‘Refrigerator Mother’ theory affects public awareness of autism

Children with autism play a game at a medical centre in HCM City. —VNA/VnExpress News Photo 

HÀ NỘI — A lack of awareness has left many parents of children with autism blaming themselves for their children’s developmental disabilities, hindering efforts to help children better integrate into society.

The “Refrigerator Mother” theory, also known as Bettelheim’s theory of autism, is a controversial psychological theory assuming that autism is caused by a lack of maternal warmth.

When US psychiatrist Leo Kanner first recognised autism in 1943, he noticed a lack of warmth and emotional care from parents of children with autism. Parents, especially mothers, were often blamed for their children’s atypical behaviour such as difficulty in speaking and self-isolation. 

However, US psychiatrist Bernard Rimland (1928-2006), whose son was diagnosed with autism, concluded that autism was not fundamentally caused by psychological issues but was related to biological conditions.

He explained that several children with autism were not born to parents with personalities that could cause autism. 

Autism appears or develops gradually in children that have brain-related problems. According to Bernard, the sex ratio of autism is about three or four boys to one girl. 

His conclusions helped eradicate the concept that parents’ coldness caused child autism and debunks the idea that autism is caused by psychological issues.

However, the theory remains a burden for many mothers of children with autism in Việt Nam.

According to the General Statistics Office, the number of people with autism in Việt Nam is nearly one million (out of 6.2 million people with disabilities aged two and older). Children with autism account for 1 per cent of the total number of newborns each year.

Many parents of children with autism in Việt Nam, who are trying hard to take care of their children, have to endure the emotional pain of being blamed for causing the “disease.”

Many Vietnamese people still believe in reincarnation – the religious belief that the soul or spirit, after biological death, begins a new life in a new body that may be human or spiritual, depending on the moral quality of the previous life’s actions.

Thus, disability is often believed to be caused by bad things done in an earlier life, making mothers of children with disabilities suffer discrimination. 

Doctor Thành Ngọc Minh, head of the Department of Psychology of the Vietnam National Children’s Hospital, said autism was a lifelong developmental disability.

Autistic children face many difficulties. Most parents feel desperate after their children are diagnosed with autism. Due to the lack of knowledge, they tend to blame themselves for not knowing how to raise and care for their children and for lacking attention to their children.

Parents play an active role in intervention activities for children with autism, according to Thành. 

Autism intervention is a long-term process, needing parents’ determination, trust and love.  

Children with autism should be early discovered and treated during the first 24 months of age for effective intervention.

Autism was detected in Việt Nam in the late 1990s. Since 2000, autism started to get more attention, and treatment has been carried out at children’s hospitals and special education centres.

Experts warn that children should be periodically screened for psychological disorders at 12, 18 and 24 months of age, but in Việt Nam, people tend to assess children’s physical condition, leading to late detection of autism. 

Many parents in Việt Nam only have their children undergo a medical examination when they show signs of communication difficulties or hyperactivity. They do not have the habit of periodically carrying out both physical and mental tests for their children 

Meanwhile, there is also a shortage of medical staff with critical knowledge and skills to monitor the development of autism in children.

Autism diagnoses in Việt Nam also face difficulties due to the lack of screening tools such as the ASQ (Ages and Stages Questionaire). 

The Director of the Vietnam National Children’s Hospital, Trần Minh Điển, said children with autism need to be cared for by the community and the family. Hence, it is essential to raise public awareness of autism.

The Ministry of Health entrusted the hospital to design measures to support all autistic children nationwide. Autistic children with severe disabilities will be treated at hospitals, while those with mild and moderate symptoms should be treated at home.

The hospital has developed training programmes for medical workers and parents.  

Government’s efforts

The Government approved the social assistance and rehabilitation programme for autistic children and people with mental disorders from 2021 to 2030.

The programme calls for society to help increase material and spiritual support, care and rehabilitation for autistic children and people with mental disorders to integrate into the community, helping ensure social security and improving the quality of social assistance services for the mentally ill.

The programme aims that in 2021-25, annually, at least 80 per cent of the mentally ill and 80 per cent of autistic children will have access to different forms of medical services.

About 70 per cent of children from birth to six years old are to be screened for early detection of autism spectrum defects and early intervention.

At least 10,000 children with severe autism receive appropriate treatment, education, rehabilitation and assistance in rehabilitation and social assistance facilities.

The programme aims for at least 80 per cent of children with autism to have access to education, and at least 20,000 people with psychiatric disorders will be provided with vocational guidance and therapeutic workers at social assistance establishments.

The Ministry of Labour, Invalids and Social Affairs proposed the National Assembly consider the legalisation of interests of children with autism and recommend the Ministry of Education and Training have regulations to create conditions for children with autism to get the best access to education.   

Communication activities 

Fifteen centres providing intervention services for children with autism in Việt Nam have conducted various communication activities to raise public awareness of the syndrome in response to World Autism Awareness Day (April 2).

Nguyễn Thị Hiền, Vice Director of the Vietnam Children’s Fund, which is conducting a project to enhance public awareness of children with autism that covers the 15 centres, said that the best way to respond to the World Autism Awareness Day is to popularise the signs of autism and call for the more robust engagement of the community in supporting them.

On March 31, Khai Trí School for Special Education in HCM City, one of the 15 facilities, held a programme for children with autism, during which the children had chances to meet each other and develop their social skills.

The event also allowed the community to gain a better understanding of autism to give more love to children with autism.

In response to World Autism Awareness Day, a parade is scheduled to take place in northern Vĩnh Phúc Province on April 2 with the participation of leaders of the Vietnam Children’s fund, teachers and children with autism. — VnExpress News