Bethany Bracken, Susan Tran, Mike Walsh

1
Bethany Bracken, Susan Tran, Mike Walsh
refrigerator mothers
2
The Setting

• The concept of refrigerator mothers was the
  prevailing view in the 1950s and 1960s.
• In this era, the mother was the sole caregiver of
  the children.
• Research consisted mainly of psychological and
  behavioral case studies, with minimal biological
  and genetic analysis techniques.

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Bruno Bettelheim

• Spent time (1938-1939) in a Nazi concentration
  camp.
• Dachau, (Columbia House Encyclopedia)
• His theories came from his observations of
  similarities between the concentration camp
  inmates and autistic children.
• Withdrawal of prisoners
• Helpless to intervene
• Constantly exposed to hate and death wishes

• The precipitating factor in infantile autism is
  the wish of the parent that his child should no
  longer exist.

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Bettelheims view of causation of autism

• When a mother fails to effectively bond with her
  child, the child withdraws from the world
  resulting in the symptoms of autism.
• Detached mothers
• Breast feeding at set intervals
• No emotional attachment
• Overbearing mothers
• Spoon Feeding
• Potty Training
• Emotionally Draining

5
Joey The boy machine(case study)

• Speech, but no communication
• Took on the persona/behaviors of mechanical
  things
• in order to function
• Clear parental neglect, although possibly
• unintentional and in reactions to childs
  autistic
• behavior
• In retrospect probably not classic autism
• -possibly higher-functioning or other autism
• spectrum disorder
• Illustration of Bettelheims Interpretations

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The Pregnancy/Birth and Joeys First Two Years
Joey was received in this world with neither
love nor rejectionambivalencesimply and
completely ignored.

• Anxiety stricken mother had minimal interaction
  with baby
• -no desire to see baby or nurse after birth
• -only touched when required for feeding
• -strict 4 hours- interval schedule
• -mostly left alone in crib or playpen
• -always crying, rare attempts to pacify
• father (also emotionally unavailable)
• -irritable
• -tried punative methods to deal with excessive
  crying

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Joeys Early Symptoms/Behavior
Never mommy daddy
Age 1 butter sugar
water
Age 2 grease sand
liquid -stop using pronouns -uncanny ability
to assemble/dissasemble electric fan

• excessive crying
• minimum response to people
• what little words uttered were towards self
• rhythmic rocking back and forth, head banging
  against seat
• Joey at age 4 left home for nursery/boarding
  schools

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By Age 4-9 (Nursery/Boarding School)

• no interest/interactions with parents/other
  children/staff
• initially ceased to use pronouns, then in
  reverse
• repetitive activities/narrow interests
• -constant gyrating hands
• -imitation of things mechanical (noises,
  rotations)
• -intense and obsessive preoccupation with
  electric fan,
• tubes, wires
• self-inflicted injuries
• -attempted suicide
• Bettelheims Care age 9-18

9
Joeys Car Machine

• occupied with making explosion, crashing,
  mechanical noises
• obsessed with electricity concept of need to be
  plugged in order to function (i.e., eat, sleep,
  breathe)

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The Mothers History

• Unhappy childhood/adolescence
• no friends in school
• -anxiety and insecurities
• -psychiatric treatments
• Preoccupation with boyfriends death (aircraft
  pilot during WWII)
• -even when married
• -often took Joey to see his father
  arrive/leave at the airport
• Inability to communicate emotional distress
• Defense Mechanism Avoidance of Past
  Traumas/Current Issues
• -active/hectic social life
• Anxiety about being a bad mother

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Mothers Interview about Joey

• indifferent when talking about Joeys birth and
  infancy
• animated when describing people and events
• stated pregnancy did not make any difference
  in life
• often changed subject
• conversation often went back to lost love
• Conclusion Never emotionally/mentally connected
  with baby
• -inability to see Joey as a person
• -preoccupation with past traumas/events

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Bettelheims View

• Cause of Autism
• Feeding intervals
• Emotional Withdrawal
• Emotionless Interactions with Mom
• Obsession with Airplanes/Mechanics
• Visits to see Dad

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Bernard Rimland
Opposing Views to the Refrigerator Mother Theory

• Research psychologist and father of an autistic
  child
• 1964 Infantile Autism The Syndrome and Its
  Implications for a Neural Theory of Behavior
• Argued that the theory of refrigerator mothers
  was based on circumstantial and anecdotal
  evidence and presented an argument for a
  biological condition for autism
• Opposing Argument on Joey from Rimlands view
• Cause of autism not due to cold mothering but
  due to hereditary determination
• Mother appeared to be severely mentally
  disturbed, possible displaying some autistic
  characteristics herself
• Autism may result from a rare recessive trait, or
  be determined by biological factors

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Case for Biological Causation

• Rimland outlined several points for a biological
  causation including
• Parents who do not fit the stereotype
  examples from literature published at the time
  where mothers did not fit the stereotype
• Eisenberg and Kanner (1956) approximately 10 of
  mothers were described as warm and friendly
• Chapman (1957) warm and affectionate
• Stereotypical parents who have normal
  non-autistic children
• Dennis (1941) conducted an experiment on the
  development of fraternal twins from the end of
  their 1st month to the end of their 14th month
  under conditions of minimum social stimulation
  by attending to their material needs only
• Normal siblings is more common than multiple
  autistic siblings example from literature
  published at the time also looked at siblings of
  autistic children
• Kanner and Lesser (1958) 3 siblings could be
  autistic out of 131 siblings
• High incidence of identical twin cases reported
  with autism
• -virtually all cases of autistic twin reported
  in the literature up to this time were
  identical twins
• Rimland noted 14 separate cases of twins reported
  in literature that he considered to have autistic
  traits

