Peer-reviewed article

Autism-related behaviors in early childhood with histories of maltreatment and alternative care: Autism or trauma?

Moretti MP, Torrecilla M, Benavidez N, Gómez JAM · 8 Sept 2026

Abstract

Background Early childhood maltreatment can disrupt development and trigger dissociative defensive mechanisms that may manifest in behaviors resembling Autism Spectrum Disorder (ASD) - atypical social interaction, communication difficulties, and stereotyped behaviors - described as quasi-autistic patterns. In institutional settings characterized by severe emotional deprivation, similar presentations have been reported as institutional autism. Although these behaviors are documented, the factors associated with ASD-related behaviors following maltreatment and alternative care remain insufficiently understood. Objective This study examined parent-reported ASD-related behaviors in adopted children with histories of maltreatment and alternative care and evaluated the effects of sex, type and duration of alternative care, age at adoption, and time spent in the adoptive family. Participants and setting 108 Argentine parents of children aged 18-30 months participated across three groups: biological parents of non-maltreated children without histories of alternative care (Group 1, n = 35), adoptive parents of children with maltreatment histories who experienced foster-family care (Group 2, n = 39), and adoptive parents of children with maltreatment histories who experienced institutional care (Group 3, n = 34). Methods A cross-sectional study was conducted. Parents completed the Argentine adaptation of the M-CHAT at a single time point. Results Group 3 exhibited significantly higher ASD-related behavior scores than Groups 1 and 2, with no significant differences between Groups 1 and 2. In hierarchical multiple regression, institutional care history, male sex, and older age at adoption were independently associated with higher ASD-related behavior scores (F(3,69) = 21.34; p < .001; R2 = 0.48). Conclusions Findings suggest that elevated ASD-related behaviors following maltreatment and alternative care may reflect overlapping trauma-related, developmental, and ASD-related features. The higher scores observed among children with histories of institutional care should be interpreted cautiously, as pre-placement adversity was not assessed and may have differed between groups.