Understanding Attachment Behaviors in Parents Raising Autistic Children: An Interpretative Phenomenological Analysis

Understanding Attachment Behaviors in Parents Raising Autistic Children: An Interpretative Phenomenological Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Understanding Attachment Behaviors in Parents Raising Autistic Children: An Interpretative Phenomenological Analysis Panicha McGuire, Alba Nino This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7254557/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 16 Nov, 2025 Read the published version in Contemporary Family Therapy → Version 1 posted 10 You are reading this latest preprint version Abstract Parenting autistic children often involves navigating unique relational, sensory and emotional needs within environments designed for neurotypical expectations. This phenomenological study explores how parents of autistic children experience and interpret attachment behaviors. Semi-structured interviews were conducted with ten primary caregivers of autistic children across the United States. Using Interpretative Phenomenological Analysis, three major themes emerged: (a) attachment behaviors, (b) separation and reunion, and (c) other factors that affect attachment dynamics. Findings highlight the intentional, attuned, and often proactive ways caregivers co-regulate with their children, even in the absence of traditional proximity-seeking behaviors. These dynamics are shaped by the child’s communication profile, sensory needs, and the broader relational environment. The study challenges deficit-based assumptions about attachment in neurodivergent families and underscores the importance of systemic support. Clinical implications include expanding attachment theory frameworks, promoting reflective parenting, and affirming diverse expressions of connection and safety. Autism attachment parenting caregiving phenomenology neurodiversity Introduction Parenting autistic children involves unique experiences that differ from parenting neurotypical children, largely due to navigating societal barriers, limited support systems, and environmental factors that may not accommodate neurodivergent traits (Bradley et al., 2023; Buchwald et al., 2025; Gao & Drani, 2025; Saccà et al., 2019). Family dynamics evolve as families adapt to their child’s diverse communication, sensory, and relational needs within contexts often designed primarily for neurotypical norms. Previous studies inaccurately framed autistic children's relational behaviors as deficits negatively impacting attachment (Cibralic et al., 2024; McKenzie & Dallos, 2017). However, contemporary research highlights that autistic children are fully capable of forming secure, meaningful attachments and clearly demonstrate preferences for familiar caregivers (Lee et al., 2024; Teague et al., 2018). These attachment outcomes are closely linked to parental sensitivity, insightfulness, and environmental fit (Cossette-Côté et al., 2021; Lee et al., 2024). Despite this growing understanding, much of the existing research has focused on autistic children’s behaviors without exploring how caregivers themselves experience and interpret these attachment dynamics. This study aims to address this gap by centering the lived experiences of parents of autistic children, with particular attention to how they navigate, interpret, and adapt to attachment behaviors in the context of neurodivergence. Using a phenomenological approach, this research explores how parents perceive their caregiving role, the challenges and adaptations they make, and how attachment unfolds within these complex relational systems. Parents’ Experience of Attachment Dynamics According toBowlby (1969), the attachment behavioral system is a system of behaviors to maintain closeness to an important other (the attachment figure) for safety and connection, and leads to predictable outcomes, although the predominant behaviors may vary across cultures. Similarly, Bowlby (1984) proposed that the caregiving behavioral system is an instinctual set of behaviors that caregivers display in order to protect their children, and promote proximity and comfort when a child expresses the need for connection or safety (Cassidy & Shaver, 2016). Caregiving actions such as retrieval, calling, soothing, rocking, and feeding can be viewed as biologically embedded relational strategies that promote connection and emotional regulation, enhancing a child’s well-being and survival (Cassidy & Shaver, 2016). The degree to which a child seeks proximity from their caregiver varies depending on both internal and external conditions. Bowlby (1969) proposed that the attachment system is activated by two primary factors: (a) the internal state of the child (such as illness, fatigue, or emotional distress), and (b) environmental conditions that signal potential threat or separation, such as an unfamiliar setting or the caregiver’s absence. Likewise, the caregiving system in adults is activated by cues suggesting the child may need support. Internal cues for caregivers may include emotional responses like concern or empathy, or culturally shaped beliefs about parenting (Cassidy & Shaver, 2016). External cues often include observable signs of the child’s distress, such as crying, withdrawal, or clinging, as well as contextual factors like danger in the environment or disruptions to routine (Cassidy & Shaver, 2016). This interplay between the child’s signals and the caregiver’s interpretation of those signals forms the core of the caregiving and attachment dynamic. Bowlby (1969) believed that the attachment behavior stops when the attachment needs of the child are met. The caregiver’s response may vary based on the intensity of the child’s attachment signals. For example, when a child is mildly distressed, simple proximity or a calm vocal tone may provide sufficient reassurance. However, if the child is experiencing significant distress, the caregiver may need to increase closeness or take active steps to co-regulate and ensure safety (Cassidy & Shaver, 2016). Caregivers are constantly engaged in monitoring and evaluating relational and environmental cues to care for the child effectively (O’Neill et al., 2021; Tsotsi et al., 2018). Bowlby (1969, 1988) described the caregiving and attachment systems as complementary and ideally functioning in synchrony. An example might include shared attempts to maintain a comfortable degree of proximity—such as a caregiver gently retrieving a wandering child, or a child reaching out for connection when the caregiver moves away (Cassidy & Shaver, 2016). Bowlby (1969) suggested that activation of a caregiver’s own attachment system—particularly during times of grief, trauma, or insecurity—may hinder their caregiving capacity. For instance, a caregiver navigating personal loss or unresolved attachment issues may struggle to remain consistently attuned to their child’s needs (Laflamme et al., 2022). Insecure attachment styles in caregivers have been linked to difficulties in caregiving, particularly when under stress, due to a tendency to either become overwhelmed or disengage as a coping strategy (Giannotti et al., 2023; McIntosh et al., 2023). Crucially, Bowlby (1969) emphasized that attachment security is shaped by how caregivers respond to children’s relational bids. When caregivers consistently and reliably validate and respond to both positive and challenging emotions, children are more likely to develop secure attachment patterns (Kohlhoff et al., 2022). Conversely, when children come to expect inconsistent, unavailable, or threatening responses from caregivers, insecure attachment patterns may emerge (Bowlby, 1969; Kohlhoff et al., 2022). Caregiver attunement plays a central role in these dynamics. Cassidy et al. (2013) described how children’s behaviors often perceived as “babyish” (e.g., crying, babbling) are actually effective relational tools for signaling a need for support and co-regulation. Caregivers, in turn, often use intuitive signals—such as facial expressions, tone of voice, and gestures—to create safety and connection (Ainsworth, 1989). These subtle, reciprocal interactions build the relational fabric from which a child’s sense of security is formed. Attunement, then, is not a fixed trait, but an ongoing, responsive process that reflects the caregiver’s ability to meet the child where they are. When caregivers are able to tune into and respond to their child's unique ways of expressing their need for safety and connection, a foundation for secure attachment can be co-created (Ainsworth, 1989; Cassidy et al., 2013). Attachment bond. An attachment bond is the affectional tie between one individual and their attachment figure (Ali et al., 2021). Ainsworth (1989) described attachment bonds as persistent and involving a specific figure who cannot be interchanged with anyone else. She also described these bonds as emotionally significant and the reason behind an individual wanting to maintain proximity with their attachment figure, and feeling distressed during involuntary separation (Ainsworth, 1989). Importantly, the presence of an attachment bond is not dependent on observable attachment behaviors alone. Children may not display proximity-seeking behaviors if their attachment needs are met and they feel a consistent sense of safety. In other words, a child’s attachment bond may be strong even in the absence of overt behaviors like crying or clinging (Ali et al., 2021). Bowlby (1969) proposed that the stability and continuity of the attachment bond across time does not necessarily correlate with attachment security. For some children, clinginess may reflect secure reliance on a caregiver as a safe base, rather than an indication of insecurity or relational dysfunction. Attachment security reflects relational quality, not just behavioral intensity. While much of the theoretical foundation for attachment bonds comes from research in non-autistic relational contexts, the essence of the bond—emotional significance, caregiver responsiveness, and relational consistency—remains relevant for neurodiverse children. Autism and Attachment Early studies suggested that autistic children react to separation from a caregiver similarly to non-autistic children (Bieberich & Morgan, 1998; Sigman & Mundy, 1989); however, other studies have historically framed autistic children as having lower sensitivity or responsiveness to caregiver approaches (Rutgers et al., 2007; van Ijzendoorn et al., 2007), often interpreting these behaviors through a deficit-based lens. More recent research recognizes that such interpretations may reflect a bias and an underappreciation of neurodivergent relational expressions (Lee et al., 2024). Although autistic children are capable of forming secure attachments, their communication and sensory differences may influence how these bonds are expressed and understood. Parent-child relationships involving autistic children may differ in sensitivity, flexibility, and synchrony—not due to relational deficits, but because of the mismatch between expressions of connection and neurotypical expectations (Beurkens et al., 2013). Recent research reinforces that inadequate social support or structural barriers are associated with increased parenting stress in caregivers of autistic children, negatively impacting relational availability and caregiving capacity (Brennan & Davis, 2025; Kapp & Brown, 2011). Since attachment is bidirectional, both child communication patterns and caregiver responsiveness play key roles (Giannotti et al., 2023; Lee et al., 2024). Research on autism and attachment has predominantly relied on frameworks developed for neurotypical dyads, particularly the Strange Situation (Ainsworth et al., 1978; Bowlby, 1969) procedure as the main assessment tool. These tools may not adequately capture attachment in autistic children, whose behaviors may not align with traditional classifications (Teague et al., 2018). Furthermore, studies often group autistic children with those who have other developmental disabilities, making it difficult to distinguish the unique relational experiences within autism. This begs the question of whether the available research findings truly reflect the unique experience of parents who have autistic children. Thus, the purpose of this phenomenological study is to explore the lived experiences of parents raising autistic children in relation to their attachment dynamics. More specifically, the question guiding this research study is: What are the lived experiences of autistic children’s parents in relation to their attachment behaviors? Methods Given that the purpose of this qualitative study was to capture the lived experiences of parents, Interpretative Phenomenological Analysis (IPA) was selected as the methodology. IPA is described as an inductive approach that empowers the participants to be experts on their own experiences while the researchers interpret how meaning is made (Howard et al., 2019; O’Brien et al., 2014). The founding principle of phenomenology could be linked back to Edmund Husserl who believed that the human experience should be examined in its own terms (Smith et al., 2009). Importantly, new applications of IPA in autism and caregiving research highlight its strengths in amplifying marginalized voices and honoring empowerment, reflexivity, and relational context (Howard et al., 2019). Participants Ten parents who met the following inclusion criteria participated in this study: (a) Be at least 18 years old at the time of the study; (b) be the primary caregiver of a child with a formal diagnosis of autism spectrum disorder or previous diagnoses of Pervasive Developmental Disorder or Asperger Syndrome; and (c) be able and willing to provide informed consent. Participants were recruited using purposive sampling to ensure each caregiver had lived experience of parenting an autistic child and primary caregiving responsibilities. Snowball sampling was then used to invite further participants within autism caregiver networks. Participants were recruited across the United States via multiple channels, including clinics, therapy centers, and social media platforms (Facebook and Instagram). Flyers encouraged caregivers to share study details with others in their networks. Demographic characteristics of participants are outlined in Table 1. Table 1 Demographic Characteristics of Participants Variable N % Gender Identity Woman 9 90 Man 1 10 Age Group 30–39 3 30 40–49 6 60 50 or older 1 10 Relationship Status Married 8 80 Divorced 1 10 In a committed relationship 1 10 Racial Identity White 8 80 Black or African American 2 20 Education Some college 1 10 Associate degree 1 10 Bachelor’s degree 5 50 Master’s degree 