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Genetic Predisposition for Autism

• MOLECULAR
• 3-12 genes have been linked to autism, with the
  most likely cause being an interaction of these
  genes. (Rutter, M., 2003)
• -except Retts Syndrome, no one gene or
  non-genetic factor shown to be solely responsible
  for autism
• Whole-Genome Searches and Linkage Studies
• (Muhle et al., 2004)
• -multiplex autistic families
• -potential loci conferring susceptibility to
  disorder found on all but 7 chromosomes.

• TWIN STUDIES
• Folstein and Rutter (1977)
• - empirical study of same sex twins
• - higher concordance of severe, as well as mild
  autistic manifestations
• Bailey et al (1995)
• Le Couteur et al (1996)
• -re-examine same set of twins, plus additional
  cases
• Severe Mild Cogn./Social
• MZ 60 92
• DZ 0 10 (higher gen. pop.)
• -variation severity in concordant MZ -strong
  complex genetic component, but also unknown
  pre/postnatal (envir.) factors as well

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Effects on Mothers of Autistic Children

• 1969 Rimland with a small group of parents who
  rejected the refrigerator mother theory founded
  the National Society for Autistic Children (NSAC)
  now the Autism Society of America (ASA)
• PBS Documentary Refrigerator Mothers" (2004)
• Shares the stories of mothers who were labeled as
  refrigerator mothers in the 1950s and 1960s
  and blamed for causing their childrens autism
• Many mothers of that time gave up their children
  for psychiatric care, which was a prevailing
  method of therapy

I just wish that I hadn't been so naive, but I
was a product of the times. Doctors were gods. I
didn't question enough. I wanted my child better,
so I'd do anything. Parting with my child is the
worse thing I did. There weren't any
alternatives. - mother June Francis in an
interview with the Washington Post about
Refrigerator Mothers
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Conclusions

• Bettelheims views indicate a completely
  behavioral cause.
• The genetics point of view indicates that it is
  completely genetically determined.
• Maybe it is a combination of both
• The child gets the genetic predisposition for
  autism from parents
• Environmental factors like watching autistic-like
  interactions of the parents and/or a specific
  incident (vaccine) activates the genetic factors.

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• References
• Bailey A., Le Couteur A., Gottesman I., Bolton
  P., Simonoff E., Yuzda E., Rutter M. (1995)
  Autism as a strongly genetic disorder evidence
  from a British twin study. Psychological
  medicine. 25 63-77.
• Bailey, A. and Parr, J. 20003. Implications of
  the broader phenotype for concepts of autism.
  Novartis Foundation symposium. 25126-35.
• Bettelheim, B. The Empty Fortress. (1967). New
  York, NY The Free Press.
• Chapman, A.H. (1957) Early infantile autism in
  identical twins Report of a case. A. M. A.
  archives of neurology and psychiatry. 78
  621-623.
• Columbia Electronic Encyclopedia, 6ed. (2004).
  Columbia University Press
• Dennis, W. (1941) Infant development under
  conditions of restricted practice and minimum
  social stimulation. Genetic psychology
  monographs. 23 143-191.
• Eisenberg, L. and Kanner, L. 1956. Early
  infantile autism, 1943-1955. The American
  journal of orthopsychiatry. 26 556-566.
• Folstein S. and Rutter M. (1977) Infantile
  autism a genetic study of 21 twin pairs. Journal
  of child psychology and psychiatry, and allied
  disciplines. 18 297-321.
• Kanner, L. and Lesser, L.I. (1948) Early
  infantile autism. Pediatric clinics of North
  America. 5 711-730.
• Le Couteur A., Bailey A., Goode S., Pickles A.,
  Robertson S., Gottesman I., Rutter M. (1996) A
  broader phenotype of autism the clinical
  spectrum in twins. Journal of child psychology
  and psychiatry, and allied disciplines. 37
  785-801.
• Muhle, R, Trentacoste, SV, Rapin, I. (2004) The
  Genetics of Autism. Pediatrics 113(5) 472-486.
• Rimland, Bernard. Infantile Autism The Syndrome
  and Its Implications for a Neural Theory of
  Behavior. Meredith Publishing Company 1964.
• Rutter, M. (2003) Introduction autism-the
  challenges ahead. In Autism Neurol Basis and
  Treatment Possibilities. Chichester, UK
  Novartis Foundation.
• Autism societys homepage http//www.autism-socie
  ty.org/site/PageServer
• http//www.autismvictoria.org.au/diagnosis/history
  .php
• Interview with mothers from the PBS documentary.
  http//discuss.washingtonpost.com/wp-srv/zforum/02
  /tv_autism071702.htm
• Part of PBS network website. http//www.itvs.org/
  outreach/RMCloseup.html
• Home page for PBS documentary Refrigerator
  Mothers. http//www.pbs.org/pov/pov2002/refrigera
  tormothers/