The refrigerator mother theory, also known as Bettelheim's theory of autism, is a discredited psychological theory that the cause of autism is a lack of parental, and in particular, maternal emotional warmth. Evidence against the refrigerator mother theory began in the late 1970s, with twin studies suggesting a genetic etiology, as well as non-social environmental factors. Modern research generally agrees that there is a largely epigenetic etiology of autism spectrum disorders. The terms refrigerator mother and refrigerator parents were coined around 1950 as a label for mothers or fathers of children diagnosed with autism or schizophrenia. Both terms are now regarded as stigmatizing and no longer used.
Origins of theory In his 1943 paper that first identified autism, Leo Kanner called attention to what appeared to him as a lack of warmth among the fathers and mothers of autistic children. In a 1949 paper, Kanner suggested that autism may be related to a "Maternal lack of genuine warmth", noted that fathers rarely stepped down to indulge in children's play, and observed that children were exposed from "the beginning to parental coldness, obsessiveness, and a mechanical type of attention to material needs only.... They were left neatly in refrigerators which did not defrost. Their withdrawal seems to be an act of turning away from such a situation to seek comfort in solitude." In a 1960 interview, Kanner bluntly described parents of autistic children as "just happening to defrost enough to produce a child". Bruno Bettelheim at the University of Chicago was instrumental in facilitating its widespread acceptance both by the public and the medical establishment. Bettelheim was hired in 1944 to be the director of the Orthogenic School for Troubled Children at the University of Chicago as a residential treatment milieu for such children, who he felt would benefit from a "parentectomy". This marked the apex of autism viewed as a disorder of parenting. Bettelheim later expounded his theories about autism in his 1967 book Empty Fortress: Infantile Autism and the Birth of the Self. In it, he compared autism to being a prisoner in a concentration camp:
The difference between the plight of prisoners in a concentration camp and the conditions which lead to autism and schizophrenia in children is, of course, that the child has never had a previous chance to develop much of a personality. In the 1950s and 1960s, in the absence of any biomedical explanation of autism's cause after the telltale symptoms were first described by scientists, Bettelheim, as well as some psychoanalysts, championed the notion that autism was the product of mothers who were cold, distant and rejecting, thus depriving their children of the chance to "bond properly". The theory was embraced by the medical establishment and went largely unchallenged into the mid-1960s, but its effects have lingered into the 21st century. Many articles and books published in that era blamed autism on a maternal lack of affection, but by 1964, Bernard Rimland, a psychologist who had an autistic son, published a book that signaled the emergence of a counter-explanation to the established misconceptions about the causes of autism. His book, Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior, attacked the refrigerator mother hypothesis directly. In 1969, Kanner addressed the refrigerator mother issue at the first annual meeting of what is now the Autism Society of America, stating:
From the very first publication until the last, I spoke of this condition in no uncertain terms as "innate." But because I described some of the characteristics of the parents as persons, I was misquoted often as having said that "it is all the parents' fault."
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