3 30 Annual Household Income $20,000–$39,000 2 20 $80,000–$99,000 2 20 $100,000 or higher 6 60 Accessed Mental Health Services Yes 2 20 No 8 80 Number of Autistic Children 1 child 7 70 2 children 2 20 3 children 1 10 In total, ten parents reported caregiving for 24 children, 14 of whom had formal autism diagnoses. Further details on the children’s demographics and diagnoses are provided in Table 2. Table 2 Children’s Characteristics Variable N % Gender Identity Girl 2 14.3 Boy 12 85.7 Age 0-5 4 28.6 6-11 9 64.3 12-17 1 7.1 Age at Diagnosis 0-5 12 85.7 6-11 2 14.3 Support Needs* Preliminary 1 7.1 Level 1 6 42.9 Level 2 4 28.6 Level 3 3 21.4 Additional Diagnoses Reported ADHD 3 21.4 “Developmental Delay” 1 7.1 Generalized Anxiety 1 7.1 *Terms such as “Level 1/2/3” reflect DSM-5-TR criteria Procedure Data collection for the study was conducted through the use of a semi-structured interview and a demographic questionnaire, following approval from the Institutional Review Board (IRB) at the University to which the authors were affiliated. Interviews were conducted in person, audio recorded, and transcribed. After the interview, participants received a $25 gift card and a list of resources that address challenges commonly experienced by parents of autistic children. Data Analysis Data was analyzed using Interpretative Phenomenological Analysis (IPA) as outlined by Smith et al. (2022). The first author followed a four-stage analytic process: reading and re-reading for immersion, initial noting, developing emergent themes, and identifying connections across themes. During immersion, the researcher engaged deeply with each transcript, annotating descriptive, linguistic, and conceptual observations. Descriptive notes focused on content, linguistic notes on features such as tone and metaphor, and conceptual notes reflected interpretative meaning-making. These informed emergent themes that captured key aspects of each participant’s lived experience. Themes were then examined for patterns and clustered into superordinate structures that reflected shared meanings. The analytic process was iterative and reflexive, consistent with IPA’s idiographic and interpretative orientation. Trustworthiness To ensure the rigor and integrity of this qualitative study, four criteria were applied: credibility, transferability, dependability, and confirmability (Korstjens & Moser, 2018). Credibility was supported through peer debriefing and member checking (Nowell et al., 2017). The first author engaged in regular peer debriefing with two colleagues throughout the analytic process. These reviewers provided external perspectives on emerging and final themes, supporting reflexivity and reducing potential bias. Six participants responded to the member-checking invitation to review a summary of the study’s emergent themes and assess whether the interpretations reflected their experiences. Transferability was enhanced through thick description of the research context, participant experiences, and analytic decisions, allowing readers to assess the relevance of findings to other settings (Korstjens & Moser, 2018). While this study focuses on parents of autistic children, the diversity within the autism spectrum means findings may not apply to all families, and this variability is acknowledged in the interpretation. Dependability was addressed through an audit trail documenting analytic decisions, coding development, and methodological reflections. This process enabled transparency in how data were interpreted over time. Confirmability was facilitated via reflexive journaling and external audit by the second author, ensuring that findings were grounded in participant data rather than researcher assumptions (Korstjens & Moser, 2018; Nowell et al., 2017). These strategies align with contemporary best practices for trustworthiness in phenomenological and IPA studies, reflecting a commitment to rigorous, ethical, and neurodiversity-affirming qualitative research (Howard et al., 2019; MacLeod, 2019). Ethical and Legal Considerations The primary ethical considerations were the participant’s well-being, informed consent to participate in the study, and confidentiality. The participants were given the opportunity to ask questions or withdraw at any time prior, during, or after the study. Participants’ confidentiality was maintained throughout the study by securely storing identifiable data, anonymizing transcripts, and using pseudonyms in study reports. Results Seven superordinate themes emerged from the data: (a) lack of frame of reference for parenthood, (b) uncertainty of child’s future, (c) attachment bond, (d) parent’s emotions about their child, (e) attachment behaviors, (f) separation and reunion,and (g) other factors that affect attachment dynamics. Due to space limitations, the present article focuses on the behavioral aspects of attachment dynamics—specifically, the final three superordinate themes. For a comprehensive description of all seven themes, see [omitted for blind review]. For additional discussion of the emotional aspects of attachment dynamics, refer to forthcoming or related publications by this research team. Attachment Behaviors All 10 participants reported tuning into their child through various methods to anticipate and understand their needs. Of the 14 autistic children whose parents were included in this study, four used verbal speech to express their feelings and needs, and ten were nonspeaking or minimally speaking, as described by the participants. The following three subordinate themes emerged from the data: hyperawareness of cues, understanding child’s cues/needs, and use of additional aids. Eight participants described being constantly hyperaware to recognize their child’s cues. Some reported watching their children closely due to safety concerns, as their children wouldn’t seek help or alert them when injured. Others were focused on better understanding their child. Several noted children's limited help-seeking behaviors, even during distressing or risky situations like elopement or self-injury, which often occurred without clear signals—intensifying caregivers’ vigilance. Deborah shared that she wanted to know more about her son so she would observe him for hours to try to understand him. She reported: It's like I'm constantly observing him and trying to figure if his words are matching what he feels. I feel he has this whole world going on inside of his head that I can't get to. It's like I'm just waiting for a secret code. I'm waiting for that code key, to be like, "that's what this means." And then it will just unlock this whole world of stuff that he is trying to say that I can’t understand. All 10 participants reported being able to anticipate when their child will become distressed. Participants discussed attending to both direct verbal cues and nonverbal cues (e.g. screams, noises, facial expression, body language, etc.) to interpret what the child needed from them. According to Lucille, she will wait to hear a bird call as birds are her son’s preferred interest. She reported bird calls are cues to whether he can find a solution to his problem on his own or if he needed help. She stated: He makes bird calls a lot, so he can actually imitate a seagull or a crow…So I know when he's shrieking a little bit. You can hear the escalation. So if we're outside of the room and him and his brother are getting into it, I can [gauge], the escalation of where it's going to go. Three participants reported they use additional aids to obtain cues from their children. These aids include: a letterboard, sensors, alarms, and social stories. Participants whose children tended to leave the home reported using tools such as door sensors or double locks to help them stay focused on other tasks while remaining aware of their child’s whereabouts. Mary, whose non-speaking child tried various communication supports—including speech therapy that proved ineffective—shared that her son now communicates well using a letterboard. While home communication mostly involves daily needs, he prefers deeper conversations with his communication specialist, who is helping him learn the letterboard. Mary believes the specialist understands her son best, as he responds more comfortably to open-ended questions with them than with family. She described the relief of finally understanding her son’s needs. It's like when you're dealing with a newborn baby and you just don't know what they want, but think about that for 15 years. I am sure it was even more frustrating for him that he could not convey when he didn't want something and we were just forcing things on him, "you're getting a banana whether you want it or not." It's like finally he can say, "I don't want it.” Separation and Reunion Although participants were the main caregivers of their children, there were times when they were momentarily separated from their children (e.g., children were at school, or attended to by a secondary caregiver). The three subordinate themes emerged regarding the parents’ experiences during separation and reunion: temporary relief during separation, anxiety about separation, and relief and joy during reunion. Five participants reported experiencing an immediate sense of relief during separation from their child as they were able to tend to responsibilities they are unable to accomplish while attending to their child. When asked about what separation from her child was like, Brenda stated: Relief. I like to get in the car and just go to Target, go get gas, go do errands for myself. Just peace. I'll still worry about him, but that immediate sense of having to deal with whatever crisis is going on at the time, it feels [good]. Someone else can deal with it for me, [the] teacher can deal with it or the swim teacher can deal with it. Just a sense of relief. Nine participants reported experiencing increased and excessive worry about whether their child will be adequately cared for, if they have gotten in trouble, or concerns regarding safety during separation from their child. Stacy recalled her experiences after dropping off her child at school: I would just wait to get [a] call or emails from his teacher, or I just worry. I worry about what he [is] going to do today; is he going to have problems? or what kind of behaviors are going to keep him from being able to do his schoolwork? Is he going to have conflict with other kids? When the phone rings and it says [name of school], I just hold my breath and think, "oh please, don't let it be something bad.” Seven participants reported relief when they were reunited with their child as they are glad their child has returned home safely. All 10 participants reported joy when they are reunited with their child despite how challenging the day may have been. Deborah, the mother of two autistic children, described her experience picking up her children from school: When I reunite with them, it's a relief. Relief and happiness. It was only for three hours, and in the afternoon, you would wait to see the class walk around the corner up to where the parents were. And I wouldn't realize it, but I would start holding my breath. And when I saw them come around the corner, it was just this feeling of, “oh my God, we did it again. Oh my God, we made it one more day.” Other Factors That Affect Attachment Dynamics Two subordinate themes emerged from the data as factors that affect attachment dynamics between the parent and child: burnout and stress, and co-parenting conflict. Seven participants reported experiencing burnout and stress from raising their autistic child as they do not have support from the community or from the family. The participants noted that the burnout affects their ability to be affectionate with their child and to tune into their needs. Of the seven participants, three reported feeling overwhelmed and expressed that they want their relationship to be simpler. Participants explained that they can be “short” or easily frustrated with their children when they are stressed. These participants reported wanting to be perceived as more “fun” and “loving” by their children. Only two participants reported receiving mental health services for themselves. This experience can be summarized through Brenda’s statement: “I wish I could be more fun. I want to be more fun. I want to have more fun with parenting. There's a part of parenting that I thought was supposed to be fun or at least rewarding.” Six participants reported having co-parenting challenges with their spouse or co-parent. Participants frequently mentioned that their differing parenting strategies have posed difficulty in their relationship with their children. Brenda discussed her emotions in regards to her son being closer to his father than to her because of their parenting conflict: I am the disciplinarian in the family. My husband doesn't really discipline and so I'm the one that draws the lines and he (her son) gets frustrated with me a lot. A lot of push and pull. So, I'm not the preferred parent. I'm the one that sets limits and boundaries and I think one day he'll appreciate that. But right now, when I pick him up at school, [he says] “I want dad to come pick me up. I didn't want you to come.” It hurts me and it breaks my heart, but I realized that that's the role I play and so I've armed myself to it. Participants who were unmarried or divorced reported challenges that were specific to them such as living as a blended family, differing opinions on treatment, and complications with shared custody. These participants are also the ones who reported anxiety during separation from their child as they are uncertain whether their co-parent will say or do something that would negatively affect their relationship with their child. Despite the challenges that participants faced in raising an autistic child, their core caregiving tasks remain true to attachment theory albeit with some modifications. Participants described providing love and care for their child. Simultaneously, participants maintained a level of vigilance as to not miss their child’s cues while some required concrete aids (e.g. sensors, letterboard) if their children had limited communication skills or did not consistently provide cues. Participants had to be adaptive and learn new skills to maintain their role as an effective caregiver for their children. Separation and reunion between parent and child have long been understood through an attachment lens. The emotions and actions that arise through separation and reunion provide insight to the bond between the dyad. In this study, participants reported feeling an immediate sense of relief during separation from their child as they have been overextended in their caretaking