Attachment-Based Interventions in Children with Autism Spectrum Disorders: A Systematic Review

Abstract Autism spectrum disorders (ASD) significantly impact children’s development, making early intervention necessary for improving social communication and reducing symptom severity. Autistic children often exhibit less secure attachment styles due to challenges in reciprocity and joint attention, among others. Therefore, interventions aimed at enhancing attachment quality may strengthen caregiver-child interactions, and positively influence core autism symptoms by improving socioemotional outcomes. We conducted a systematic review to synthesize the evidence derived from attachment-based interventions for autistic children. Seventeen articles (15 studies) met the inclusion criteria. Reviewed findings showed that promoting caregivers’ sensitivity and reflective function improves the relationship quality and enhances children’s joint attention along with the suitable use of parents as a safe haven. Moreover, changes in parent-child interaction were explained mainly by modifications in maternal responses. The reviewed treatments enhanced children’s adaptive behavior, language expression, and communication skills. The role of caregivers is discussed, highlighting that attachment-based treatments involve them as co-therapists and yield benefits, including improved attachment quality.