible environmental causes from parents and these controversial advocacy groups, it has been suggested vaccine theories simply promote and prey upon feelings of guilt among parents, much as the discredited refrigerator mother theory fostered guilt among mothers decades ago. Most observers, meanwhile, are mystified by the conflicting explanations for the explosion in autism diagnoses.

Persistence of a stereotype
A definition of autism reflecting the outmoded 'refrigerator mother' theory appears in a prestigious reference work, the 2001 edition of Rizzoli-Larousse Encyclopedia:
 * "Autism is the fundamental nature of the schizoid constitution which can merge into clear schizophrenia ... The autistic child, if he receives the appropriate treatment and this is followed up by his relatives (who are often the cause of the syndrome, especially when they overstep the mark and insist on an over-perfectionistic upbringing) can be more or less completely cured. Nevertheless, even when the problem is resolved, he will still have difficulties in forging normal connections and calm inter-personal relationships."