role. They reported feeling guilt for the peace and calm they felt; however, their time away from their child was used to recuperate both physically and emotionally, and to complete essential tasks (e.g. planning their day, running errands). Participants with children who required a higher level of support (e.g., safety monitoring, constant behavioral supervision) reported anxiety during their separation. All participants had positive associations with reuniting with their child, and felt more capable in meeting their children’s needs. Lastly, parent stress/burnout and coparenting conflict were other factors that affected attachment dynamics. The increased demands placed on parents of autistic children resulted in the parents’ limited capacity to provide affection. Daily challenges depleted their emotional resources leaving participants wishing they could be more fun and loving to their children. Participants whose parenting styles or opinions on parenting a child with autism differed from those of their coparent found that this disagreement negatively affected their connection with their children. These challenges stem from issues such as experiencing the child’s favoritism for the other parent or disagreement on discipline. Challenges within the parental subsystem also play a role into their availability and responsiveness as a caregiver. Discussion Attachment Behaviors Within the context of attachment behaviors, the three subordinate themes emerged: hyperawareness of cues, interpreting child’s needs, and the use of additional aids. In attachment theory, behaviors that seek proximity to an attachment figure serve to signal emotional or physical needs (Bowlby, 1969 ). Participants in this study described various strategies they used to recognize and interpret their child’s unique expressions of attachment, many of which were subtle, idiosyncratic, or easily missed by others. Participants reported becoming highly attuned to the child’s behaviors, often monitoring closely for changes in tone, affect, or movement, especially for the ten children described by participants as nonspeaking or minimally speaking Many described needing to remain highly focused throughout the day, noting that missing even a small cue could mean overlooking a need or moment of distress. While the caregiving behavioral system is typically activated in response to proximity-seeking behaviors from a child (Bowlby, 1988), these findings indicate that activation of the caregiving behavioral system for parents of autistic children seems to be more constant and proactive. Despite these challenges, all participants reported understanding their child’s needs, even when cues were subtle or nontraditional. The caregiving behavioral system is activated with the influence of the child’s attachment behaviors, but the caregiver must also be able to attune and be responsive to the child (Ainsworth, 1989). Participants reported having the ability to make inferences from their children’s facial expression, tone of voice, or patterns of behaviors that may not be understood by others. This insight came not from instinct alone but through deep emotional investment, observation, and intentional adaptation. Participants emphasized that their attunement was developed over time, not assumed, and required sustained effort and emotional labor. Attuning to children’s needs is important in establishing a sense of security (Ainsworth, 1989). Additionally, participants reported that their ability to understand their child’s idiosyncratic and peculiar cues also limits the capability for others to provide support in caretaking tasks such as respite care workers or extended family members. Many described learning their child’s unique communication style through repetition and close connection. While effective for the primary caregiver, this understanding was difficult to convey to others. As a result, participants expressed concern that extended family members or respite workers often struggled to interpret their child’s signals, which limited opportunities for shared caregiving and contributed to caregiver stress and burnout. Participants whose children had high support needs and limited spoken communication also described using supportive tools to bridge communication gaps and enhance safety. These included motion sensors on doors, visual communication supports, and augmentative systems like letterboards. These resources enabled caregivers to fulfill their role as a secure base and safe haven in creative and individualized ways. Importantly, these adaptations were not seen as indicators of deficits but as meaningful extensions of the caregiving relationship. Parental attunement in autism is often the result of intentional, insight-driven engagement, rather than assumed intuition, reflecting the caregiver’s commitment to understanding their child’s unique ways of connecting and communicating (Di Renzo et al., 2020 ). Through patient observation and relational commitment, participants in this study cultivated a nuanced understanding of their child’s needs and signals. These findings affirm that secure attachment is possible and meaningful in neurodivergent caregiving relationships when supported by intentional attunement and responsive environments. Separation and Reunion Results revealed three subordinate themes within separation and reunion: temporary relief during separation, parental anxiety about separation, and relief during reunion. Participants described immediate relief from constant daily stressors during separation, as others (e.g., teachers or providers) were managing crises. This relief enabled them to complete tasks otherwise hindered by caregiving demands. However, the relief was often short-lived, followed by anxiety about their child’s well-being once the task was done. Although typical attachment literature doesn’t describe this temporary relief, recent research notes that caregivers under prolonged stress may seek brief separations as a coping mechanism to regain emotional energy and reorganize capacity for caregiving (de la Roche & Im-Bolter, 2024 ; Edmunds et al., 2025 ; Warreman et al., 2023 ). In this context, temporary separation may serve as a form of regulation that supports a caregiver's long-term availability. For caregivers of autistic children, these moments may offer a greater sense of control and allow them to return to caregiving roles with more capacity for attunement. At the same time, nearly all participants experienced anxiety during separation, worrying about their child’s safety and wellbeing while not in their care. This anxiety was especially pronounced among parents whose children engage in behavior that could pose safety concerns, such as bolting, self-injury, or difficulty communicating needs to unfamiliar people. Though qualitative studies specifically capturing this phenomenon in parents of autistic children remain limited, broader caregiver research confirms elevated anxiety and distress for these parents, particularly when supports feel inadequate (Crowell et al., 2019 ; de la Roche & Im-Bolter, 2024 ; van Niekerk et al., 2023 ). In this study, participants described a deep sense of responsibility and awareness that their children’s needs may not be well understood or accommodated in unfamiliar environments, reinforcing the feeling that separation carries risk. In the context of attachment theory (Bowlby, 1969 ), the prolonged nature of this anxiety may reflect a hyperactivated parental caregiving system, continuously monitoring potential threat and responsibility, whether in the presence of the child or not. They might also view themselves as the only ones who are capable of keeping their child safe rather than a shared role between multiple caregivers. After separation, participants in this study experienced relief upon their reunion with their child. Many described positive emotions such as happiness, calm, and a sense of grounding when their child returned to them. Several shared that knowing their child was back in their care provided comfort after periods of worry or uncertainty. Participants also reflected that the anxiety they experienced during separation made the reunion feel even more meaningful. Being reunited brought a tangible sense of safety and reassurance. Parents also reflected that the anxiety they experienced during separation made the reunion feel even more meaningful. Being reunited brought a tangible sense of safety and reassurance. However, two participants shared that they could not recall ever being apart from their child. In these cases, the children had high support needs, and the parents reported not feeling confident that others would adequately understand or care for their child. For these families, separation was not just emotionally challenging—it was not an option. This highlights how limited access to trusted, affirming caregiving support can shape the caregiving experience in ways that go beyond personal preference. Other Factors That Affect Attachment Dynamics Two key themes emerged as factors shaping attachment dynamics between participants and their children: burnout/stress and co-parenting conflict. Burnout/stress. Experiences of burnout and overwhelming stress were commonly reported and appeared to impact the relational aspects of parenting. Participants often described how limited support from family or community contributed to exhaustion, which in turn made it harder to be affectionate or attuned to their child. Several shared that as burnout increased, their role shifted toward practical caretaking, leaving less capacity for playfulness or emotional connection. This is consistent with prior research that as stress rises, opportunities for emotionally rich, reciprocal interaction may decrease—not because parents are disinterested or unloving, but because their capacity is depleted (Bradley et al., 2023 ; Brennan & Davis, 2025 ; Buchwald et al., 2025 ). Parental stress is associated with the child’s support needs, communication profile, and adaptive behavior (Giannotti et al., 2023 ; van Niekerk et al., 2023 ). In this study, several participants whose children were diagnosed with Autism Level 2 or Level 3 expressed a longing for a "simpler" relationship—not in terms of who their child is, but in terms of having fewer barriers to connection. Many spoke about wanting to engage more emotionally without navigating sensory sensitivities, communication mismatches, or behavioral care protocols. Broader research on attachment highlights that stress may not only impact the security of the attachment bond, but also its organization. A meta-analysis by O’Neill et al. ( 2021 ) found that caregiver sensitivity has a stronger longitudinal relationship to whether a child develops an organized or disorganized attachment style than to whether they develop a secure or insecure attachment style, particularly in the preschool years. While disorganization is often attributed to frightening or chaotic caregiving environments, the authors note that it is also associated with caregiver stress, trauma, and contextual adversity (O’Neill et al., 2021 ). This is particularly relevant to the current findings, where participants described chronic stress, lack of respite, and isolation as barriers to consistent responsiveness. When attunement requires intense effort and caregiving is unsupported, the attachment system may shift not only in security but in organization—suggesting the need for early and sustained relational support for families of autistic children. Although there is limited research on how burnout specifically impacts attachment in autistic families, findings from non-autistic samples provide relevant insight. Stelter and Halberstadt (2011) found that high levels of parental stress are associated with children perceiving their caregivers as less secure bases. Children whose caregivers experience chronic stress may not always perceive them as reliably available, which can impact their internal working models. This concern may be heightened in families navigating complex communication or behavioral needs, where attunement requires heightened vigilance, patience, and effort. Many participants reported being hypervigilant to potential stressors or needs. Several reflected on times when stress led them to be “short” or reactive with their children, even though they cared deeply. Only two participants in the study reported receiving mental health services for themselves. Importantly, several participants whose children received psychotherapy—particularly play therapy or family therapy—shared that these services helped them better understand their child’s cues and respond in ways that deepened their connection. They described learning how to attune to their child through shared therapeutic work, which enhanced their sense of confidence and emotional availability. Co-parenting conflict. Participants in this study reported experiencing challenges in co-parenting, particularly when they disagreed on approaches like boundaries, rewards, or consequences. These differing viewpoints created confusion around how to relate to and support their autistic child. Some participants expressed frustration that these disagreements made it harder to show up consistently and attune to their child. These findings align with recent research showing that an autism diagnosis can increase family stress and strain the co-parenting relationship (Bradley et al., 2023 ; Brennan & Davis, 2025 ). When the parenting alliance is weakened, parents may feel less supported and more overwhelmed—both of which can affect their ability to remain emotionally available to their child. Sim et al. (2017) found that negative co-parenting experiences were linked to heightened family stress and impacted the parent’s relationship with other children in the household as well. Strengthening the co-parenting relationship was associated with lower stress levels and more coordinated, responsive parenting. Emerging research also emphasizes that collaborative parenting practices may buffer the emotional impact of caregiving stress, especially when caregivers feel validated and aligned in their approaches (Phelan et al., 2022). Literature exploring co-parenting of autistic children is still limited, particularly in connection to attachment. However, broader research has identified factors that affect a parent’s ability to connect with their children, such as caregiver mental health (Giannotti et al., 2023 ; Teague et al., 2018 ), parenting conflict (Brock & Kochanska, 2016 ; Martin et al., 2017), and family instability (Ferraro & Lucier-Greer, 2022 ). When parents are emotionally attuned, responsive, and available, children are more likely to develop confidence in the caregiving