The "Refrigerator Mother" Hypothesis of Autism

James R. Laidler, MD

Although it is hard to find the specific instance when the “refrigerator mother” hypothesis of autism was first used, it is not difficult to find who first proposed it. As early as his 1943 paper, Leo Kanner was calling attention to what he saw as a lack of parental warmth and attachment to their autistic children. In his 1949 paper, he attributed autism to a “genuine lack of maternal warmth” and the “Refrigerator Mother” theory of autism was born.

In retrospect, it would appear that Kanner was confusing cause and effect. It is more likely that any lack of attachment he saw between the parents and their autistic children was due to the lack of social reciprocity in the children. He consistently ignored the fact that the affected children in his 1943 paper had unaffected siblings who were, presumably, exposed to the same parents and their warmth or lack of it. In a 1960 Time Magazine interview, Kanner described the mothers of autistic children as “just happening to defrost enough to produce a child.”

As instrumental as Kanner was in forming the “Refrigerator Mother” hypothesis, it was Bruno Bettleheim who gave it widespread popularity. His articles, primarily in the 1950s and 1960s, popularized the idea that autism was caused by maternal coldness toward their children—ignoring, as Kanner did, that these same mothers had other children who were not autistic. This was, without a doubt, the low ebb of professional opinion about the parents (especially the mothers) of autistic children.

Despite a number of articles and books published during the 1950’s and 1960’s that blamed autism an a maternal lack of affection, there was a growing sense in the medical community that this did not explain autism as it was seen in the community. In 1964, Bernard Rimland, a psychologist with an autistic son, produced the book Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior, which attacked the “Refrigerator Mother” hypothesis directly.

In what appears to be a direct response to Rimland’s book, Bettleheim wrote The Empty Fortress: Infantile Autism and the Birth of the Self, in which he compared the autistic child to a prisoner in a concentration camp (casting the parents as the SS guards). He states:

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.

As it later turned out, Bettleheim’s book was one of the last gasps of the “refrigerator mother “ hypothesis. Although many other authors subsequently argued that is was valid to blame parents (especially the mother) for autism, it was a doomed cause. Although a few people, and even a few medical professionals, still blame autism on maternal lack of affection, the growing volume of data supporting a biological cause clearly refutes this. However, other potentially dangerous "blame-the-parent" notions have arisen. According to these, parents are responsible for their children’s autism in two ways:

  1. Causing the autism (through ignorance or willfully disregarding warnings) by allowing their child to receive routine vaccinations with products that contain thimerosal (a mercury-containing preservative) preservative or a combination measles, mumps, and rubella vaccines.
  2. Allowing the autism to persist by not administering all of the therapies recommended by a burgeoning number of “experts” and healers. This is evidenced by repeated references to “the window of opportunity” in treating autism.
Many of the leaders in the autism recovery movement are very active in opposing any hypothesis (or, in fact, any research) of the genetic component of autism, fearing that it will undermine their assertion that all cases are caused by external, controllable (and, therefore, preventable or treatable) factors. Although it is probably not their intention, this has the effect of blaming the parents for their children’s autism.

This article was revised on September 15, 2004.

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