relationship (van IJzendoorn, 1995). When caregivers are not consistently available, however, children may internalize a sense of uncertainty, developing negative internal working models of themselves and others. Recent studies in family systems research also suggest that unresolved parental conflict can undermine a child’s emotional security and self-concept, even when the child is not directly involved in the conflict (Brock & Kochanska, 2016 ; O’Hara et al., 2023 ). Furthermore, co‑parenting conflict may amplify existing stressors and contribute to ruptures in the attachment relationship—not necessarily because of the child’s needs, but because of a mismatch in caregiver responses. Several participants described feeling isolated in their parenting role, or like the “default” parent, which further intensified feelings of exhaustion. While not all participants reported disagreement in co-parenting, those who did expressed a desire for more support and communication, recognizing that alignment in parenting approaches could improve both their partnership and their connection with their child. Limitations and Recommendations for Future Research This study has several limitations that may affect the transferability of findings. Although participants described a range of support needs in their children, the diversity of autism profiles limits generalizability across all parent-child relationships. The sample was predominantly composed of White, cisgender, female caregivers with household incomes above $ 80,000, many of whom were stay-at-home parents. These demographic characteristics likely shaped caregiving experiences, particularly through access to private therapies, flexible employment, and broader support networks. In contrast, caregivers with fewer financial, social, or cultural resources may face greater challenges navigating systems of care—factors that can meaningfully impact attachment dynamics. Fathers, nonbinary caregivers, and racially or ethnically minoritized parents may also have distinct experiences shaped by intersecting cultural expectations and structural inequities. Future research should prioritize more diverse participant recruitment across race, ethnicity, gender, socioeconomic status, and family structure to better capture the full spectrum of caregiver experiences. Continued qualitative exploration of attachment dynamics is recommended to deepen understanding of how caregivers navigate connection, emotional availability, and responsiveness within neurodivergent families. Further studies should also examine how caregivers’ own attachment histories influence their parenting, as several participants spontaneously linked their approaches to their upbringing. Finally, investigating attachment in blended, adoptive, or multi-generational families could offer valuable insights into how diverse caregiving systems support or shape autistic children’s relational development. Clinical Implications One clinical implication of this study is the importance of systemic work with families of autistic children. Clinicians are encouraged to advocate for support not only for the child, but for the entire family unit—including the caregivers. Although participants reported high levels of stress, anxiety, and emotional exhaustion, only two out of ten reported receiving mental health services for themselves. Participants shared statements such as “it is not my time,” reflecting how caregivers often defer their own needs to prioritize their child’s care. Clinicians may interpret this not as a lack of interest in services, but rather as an opportunity to gently invite caregivers into therapeutic support—even if they do not directly request it. Mental health support for caregivers has systemic benefits, as caregiver well-being can influence the quality of parent-child interactions and overall family functioning. Research has shown that parents with greater insight into their own attachment patterns may be better able to respond sensitively to their child’s needs (Mikulincer & Shaver, 2019 ; Oppenheim et al., 2024; Oppenheim et al., 2023 ; Parashar et al., 2024 ). Classic attachment interventions, such as those developed by Ainsworth (1973), highlight how reflective parenting practices and emotional attunement foster secure caregiving behaviors. Participants in the current study who responded to the member checking invitation shared that they experienced emotional relief when discussing their caregiving experiences with a clinician-researcher. They described this process as validating, and reported that it supported greater self-awareness in their relationship with their child. This shows that opening spaces for parents to reflect on these experiences in the presence of an attuned listener, even if occasional, can yield benefits. Given the stressors described by participants, multi-modal support may be particularly helpful. In addition to psychotherapy, parents may benefit from referrals to support groups, psychoeducation, and practical assistance such as childcare navigation or respite care. These resources can create space for caregivers to regulate, recharge, and return to their role with increased emotional availability. Many participants described feelings of social isolation, and some expressed difficulty maintaining extended family or friendship networks due to their caregiving responsibilities. Clinicians may consider inviting extended family, partners, or other natural supports into sessions to increase the caregiver’s circle of care. Social support has been shown to buffer the effects of parenting stress in families of autistic children (Ekas et al., 2010 ; de la Roche & Im-Bolter, 2024 ). Systemic therapy for autistic children themselves can also be beneficial, particularly when attachment, family dynamics, or relational repair are supportive goals. In this study, participants shared how they attuned to their children using highly individualized strategies—including the use of assistive tools (e.g., letterboards, sensors) and developing a nuanced understanding of their child’s unique cues. Clinicians can build on these efforts by supporting parents in tracking and interpreting their child’s communication styles, offering tools that match the child’s sensory or cognitive profile, and integrating the child’s interests (e.g., favorite cartoons, preferred interests) into therapeutic strategies. On a broader scale, the findings of this study suggest a role for systemic advocacy. Clinicians, healthcare providers, educators, and policymakers must begin to view caregiver support as a critical part of comprehensive autism care. Finally, at the systems level, findings from this study suggest a need for broader recognition that caregiver support is not a luxury—it is an essential component of sustainable care. Embedding mental health resources, community connection, neurodiversity-informed care, and respite options into standard services can enhance not only the parent-child relationship but the long-term wellbeing of families navigating a world that often overlooks their needs. Conclusion This study explored the lived experiences of parents raising autistic children through the lens of attachment, illuminating the nuanced ways in which caregivers navigate connection, stress, and relational dynamics. The findings affirm that attachment in families of autistic children may not follow the traditional models of attachment theory, but rather reflects adaptive, responsive, and often creative efforts by caregivers to meet their child’s needs within a society that frequently lacks structural support. While participants reported familiar attachment processes—such as attunement, distress during separation, and joy in reunion—the intensity and expression of these dynamics were shaped by the child’s support needs, communication profile, and environmental demands. By centering lived experiences, this study highlights the importance of validating diverse attachment presentations and resisting normative assumptions about parent-child relationships. It also underscores the need for clinicians, researchers, and systems of care to recognize that caregiver wellbeing is essential to relational health—not as an afterthought, but as an integral part of therapeutic and policy interventions. 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Cite Share Download PDF Status: Published Journal Publication published 16 Nov, 2025 Read the published version in Contemporary Family Therapy → Version 1 posted Editorial decision: Revision requested 06 Oct, 2025 Reviews received at journal 24 Sep, 2025 Reviews received at journal 17 Sep, 2025 Reviewers agreed at journal 25 Aug, 2025 Reviewers agreed at journal 20 Aug, 2025 Reviewers agreed at journal 20 Aug, 2025 Reviewers invited by journal 20 Aug, 2025 Editor assigned by journal 01 Aug, 2025 Submission checks completed at journal 01 Aug, 2025 First submitted to journal 30 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7254557","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":505318689,"identity":"633558ab-6b03-4ba0-af24-2058b2af61bb","order_by":0,"name":"Panicha McGuire","email":"data:image/png;base64,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","orcid":"","institution":"Living Lotus Family Therapy, Inc.","correspondingAuthor":true,"prefix":"","firstName":"Panicha","middleName":"","lastName":"McGuire","suffix":""},{"id":505318690,"identity":"cd9c5616-6754-466d-b226-6415bc94a867","order_by":1,"name":"Alba Nino","email":"","orcid":"","institution":"Alliant International University","correspondingAuthor":false,"prefix":"","firstName":"Alba","middleName":"","lastName":"Nino","suffix":""}],"badges":[],"createdAt":"2025-07-30 15:38:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7254557/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7254557/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s10591-025-09765-9","type":"published","date":"2025-11-16T15:58:06+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":96105088,"identity":"302bff50-402c-4512-9ece-18664068b7b9","added_by":"auto","created_at":"2025-11-17 16:08:27","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":712488,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7254557/v1/697bbb7a-1565-4e7d-89ee-54399f9a7ac3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Understanding Attachment Behaviors in Parents Raising Autistic Children: An Interpretative Phenomenological Analysis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eParenting autistic children involves unique experiences that differ from parenting neurotypical children, largely due to navigating societal barriers, limited support systems, and environmental factors that may not accommodate neurodivergent traits (Bradley et al., 2023; Buchwald et al., 2025; Gao \u0026amp; Drani, 2025; Sacc\u0026agrave; et al., 2019). Family dynamics evolve as families adapt to their child\u0026rsquo;s diverse communication, sensory, and relational needs within contexts often designed primarily for neurotypical norms. Previous studies inaccurately framed autistic children\u0026apos;s relational behaviors as deficits negatively impacting attachment (Cibralic et al., 2024; McKenzie \u0026amp; Dallos, 2017). However, contemporary research highlights that autistic children are fully capable of forming secure, meaningful attachments and clearly demonstrate preferences for familiar caregivers (Lee et al., 2024; Teague et al., 2018). These attachment outcomes are closely linked to parental sensitivity, insightfulness, and environmental fit (Cossette-C\u0026ocirc;t\u0026eacute; et al., 2021; Lee et al., 2024).\u003c/p\u003e\n\u003cp\u003eDespite this growing understanding, much of the existing research has focused on autistic children\u0026rsquo;s behaviors without exploring how caregivers themselves experience and interpret these attachment dynamics. This study aims to address this gap by centering the lived experiences of parents of autistic children, with particular attention to how they navigate, interpret, and adapt to attachment behaviors in the context of neurodivergence. Using a phenomenological approach, this research explores how parents perceive their caregiving role, the challenges and adaptations they make, and how attachment unfolds within these complex relational systems.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParents\u0026rsquo; Experience of Attachment Dynamics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAccording toBowlby (1969), the \u003cem\u003eattachment behavioral system\u003c/em\u003e is a system of behaviors to maintain closeness to an important other (the attachment figure) for safety and connection, and leads to predictable outcomes, although the predominant behaviors may vary across cultures. Similarly, Bowlby (1984) proposed that the \u003cem\u003ecaregiving behavioral system\u003c/em\u003e is an instinctual set of behaviors that caregivers display in order to protect their children, and promote proximity and comfort when a child expresses the need for connection or safety (Cassidy \u0026amp; Shaver, 2016). Caregiving actions such as retrieval, calling, soothing, rocking, and feeding can be viewed as biologically embedded relational strategies that promote connection and emotional regulation, enhancing a child\u0026rsquo;s well-being and survival (Cassidy \u0026amp; Shaver, 2016).\u003c/p\u003e\n\u003cp\u003eThe degree to which a child seeks proximity from their caregiver varies depending on both internal and external conditions. Bowlby (1969) proposed that the attachment system is activated by two primary factors: (a) the internal state of the child (such as illness, fatigue, or emotional distress), and (b) environmental conditions that signal potential threat or separation, such as an unfamiliar setting or the caregiver\u0026rsquo;s absence. Likewise, the caregiving system in adults is activated by cues suggesting the child may need support. Internal cues for caregivers may include emotional responses like concern or empathy, or culturally shaped beliefs about parenting (Cassidy \u0026amp; Shaver, 2016). External cues often include observable signs of the child\u0026rsquo;s distress, such as crying, withdrawal, or clinging, as well as contextual factors like danger in the environment or disruptions to routine (Cassidy \u0026amp; Shaver, 2016). This interplay between the child\u0026rsquo;s signals and the caregiver\u0026rsquo;s interpretation of those signals forms the core of the caregiving and attachment dynamic.\u003c/p\u003e\n\u003cp\u003eBowlby (1969) believed that the attachment behavior stops when the attachment needs of the child are met. The caregiver\u0026rsquo;s response may vary based on the intensity of the child\u0026rsquo;s attachment signals. For example, when a child is mildly distressed, simple proximity or a calm vocal tone may provide sufficient reassurance. However, if the child is experiencing significant distress, the caregiver may need to increase closeness or take active steps to co-regulate and ensure safety (Cassidy \u0026amp; Shaver, 2016). Caregivers are constantly engaged in monitoring and evaluating relational and environmental cues to care for the child effectively (O\u0026rsquo;Neill et al., 2021; Tsotsi et al., 2018).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBowlby (1969, 1988) described the caregiving and attachment systems as complementary and ideally functioning in synchrony. An example might include shared attempts to maintain a comfortable degree of proximity\u0026mdash;such as a caregiver gently retrieving a wandering child, or a child reaching out for connection when the caregiver moves away (Cassidy \u0026amp; Shaver, 2016). \u0026nbsp;Bowlby (1969) suggested that activation of a caregiver\u0026rsquo;s own attachment system\u0026mdash;particularly during times of grief, trauma, or insecurity\u0026mdash;may hinder their caregiving capacity. For instance, a caregiver navigating personal loss or unresolved attachment issues may struggle to remain consistently attuned to their child\u0026rsquo;s needs (Laflamme et al., 2022). Insecure attachment styles in caregivers have been linked to difficulties in caregiving, particularly when under stress, due to a tendency to either become overwhelmed or disengage as a coping strategy (Giannotti et al., 2023; McIntosh et al., 2023).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCrucially, Bowlby (1969) emphasized that attachment security is shaped by how caregivers respond to children\u0026rsquo;s relational bids. When caregivers consistently and reliably validate and respond to both positive and challenging emotions, children are more likely to develop secure attachment patterns (Kohlhoff et al., 2022). Conversely, when children come to expect inconsistent, unavailable, or threatening responses from caregivers, insecure attachment patterns may emerge (Bowlby, 1969; Kohlhoff et al., 2022).\u003c/p\u003e\n\u003cp\u003eCaregiver attunement plays a central role in these dynamics. Cassidy et al. (2013) described how children\u0026rsquo;s behaviors often perceived as \u0026ldquo;babyish\u0026rdquo; (e.g., crying, babbling) are actually effective relational tools for signaling a need for support and co-regulation. Caregivers, in turn, often use intuitive signals\u0026mdash;such as facial expressions, tone of voice, and gestures\u0026mdash;to create safety and connection (Ainsworth, 1989). These subtle, reciprocal interactions build the relational fabric from which a child\u0026rsquo;s sense of security is formed. Attunement, then, is not a fixed trait, but an ongoing, responsive process that reflects the caregiver\u0026rsquo;s ability to meet the child where they are. When caregivers are able to tune into and respond to their child\u0026apos;s unique ways of expressing their need for safety and connection, a foundation for secure attachment can be co-created (Ainsworth, 1989; Cassidy et al., 2013).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAttachment bond.\u0026nbsp;\u003c/strong\u003e An attachment bond is the affectional tie between one individual and their attachment figure (Ali et al., 2021). Ainsworth (1989) described attachment bonds as persistent and involving a specific figure who cannot be interchanged with anyone else. She also described these bonds as emotionally significant and the reason behind an individual wanting to maintain proximity with their attachment figure, and feeling distressed during involuntary separation (Ainsworth, 1989). Importantly, the presence of an attachment bond is not dependent on observable attachment behaviors alone. Children may not display proximity-seeking behaviors if their attachment needs are met and they feel a consistent sense of safety. In other words, a child\u0026rsquo;s attachment bond may be strong even in the absence of overt behaviors like crying or clinging (Ali et al., 2021). Bowlby (1969) proposed that the stability and continuity of the attachment bond across time does not necessarily correlate with attachment security. For some children, clinginess may reflect secure reliance on a caregiver as a safe base, rather than an indication of insecurity or relational dysfunction. Attachment security reflects relational quality, not just behavioral intensity. While much of the theoretical foundation for attachment bonds comes from research in non-autistic relational contexts, the essence of the bond\u0026mdash;emotional significance, caregiver responsiveness, and relational consistency\u0026mdash;remains relevant for neurodiverse children.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAutism and Attachment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEarly studies suggested that autistic children react to separation from a caregiver similarly to non-autistic children (Bieberich \u0026amp; Morgan, 1998; Sigman \u0026amp; Mundy, 1989); however, other studies have historically framed autistic children as having lower sensitivity or responsiveness to caregiver approaches (Rutgers et al., 2007; van Ijzendoorn et al., 2007), often interpreting these behaviors through a deficit-based lens. More recent research recognizes that such interpretations may reflect a bias and an underappreciation of neurodivergent relational expressions (Lee et al., 2024).\u003c/p\u003e\n\u003cp\u003eAlthough autistic children are capable of forming secure attachments, their communication and sensory differences may influence how these bonds are expressed and understood. Parent-child relationships involving autistic children may differ in sensitivity, flexibility, and synchrony\u0026mdash;not due to relational deficits, but because of the mismatch between expressions of connection and neurotypical expectations (Beurkens et al., 2013). Recent research reinforces that inadequate social support or structural barriers are associated with increased parenting stress in caregivers of autistic children, negatively impacting relational availability and caregiving capacity (Brennan \u0026amp; Davis, 2025; Kapp \u0026amp; Brown, 2011). \u0026nbsp;Since attachment is bidirectional, both child communication patterns and caregiver responsiveness play key roles (Giannotti et al., 2023; Lee et al., 2024).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResearch on autism and attachment has predominantly relied on frameworks developed for neurotypical dyads, particularly the Strange Situation (Ainsworth et al., 1978; Bowlby, 1969) procedure as the main assessment tool. These tools may not adequately capture attachment in autistic children, whose behaviors may not align with traditional classifications (Teague et al., 2018). Furthermore, studies often group autistic children with those who have other developmental disabilities, making it difficult to distinguish the unique relational experiences within autism. This begs the question of whether the available research findings truly reflect the unique experience of parents who have autistic children. Thus, the purpose of this phenomenological study is to explore the lived experiences of parents raising autistic children in relation to their attachment dynamics. More specifically, the question guiding this research study is: What are the lived experiences of autistic children\u0026rsquo;s parents in relation to their attachment behaviors?\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eGiven that the purpose of this qualitative study was to capture the lived experiences of parents, Interpretative Phenomenological Analysis (IPA) was selected as the methodology. \u0026nbsp;IPA is described as an inductive approach that empowers the participants to be experts on their own experiences while the researchers interpret how meaning is made (Howard et al., 2019; O\u0026rsquo;Brien et al., 2014). The founding principle of phenomenology could be linked back to Edmund Husserl who believed that the human experience should be examined in its own terms (Smith et al., 2009). Importantly, new applications of IPA in autism and caregiving research highlight its strengths in amplifying marginalized voices and honoring empowerment, reflexivity, and relational context (Howard et al., 2019).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTen parents who met the following inclusion criteria participated in this study: (a) \u0026nbsp;Be at least 18 years old at the time of the study; (b) be the primary caregiver of a child with a formal diagnosis of autism spectrum disorder or previous diagnoses of Pervasive Developmental Disorder or Asperger Syndrome; and (c) be able and willing to provide informed consent.\u003c/p\u003e\n\u003cp\u003eParticipants were recruited using purposive sampling to ensure each caregiver had lived experience of parenting an autistic child and primary caregiving responsibilities. Snowball sampling was then used to invite further participants within autism caregiver networks. Participants were recruited across the United States via multiple channels, including clinics, therapy centers, and social media platforms (Facebook and Instagram). Flyers encouraged caregivers to share study details with others in their networks. \u0026nbsp;Demographic characteristics of participants are outlined in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003cbr\u003e\u003c/strong\u003e\u003cem\u003eDemographic Characteristics of Participants\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"627\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGender Identity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWoman\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAge Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u0026ndash;39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40\u0026ndash;49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50 or older\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRelationship Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eIn a committed relationship\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRacial Identity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWhite\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBlack or African American\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSome college\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAssociate degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMaster\u0026rsquo;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAnnual Household Income\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e$20,000\u0026ndash;$39,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e$80,000\u0026ndash;$99,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e$100,000 or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAccessed Mental Health Services\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNumber of Autistic Children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eIn total, ten parents reported caregiving for 24 children, 14 of whom had formal autism diagnoses. Further details on the children\u0026rsquo;s demographics and diagnoses are provided in Table 2.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eChildren\u0026rsquo;s Characteristics\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"627\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGender Identity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGirl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBoy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAge\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e64.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12-17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAge at Diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSupport Needs*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePreliminary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLevel 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLevel 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLevel 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAdditional Diagnoses Reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eADHD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ldquo;Developmental Delay\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGeneralized Anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e*Terms such as \u0026ldquo;Level 1/2/3\u0026rdquo; reflect DSM-5-TR criteria\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProcedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData collection for the study was conducted through the use of a semi-structured interview and a demographic questionnaire, following approval from the Institutional Review Board (IRB) at the University to which the authors were affiliated. Interviews were conducted in person, audio recorded, and transcribed. After the interview, participants received a $25 gift card and a list of resources that address challenges commonly experienced by parents of autistic children.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData was analyzed using Interpretative Phenomenological Analysis (IPA) as outlined by Smith et al. (2022). The first author followed a four-stage analytic process: reading and re-reading for immersion, initial noting, developing emergent themes, and identifying connections across themes. During immersion, the researcher engaged deeply with each transcript, annotating descriptive, linguistic, and conceptual observations. Descriptive notes focused on content, linguistic notes on features such as tone and metaphor, and conceptual notes reflected interpretative meaning-making. These informed emergent themes that captured key aspects of each participant\u0026rsquo;s lived experience. Themes were then examined for patterns and clustered into superordinate structures that reflected shared meanings. The analytic process was iterative and reflexive, consistent with IPA\u0026rsquo;s idiographic and interpretative orientation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrustworthiness\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo ensure the rigor and integrity of this qualitative study, four criteria were applied: credibility, transferability, dependability, and confirmability (Korstjens \u0026amp; Moser, 2018). Credibility was supported through peer debriefing and member checking (Nowell et al., 2017). The first author engaged in regular peer debriefing with two colleagues throughout the analytic process. These reviewers provided external perspectives on emerging and final themes, supporting reflexivity and reducing potential bias. Six participants responded to the member-checking invitation to review a summary of the study\u0026rsquo;s emergent themes and assess whether the interpretations reflected their experiences.\u003c/p\u003e\n\u003cp\u003eTransferability was enhanced through thick description of the research context, participant experiences, and analytic decisions, allowing readers to assess the relevance of findings to other settings (Korstjens \u0026amp; Moser, 2018). While this study focuses on parents of autistic children, the diversity within the autism spectrum means findings may not apply to all families, and this variability is acknowledged in the interpretation. Dependability was addressed through an audit trail documenting analytic decisions, coding development, and methodological reflections. This process enabled transparency in how data were interpreted over time. Confirmability was facilitated via reflexive journaling and external audit by the second author, ensuring that findings were grounded in participant data rather than researcher assumptions (Korstjens \u0026amp; Moser, 2018; Nowell et al., 2017). These strategies align with contemporary best practices for trustworthiness in phenomenological and IPA studies, reflecting a commitment to rigorous, ethical, and neurodiversity-affirming qualitative research (Howard et al., 2019; MacLeod, 2019).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical and Legal Considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe primary ethical considerations were the participant\u0026rsquo;s well-being, informed consent to participate in the study, and confidentiality. The participants were given the opportunity to ask questions or withdraw at any time prior, during, or after the study. Participants\u0026rsquo; confidentiality was maintained throughout the study by securely storing identifiable data, anonymizing transcripts, and using pseudonyms in study reports.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eSeven superordinate themes emerged from the data: (a) lack of frame of reference for parenthood, (b) uncertainty of child\u0026rsquo;s future, (c) attachment bond, (d) parent\u0026rsquo;s emotions about their child, (e) attachment behaviors, (f) separation and reunion,and (g) other factors that affect attachment dynamics. Due to space limitations, the present article focuses on the behavioral aspects of attachment dynamics\u0026mdash;specifically, the final three superordinate themes. For a comprehensive description of all seven themes, see [omitted for blind review]. For additional discussion of the emotional aspects of attachment dynamics, refer to forthcoming or related publications by this research team.\u003c/p\u003e\u003cp\u003e\u003cb\u003eAttachment Behaviors\u003c/b\u003e\u003c/p\u003e\u003cp\u003e All 10 participants reported tuning into their child through various methods to anticipate and understand their needs. Of the 14 autistic children whose parents were included in this study, four used verbal speech to express their feelings and needs, and ten were nonspeaking or minimally speaking, as described by the participants. The following three subordinate themes emerged from the data: hyperawareness of cues, understanding child\u0026rsquo;s cues/needs, and use of additional aids.\u003c/p\u003e\u003cp\u003eEight participants described being constantly hyperaware to recognize their child\u0026rsquo;s cues. Some reported watching their children closely due to safety concerns, as their children wouldn\u0026rsquo;t seek help or alert them when injured. Others were focused on better understanding their child. Several noted children's limited help-seeking behaviors, even during distressing or risky situations like elopement or self-injury, which often occurred without clear signals\u0026mdash;intensifying caregivers\u0026rsquo; vigilance. Deborah shared that she wanted to know more about her son so she would observe him for hours to try to understand him. She reported:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eIt's like I'm constantly observing him and trying to figure if his words are matching what he feels. I feel he has this whole world going on inside of his head that I can't get to. It's like I'm just waiting for a secret code. I'm waiting for that code key, to be like, \"that's what this means.\" And then it will just unlock this whole world of stuff that he is trying to say that I can\u0026rsquo;t understand.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e All 10 participants reported being able to anticipate when their child will become distressed. Participants discussed attending to both direct verbal cues and nonverbal cues (e.g. screams, noises, facial expression, body language, etc.) to interpret what the child needed from them. According to Lucille, she will wait to hear a bird call as birds are her son\u0026rsquo;s preferred interest. She reported bird calls are cues to whether he can find a solution to his problem on his own or if he needed help. She stated:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eHe makes bird calls a lot, so he can actually imitate a seagull or a crow\u0026hellip;So I know when he's shrieking a little bit. You can hear the escalation. So if we're outside of the room and him and his brother are getting into it, I can [gauge], the escalation of where it's going to go.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e Three participants reported they use additional aids to obtain cues from their children. These aids include: a letterboard, sensors, alarms, and social stories. Participants whose children tended to leave the home reported using tools such as door sensors or double locks to help them stay focused on other tasks while remaining aware of their child\u0026rsquo;s whereabouts. Mary, whose non-speaking child tried various communication supports\u0026mdash;including speech therapy that proved ineffective\u0026mdash;shared that her son now communicates well using a letterboard. While home communication mostly involves daily needs, he prefers deeper conversations with his communication specialist, who is helping him learn the letterboard. Mary believes the specialist understands her son best, as he responds more comfortably to open-ended questions with them than with family. She described the relief of finally understanding her son\u0026rsquo;s needs.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eIt's like when you're dealing with a newborn baby and you just don't know what they want, but think about that for 15 years. I am sure it was even more frustrating for him that he could not convey when he didn't want something and we were just forcing things on him, \"you're getting a banana whether you want it or not.\" It's like finally he can say, \"I don't want it.\u0026rdquo;\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eSeparation and Reunion\u003c/b\u003e\u003c/p\u003e\u003cp\u003e Although participants were the main caregivers of their children, there were times when they were momentarily separated from their children (e.g., children were at school, or attended to by a secondary caregiver). The three subordinate themes emerged regarding the parents\u0026rsquo; experiences during separation and reunion: temporary relief during separation, anxiety about separation, and relief and joy during reunion.\u003c/p\u003e\u003cp\u003e Five participants reported experiencing an immediate sense of relief during separation from their child as they were able to tend to responsibilities they are unable to accomplish while attending to their child. When asked about what separation from her child was like, Brenda stated:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eRelief. I like to get in the car and just go to Target, go get gas, go do errands for myself. Just peace. I'll still worry about him, but that immediate sense of having to deal with whatever crisis is going on at the time, it feels [good]. Someone else can deal with it for me, [the] teacher can deal with it or the swim teacher can deal with it. Just a sense of relief.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e Nine participants reported experiencing increased and excessive worry about whether their child will be adequately cared for, if they have gotten in trouble, or concerns regarding safety during separation from their child. Stacy recalled her experiences after dropping off her child at school:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eI would just wait to get [a] call or emails from his teacher, or I just worry. I worry about what he [is] going to do today; is he going to have problems? or what kind of behaviors are going to keep him from being able to do his schoolwork? Is he going to have conflict with other kids? When the phone rings and it says [name of school], I just hold my breath and think, \"oh please, don't let it be something bad.\u0026rdquo;\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e Seven participants reported relief when they were reunited with their child as they are glad their child has returned home safely. All 10 participants reported joy when they are reunited with their child despite how challenging the day may have been. Deborah, the mother of two autistic children, described her experience picking up her children from school:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eWhen I reunite with them, it's a relief. Relief and happiness. It was only for three hours, and in the afternoon, you would wait to see the class walk around the corner up to where the parents were. And I wouldn't realize it, but I would start holding my breath. And when I saw them come around the corner, it was just this feeling of, \u0026ldquo;oh my God, we did it again. Oh my God, we made it one more day.\u0026rdquo;\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eOther Factors That Affect Attachment Dynamics\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTwo subordinate themes emerged from the data as factors that affect attachment dynamics between the parent and child: burnout and stress, and co-parenting conflict. Seven participants reported experiencing burnout and stress from raising their autistic child as they do not have support from the community or from the family. The participants noted that the burnout affects their ability to be affectionate with their child and to tune into their needs. Of the seven participants, three reported feeling overwhelmed and expressed that they want their relationship to be simpler. Participants explained that they can be \u0026ldquo;short\u0026rdquo; or easily frustrated with their children when they are stressed. These participants reported wanting to be perceived as more \u0026ldquo;fun\u0026rdquo; and \u0026ldquo;loving\u0026rdquo; by their children. Only two participants reported receiving mental health services for themselves. This experience can be summarized through Brenda\u0026rsquo;s statement: \u0026ldquo;I wish I could be more fun. I want to be more fun. I want to have more fun with parenting. There's a part of parenting that I thought was supposed to be fun or at least rewarding.\u0026rdquo;\u003c/p\u003e\u003cp\u003eSix participants reported having co-parenting challenges with their spouse or co-parent. Participants frequently mentioned that their differing parenting strategies have posed difficulty in their relationship with their children. Brenda discussed her emotions in regards to her son being closer to his father than to her because of their parenting conflict:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eI am the disciplinarian in the family. My husband doesn't really discipline and so I'm the\u003c/p\u003e\u003cp\u003eone that draws the lines and he (her son) gets frustrated with me a lot. A lot of push and\u003c/p\u003e\u003cp\u003epull. So, I'm not the preferred parent. I'm the one that sets limits and boundaries and I\u003c/p\u003e\u003cp\u003ethink one day he'll appreciate that. But right now, when I pick him up at school, [he says]\u003c/p\u003e\u003cp\u003e\u0026ldquo;I want dad to come pick me up. I didn't want you to come.\u0026rdquo; It hurts me and it breaks my\u003c/p\u003e\u003cp\u003eheart, but I realized that that's the role I play and so I've armed myself to it.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eParticipants who were unmarried or divorced reported challenges that were specific to them such as living as a blended family, differing opinions on treatment, and complications with shared custody. These participants are also the ones who reported anxiety during separation from their child as they are uncertain whether their co-parent will say or do something that would negatively affect their relationship with their child.\u003c/p\u003e\u003cp\u003eDespite the challenges that participants faced in raising an autistic child, their core caregiving tasks remain true to attachment theory albeit with some modifications. Participants described providing love and care for their child. Simultaneously, participants maintained a level of vigilance as to not miss their child\u0026rsquo;s cues while some required concrete aids (e.g. sensors, letterboard) if their children had limited communication skills or did not consistently provide cues. Participants had to be adaptive and learn new skills to maintain their role as an effective caregiver for their children.\u003c/p\u003e\u003cp\u003eSeparation and reunion between parent and child have long been understood through an attachment lens. The emotions and actions that arise through separation and reunion provide insight to the bond between the dyad. In this study, participants reported feeling an immediate sense of relief during separation from their child as they have been overextended in their caretaking role. They reported feeling guilt for the peace and calm they felt; however, their time away from their child was used to recuperate both physically and emotionally, and to complete essential tasks (e.g. planning their day, running errands). Participants with children who required a higher level of support (e.g., safety monitoring, constant behavioral supervision) reported anxiety during their separation. All participants had positive associations with reuniting with their child, and felt more capable in meeting their children\u0026rsquo;s needs.\u003c/p\u003e\u003cp\u003eLastly, parent stress/burnout and coparenting conflict were other factors that affected attachment dynamics. The increased demands placed on parents of autistic children resulted in the parents\u0026rsquo; limited capacity to provide affection. Daily challenges depleted their emotional resources leaving participants wishing they could be more fun and loving to their children. Participants whose parenting styles or opinions on parenting a child with autism differed from those of their coparent found that this disagreement negatively affected their connection with their children. These challenges stem from issues such as experiencing the child\u0026rsquo;s favoritism for the other parent or disagreement on discipline. Challenges within the parental subsystem also play a role into their availability and responsiveness as a caregiver.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e\u003cb\u003eAttachment Behaviors\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWithin the context of attachment behaviors, the three subordinate themes emerged: hyperawareness of cues, interpreting child\u0026rsquo;s needs, and the use of additional aids. In attachment theory, behaviors that seek proximity to an attachment figure serve to signal emotional or physical needs (Bowlby, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e1969\u003c/span\u003e). Participants in this study described various strategies they used to recognize and interpret their child\u0026rsquo;s unique expressions of attachment, many of which were subtle, idiosyncratic, or easily missed by others. Participants reported becoming highly attuned to the child\u0026rsquo;s behaviors, often monitoring closely for changes in tone, affect, or movement, especially for the ten children described by participants as nonspeaking or minimally speaking Many described needing to remain highly focused throughout the day, noting that missing even a small cue could mean overlooking a need or moment of distress. While the caregiving behavioral system is typically activated in response to proximity-seeking behaviors from a child (Bowlby, 1988), these findings indicate that activation of the caregiving behavioral system for parents of autistic children seems to be more constant and proactive.\u003c/p\u003e\u003cp\u003eDespite these challenges, all participants reported understanding their child\u0026rsquo;s needs, even when cues were subtle or nontraditional. The caregiving behavioral system is activated with the influence of the child\u0026rsquo;s attachment behaviors, but the caregiver must also be able to attune and be responsive to the child (Ainsworth, 1989). Participants reported having the ability to make inferences from their children\u0026rsquo;s facial expression, tone of voice, or patterns of behaviors that may not be understood by others. This insight came not from instinct alone but through deep emotional investment, observation, and intentional adaptation. Participants emphasized that their attunement was developed over time, not assumed, and required sustained effort and emotional labor. Attuning to children\u0026rsquo;s needs is important in establishing a sense of security (Ainsworth, 1989). Additionally, participants reported that their ability to understand their child\u0026rsquo;s idiosyncratic and peculiar cues also limits the capability for others to provide support in caretaking tasks such as respite care workers or extended family members. Many described learning their child\u0026rsquo;s unique communication style through repetition and close connection. While effective for the primary caregiver, this understanding was difficult to convey to others. As a result, participants expressed concern that extended family members or respite workers often struggled to interpret their child\u0026rsquo;s signals, which limited opportunities for shared caregiving and contributed to caregiver stress and burnout.\u003c/p\u003e\u003cp\u003eParticipants whose children had high support needs and limited spoken communication also described using supportive tools to bridge communication gaps and enhance safety. These included motion sensors on doors, visual communication supports, and augmentative systems like letterboards. These resources enabled caregivers to fulfill their role as a secure base and safe haven in creative and individualized ways. Importantly, these adaptations were not seen as indicators of deficits but as meaningful extensions of the caregiving relationship. Parental attunement in autism is often the result of intentional, insight-driven engagement, rather than assumed intuition, reflecting the caregiver\u0026rsquo;s commitment to understanding their child\u0026rsquo;s unique ways of connecting and communicating (Di Renzo et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Through patient observation and relational commitment, participants in this study cultivated a nuanced understanding of their child\u0026rsquo;s needs and signals. These findings affirm that secure attachment is possible and meaningful in neurodivergent caregiving relationships when supported by intentional attunement and responsive environments.\u003c/p\u003e\u003cp\u003e\u003cb\u003eSeparation and Reunion\u003c/b\u003e\u003c/p\u003e\u003cp\u003eResults revealed three subordinate themes within separation and reunion: temporary relief during separation, parental anxiety about separation, and relief during reunion. Participants described immediate relief from constant daily stressors during separation, as others (e.g., teachers or providers) were managing crises. This relief enabled them to complete tasks otherwise hindered by caregiving demands. However, the relief was often short-lived, followed by anxiety about their child\u0026rsquo;s well-being once the task was done. Although typical attachment literature doesn\u0026rsquo;t describe this temporary relief, recent research notes that caregivers under prolonged stress may seek brief separations as a coping mechanism to regain emotional energy and reorganize capacity for caregiving (de la Roche \u0026amp; Im-Bolter, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Edmunds et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Warreman et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In this context, temporary separation may serve as a form of regulation that supports a caregiver's long-term availability. For caregivers of autistic children, these moments may offer a greater sense of control and allow them to return to caregiving roles with more capacity for attunement.\u003c/p\u003e\u003cp\u003e At the same time, nearly all participants experienced anxiety during separation, worrying about their child\u0026rsquo;s safety and wellbeing while not in their care. This anxiety was especially pronounced among parents whose children engage in behavior that could pose safety concerns, such as bolting, self-injury, or difficulty communicating needs to unfamiliar people. Though qualitative studies specifically capturing this phenomenon in parents of autistic children remain limited, broader caregiver research confirms elevated anxiety and distress for these parents, particularly when supports feel inadequate (Crowell et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; de la Roche \u0026amp; Im-Bolter, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; van Niekerk et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In this study, participants described a deep sense of responsibility and awareness that their children\u0026rsquo;s needs may not be well understood or accommodated in unfamiliar environments, reinforcing the feeling that separation carries risk. In the context of attachment theory (Bowlby, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e1969\u003c/span\u003e), the prolonged nature of this anxiety may reflect a hyperactivated parental caregiving system, continuously monitoring potential threat and responsibility, whether in the presence of the child or not. They might also view themselves as the only ones who are capable of keeping their child safe rather than a shared role between multiple caregivers.\u003c/p\u003e\u003cp\u003eAfter separation, participants in this study experienced relief upon their reunion with their child. Many described positive emotions such as happiness, calm, and a sense of grounding when their child returned to them. Several shared that knowing their child was back in their care provided comfort after periods of worry or uncertainty. Participants also reflected that the anxiety they experienced during separation made the reunion feel even more meaningful. Being reunited brought a tangible sense of safety and reassurance. Parents also reflected that the anxiety they experienced during separation made the reunion feel even more meaningful. Being reunited brought a tangible sense of safety and reassurance. However, two participants shared that they could not recall ever being apart from their child. In these cases, the children had high support needs, and the parents reported not feeling confident that others would adequately understand or care for their child. For these families, separation was not just emotionally challenging\u0026mdash;it was not an option. This highlights how limited access to trusted, affirming caregiving support can shape the caregiving experience in ways that go beyond personal preference.\u003c/p\u003e\u003cp\u003e\u003cb\u003eOther Factors That Affect Attachment Dynamics\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTwo key themes emerged as factors shaping attachment dynamics between participants and their children: burnout/stress and co-parenting conflict.\u003c/p\u003e\u003cp\u003e\u003cb\u003eBurnout/stress.\u003c/b\u003e Experiences of burnout and overwhelming stress were commonly reported and appeared to impact the relational aspects of parenting. Participants often described how limited support from family or community contributed to exhaustion, which in turn made it harder to be affectionate or attuned to their child. Several shared that as burnout increased, their role shifted toward practical caretaking, leaving less capacity for playfulness or emotional connection. This is consistent with prior research that as stress rises, opportunities for emotionally rich, reciprocal interaction may decrease\u0026mdash;not because parents are disinterested or unloving, but because their capacity is depleted (Bradley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Brennan \u0026amp; Davis, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Buchwald et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eParental stress is associated with the child\u0026rsquo;s support needs, communication profile, and adaptive behavior (Giannotti et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; van Niekerk et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In this study, several participants whose children were diagnosed with Autism Level 2 or Level 3 expressed a longing for a \"simpler\" relationship\u0026mdash;not in terms of who their child is, but in terms of having fewer barriers to connection. Many spoke about wanting to engage more emotionally without navigating sensory sensitivities, communication mismatches, or behavioral care protocols.\u003c/p\u003e\u003cp\u003eBroader research on attachment highlights that stress may not only impact the security of the attachment bond, but also its organization. A meta-analysis by O\u0026rsquo;Neill et al. (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) found that caregiver sensitivity has a stronger longitudinal relationship to whether a child develops an organized or disorganized attachment style than to whether they develop a secure or insecure attachment style, particularly in the preschool years. While disorganization is often attributed to frightening or chaotic caregiving environments, the authors note that it is also associated with caregiver stress, trauma, and contextual adversity (O\u0026rsquo;Neill et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). This is particularly relevant to the current findings, where participants described chronic stress, lack of respite, and isolation as barriers to consistent responsiveness. When attunement requires intense effort and caregiving is unsupported, the attachment system may shift not only in security but in organization\u0026mdash;suggesting the need for early and sustained relational support for families of autistic children.\u003c/p\u003e\u003cp\u003eAlthough there is limited research on how burnout specifically impacts attachment in autistic families, findings from non-autistic samples provide relevant insight. Stelter and Halberstadt (2011) found that high levels of parental stress are associated with children perceiving their caregivers as less secure bases. Children whose caregivers experience chronic stress may not always perceive them as reliably available, which can impact their internal working models. This concern may be heightened in families navigating complex communication or behavioral needs, where attunement requires heightened vigilance, patience, and effort.\u003c/p\u003e\u003cp\u003eMany participants reported being hypervigilant to potential stressors or needs. Several reflected on times when stress led them to be \u0026ldquo;short\u0026rdquo; or reactive with their children, even though they cared deeply. Only two participants in the study reported receiving mental health services for themselves. Importantly, several participants whose children received psychotherapy\u0026mdash;particularly play therapy or family therapy\u0026mdash;shared that these services helped them better understand their child\u0026rsquo;s cues and respond in ways that deepened their connection. They described learning how to attune to their child through shared therapeutic work, which enhanced their sense of confidence and emotional availability.\u003c/p\u003e\u003cp\u003e\u003cb\u003eCo-parenting conflict.\u003c/b\u003e Participants in this study reported experiencing challenges in co-parenting, particularly when they disagreed on approaches like boundaries, rewards, or consequences. These differing viewpoints created confusion around how to relate to and support their autistic child. Some participants expressed frustration that these disagreements made it harder to show up consistently and attune to their child. These findings align with recent research showing that an autism diagnosis can increase family stress and strain the co-parenting relationship (Bradley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Brennan \u0026amp; Davis, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). When the parenting alliance is weakened, parents may feel less supported and more overwhelmed\u0026mdash;both of which can affect their ability to remain emotionally available to their child. Sim et al. (2017) found that negative co-parenting experiences were linked to heightened family stress and impacted the parent\u0026rsquo;s relationship with other children in the household as well. Strengthening the co-parenting relationship was associated with lower stress levels and more coordinated, responsive parenting. Emerging research also emphasizes that collaborative parenting practices may buffer the emotional impact of caregiving stress, especially when caregivers feel validated and aligned in their approaches (Phelan et al., 2022).\u003c/p\u003e\u003cp\u003eLiterature exploring co-parenting of autistic children is still limited, particularly in connection to attachment. However, broader research has identified factors that affect a parent\u0026rsquo;s ability to connect with their children, such as caregiver mental health (Giannotti et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Teague et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), parenting conflict (Brock \u0026amp; Kochanska, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Martin et al., 2017), and family instability (Ferraro \u0026amp; Lucier-Greer, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). When parents are emotionally attuned, responsive, and available, children are more likely to develop confidence in the caregiving relationship (van IJzendoorn, 1995). When caregivers are not consistently available, however, children may internalize a sense of uncertainty, developing negative internal working models of themselves and others. Recent studies in family systems research also suggest that unresolved parental conflict can undermine a child\u0026rsquo;s emotional security and self-concept, even when the child is not directly involved in the conflict (Brock \u0026amp; Kochanska, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; O\u0026rsquo;Hara et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e Furthermore, co‑parenting conflict may amplify existing stressors and contribute to ruptures in the attachment relationship\u0026mdash;not necessarily because of the child\u0026rsquo;s needs, but because of a mismatch in caregiver responses. Several participants described feeling isolated in their parenting role, or like the \u0026ldquo;default\u0026rdquo; parent, which further intensified feelings of exhaustion. While not all participants reported disagreement in co-parenting, those who did expressed a desire for more support and communication, recognizing that alignment in parenting approaches could improve both their partnership and their connection with their child.\u003c/p\u003e\u003cp\u003e\u003cb\u003eLimitations and Recommendations for Future Research\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study has several limitations that may affect the transferability of findings. Although participants described a range of support needs in their children, the diversity of autism profiles limits generalizability across all parent-child relationships. The sample was predominantly composed of White, cisgender, female caregivers with household incomes above \u003cspan\u003e$\u003c/span\u003e80,000, many of whom were stay-at-home parents. These demographic characteristics likely shaped caregiving experiences, particularly through access to private therapies, flexible employment, and broader support networks. In contrast, caregivers with fewer financial, social, or cultural resources may face greater challenges navigating systems of care\u0026mdash;factors that can meaningfully impact attachment dynamics. Fathers, nonbinary caregivers, and racially or ethnically minoritized parents may also have distinct experiences shaped by intersecting cultural expectations and structural inequities. Future research should prioritize more diverse participant recruitment across race, ethnicity, gender, socioeconomic status, and family structure to better capture the full spectrum of caregiver experiences.\u003c/p\u003e\u003cp\u003eContinued qualitative exploration of attachment dynamics is recommended to deepen understanding of how caregivers navigate connection, emotional availability, and responsiveness within neurodivergent families. Further studies should also examine how caregivers\u0026rsquo; own attachment histories influence their parenting, as several participants spontaneously linked their approaches to their upbringing. Finally, investigating attachment in blended, adoptive, or multi-generational families could offer valuable insights into how diverse caregiving systems support or shape autistic children\u0026rsquo;s relational development.\u003c/p\u003e\u003cp\u003e\u003cb\u003eClinical Implications\u003c/b\u003e\u003c/p\u003e\u003cp\u003eOne clinical implication of this study is the importance of systemic work with families of autistic children. Clinicians are encouraged to advocate for support not only for the child, but for the entire family unit\u0026mdash;including the caregivers. Although participants reported high levels of stress, anxiety, and emotional exhaustion, only two out of ten reported receiving mental health services for themselves. Participants shared statements such as \u0026ldquo;it is not my time,\u0026rdquo; reflecting how caregivers often defer their own needs to prioritize their child\u0026rsquo;s care. Clinicians may interpret this not as a lack of interest in services, but rather as an opportunity to gently invite caregivers into therapeutic support\u0026mdash;even if they do not directly request it. Mental health support for caregivers has systemic benefits, as caregiver well-being can influence the quality of parent-child interactions and overall family functioning. Research has shown that parents with greater insight into their own attachment patterns may be better able to respond sensitively to their child\u0026rsquo;s needs (Mikulincer \u0026amp; Shaver, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Oppenheim et al., 2024; Oppenheim et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Parashar et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Classic attachment interventions, such as those developed by Ainsworth (1973), highlight how reflective parenting practices and emotional attunement foster secure caregiving behaviors. Participants in the current study who responded to the member checking invitation shared that they experienced emotional relief when discussing their caregiving experiences with a clinician-researcher. They described this process as validating, and reported that it supported greater self-awareness in their relationship with their child. This shows that opening spaces for parents to reflect on these experiences in the presence of an attuned listener, even if occasional, can yield benefits.\u003c/p\u003e\u003cp\u003eGiven the stressors described by participants, multi-modal support may be particularly helpful. In addition to psychotherapy, parents may benefit from referrals to support groups, psychoeducation, and practical assistance such as childcare navigation or respite care. These resources can create space for caregivers to regulate, recharge, and return to their role with increased emotional availability. Many participants described feelings of social isolation, and some expressed difficulty maintaining extended family or friendship networks due to their caregiving responsibilities. Clinicians may consider inviting extended family, partners, or other natural supports into sessions to increase the caregiver\u0026rsquo;s circle of care. Social support has been shown to buffer the effects of parenting stress in families of autistic children (Ekas et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; de la Roche \u0026amp; Im-Bolter, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eSystemic therapy for autistic children themselves can also be beneficial, particularly when attachment, family dynamics, or relational repair are supportive goals. In this study, participants shared how they attuned to their children using highly individualized strategies\u0026mdash;including the use of assistive tools (e.g., letterboards, sensors) and developing a nuanced understanding of their child\u0026rsquo;s unique cues. Clinicians can build on these efforts by supporting parents in tracking and interpreting their child\u0026rsquo;s communication styles, offering tools that match the child\u0026rsquo;s sensory or cognitive profile, and integrating the child\u0026rsquo;s interests (e.g., favorite cartoons, preferred interests) into therapeutic strategies.\u003c/p\u003e\u003cp\u003eOn a broader scale, the findings of this study suggest a role for systemic advocacy. Clinicians, healthcare providers, educators, and policymakers must begin to view caregiver support as a critical part of comprehensive autism care. Finally, at the systems level, findings from this study suggest a need for broader recognition that caregiver support is not a luxury\u0026mdash;it is an essential component of sustainable care. Embedding mental health resources, community connection, neurodiversity-informed care, and respite options into standard services can enhance not only the parent-child relationship but the long-term wellbeing of families navigating a world that often overlooks their needs.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study explored the lived experiences of parents raising autistic children through the lens of attachment, illuminating the nuanced ways in which caregivers navigate connection, stress, and relational dynamics. The findings affirm that attachment in families of autistic children may not follow the traditional models of attachment theory, but rather reflects adaptive, responsive, and often creative efforts by caregivers to meet their child\u0026rsquo;s needs within a society that frequently lacks structural support. While participants reported familiar attachment processes\u0026mdash;such as attunement, distress during separation, and joy in reunion\u0026mdash;the intensity and expression of these dynamics were shaped by the child\u0026rsquo;s support needs, communication profile, and environmental demands.\u003c/p\u003e\u003cp\u003eBy centering lived experiences, this study highlights the importance of validating diverse attachment presentations and resisting normative assumptions about parent-child relationships. It also underscores the need for clinicians, researchers, and systems of care to recognize that caregiver wellbeing is essential to relational health\u0026mdash;not as an afterthought, but as an integral part of therapeutic and policy interventions. Future work should continue to expand representations of neurodivergent families, ensuring that research and services reflect the realities of those most affected.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eP.M. conceptualized the study, developed the manuscript structure, conducted the literature review, and wrote the original draft. A.N. served as an external auditor to support confirmability, providing intellectual mentorship, contributed to critical revisions, and assisting with formatting and references. Both authors reviewed and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWith gratitude to the autistic children and families who shared their stories. Your courage, insight, and love illuminate every page of this work.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAinsworth, M. D. S., Blehar, M. C., Waters, E., \u0026amp; Wall, S. (1978). \u003cem\u003ePatterns of Attachment : A Psychological Study of the Strange Situation\u003c/em\u003e. Taylor and Francis.\u003c/li\u003e\n\u003cli\u003eAli, E., Letourneau, N., \u0026amp; Benzies, K. (2021). Parent-Child Attachment: A principle-based concept analysis. \u003cem\u003eSAGE Open Nursing\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(1). https://doi.org/10.1177/23779608211009000\u003c/li\u003e\n\u003cli\u003eBieberich, A. A., \u0026amp; Morgan, S. B. (1998). 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K., Tonge, B. J., \u0026amp; Gray, K. M. (2018). Caregiver Mental Health, Parenting Practices, and Perceptions of Child Attachment in Children with Autism Spectrum Disorder. \u003cem\u003eJournal of Autism and Developmental Disorders\u003c/em\u003e, \u003cem\u003e48\u003c/em\u003e(8), 2642\u0026ndash;2652. https://doi.org/10.1007/s10803-018-3517-x\u003c/li\u003e\n\u003cli\u003eTsotsi, S., Borelli, J. L., Abdulla, N. B., Tan, H. M., Sim, L. W., Sanmugam, S., Tan, K. H., Chong, Y. S., Qiu, A., Chen, H., \u0026amp; Rifkin-Graboi, A. (2018). Maternal sensitivity during infancy and the regulation of startle in preschoolers. \u003cem\u003eAttachment \u0026amp; Human Development\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(2), 207\u0026ndash;224. https://doi.org/10.1080/14616734.2018.1542737\u003c/li\u003e\n\u003cli\u003evan Ijzendoorn, M. H., Rutgers, A. H., Bakermans-Kranenburg, M. J., Swinkels, S. H. N., van Daalen, E., Dietz, C., Naber, F. B. A., Buitelaar, J. 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Psychological, behavioural, and physical aspects of caregiver strain in autism-caregivers: a cohort study. \u003cem\u003eEClinicalMedicine\u003c/em\u003e, \u003cem\u003e64\u003c/em\u003e, 102211\u0026ndash;102211. https://doi.org/10.1016/j.eclinm.2023.102211\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"contemporary-family-therapy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"coft","sideBox":"Learn more about [Contemporary Family Therapy](http://link.springer.com/journal/10591)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/coft/default.aspx","title":"Contemporary Family Therapy","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Autism, attachment, parenting, caregiving, phenomenology, neurodiversity","lastPublishedDoi":"10.21203/rs.3.rs-7254557/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7254557/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eParenting autistic children often involves navigating unique relational, sensory and emotional needs within environments designed for neurotypical expectations. This phenomenological study explores how parents of autistic children experience and interpret attachment behaviors. Semi-structured interviews were conducted with ten primary caregivers of autistic children across the United States. Using Interpretative Phenomenological Analysis, three major themes emerged: (a) attachment behaviors, (b) separation and reunion, and (c) other factors that affect attachment dynamics. Findings highlight the intentional, attuned, and often proactive ways caregivers co-regulate with their children, even in the absence of traditional proximity-seeking behaviors. These dynamics are shaped by the child\u0026rsquo;s communication profile, sensory needs, and the broader relational environment. The study challenges deficit-based assumptions about attachment in neurodivergent families and underscores the importance of systemic support. 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