Sir Michael Rutter, who has died aged 88, was often described as the father of modern child psychiatry. Through incorporating rigorous scientific methods, he revolutionised his field, and laid the foundations for current understanding of normal and abnormal child developmental psychology.
In the early 1960s, child psychiatry was a comparatively new discipline, heavily dependent on clinical opinion and strongly influenced by psychoanalytic theory. Michael, in his role as the first chair of child psychiatry at the Institute of Psychiatry, London, from 1973, played a huge role in changing all of that.
Using objective research methods from areas such as epidemiology, developmental psychology and genetics, Michael led breakthroughs in such areas as our understanding of autism and in challenging the long-held belief, from theories first proposed in the late 40s by the psychoanalyst John Bowlby, that lack of a secure early attachment to a mother would almost inevitably result in later psychological impairment. In fact, Michael pointed out, maternal deprivation was best viewed as a vulnerability factor rather than a causative one for later psychological problems.
Such discoveries came from Michael’s talent for spotting opportunities for “natural experiments”, that is, studies of children exposed to differing conditions. One such natural experiment, published in 1977, looked at twins. Identical twins share all of their genes, whereas non-identical twins share only half. With Susan Folstein, a visiting fellow from Johns Hopkins University, Michael performed a study showing that there was increased prevalence of autism in the identical co-twins of children diagnosed with autism but not in non-identical co-twins. The paper, in the journal Nature, caused a controversy. The implication that autism has a strong genetic component was criticised not just by family theorists, who held that autism resulted from an emotionally cool upbringing by “refrigerator parents”, but also by some geneticists on methodological grounds. Nevertheless, the findings were subsequently upheld by other family and twin studies as well as by much more recent molecular genetic studies, and it is now accepted that autism is a highly heritable condition, the causes of which are beginning to be understood at a genomic level.
Another set of natural experiments was epidemiological studies from the 60s onwards of the wellbeing and educational attainment of primary school children raised in contrasting urban and rural environments – the inner south London borough of Camberwell and the Isle of Wight. Among the many findings were that behavioural deviance, psychiatric disorder and specific reading retardation were all twice as common in London as in those living on the Isle of Wight.
However, once measures of family disadvantage were taken into account, these differences largely disappeared. The studies also showed that wellbeing and attainment differed hugely between schools, with the implication that schooling quality helps shape child development. A book based on a collaboration between researchers and teachers of secondary-aged children in inner London, Fifteen Thousand Hours (1979), reached similar conclusions.
Following the collapse of Romania’s communist regime in the early 90s, one of the striking media stories was of the horrifying conditions endured by children incarcerated in its orphanages. Such coverage resulted in many Romanian orphans being adopted by families in the UK. Michael followed them up and found encouraging outcomes. Despite early severe deprivation, the majority of children achieved marked physical and psychological improvements following their transfer into more caring and nurturing environments.
Such good outcomes contradicted Bowlby’s established theories. Michael had earlier written a book-long critique of Bowlby, Maternal Deprivation Reassessed (1972), in which he argued that Bowlby’s theories were at best only partially correct and even then not always for the correct reasons. Now, in the Romanian adoptee study results, here was tangible evidence that even the effects of the most extreme varieties of early deprivation could be ameliorated by caring parenting.
The oldest son of Winifred (nee Barber) and Llewellyn Rutter, Michael was born in Lebanon, where his father was working as a doctor. The family moved back to the UK soon after, where Llewellyn became a GP, like his father before him. The family were Quakers and, after a period of evacuation to the US during the second world war, Michael was educated at Wolverhampton grammar school and, as a boarder, at Bootham school, a Quaker school in York.
After graduating from Birmingham University medical school in 1956, Michael trained in neurology and paediatrics before moving to the Maudsley hospital and the Institute of Psychiatry, London, to complete his clinical training. His career rise there was rapid. In 1984 he was appointed to the directorship of the Medical Research Council (MRC) child psychiatry unit based at the institute. The unit soon became world renowned for its leadership in advancing child psychiatry research.
In 1994 the Social, Genetic and Developmental Psychiatry (SGDP) Centre was set up, as a partnership between the Institute and the MRC, with Michael as director. The SGDP Centre was the joint brainchild of Michael, David Goldberg, the head of the institute’s psychiatry department, and George Radda, the CEO of the MRC. All three wanted to further the study of environmental factors in psychiatry alongside the rapid recent advances in genetic and developmental research. The SGDP became a model for other multidisciplinary MRC-university centre partnerships throughout the UK.
Michael married Marjorie Heys, a nurse, in 1958. They had three children, after which Marjorie returned to work as a clinical nurse specialist. She and Michael co-authored Developing Minds (1993), a well-received book for the general reader.
Michael received many awards, including a knighthood in 1992. He was elected as a fellow of the Royal Society in 1984, at that time the only psychiatrist to be so honoured, and was a founding fellow of the Academy of Medical Sciences.
He stepped down as director of the MRC SGDP Centre in 1998. I succeeded him, but most mornings thereafter he was in the building well ahead of me and he only fully retired this year. In the edition of the BBC Radio 4 programme The Life Scientific that featured Michael in his 82nd year, he described his days as working “part-time” from “about 8.30 in the morning until 4 in the afternoon”.
He is survived by Marjorie, their children, Sheila, Stephen and Christine, and seven grandchildren.
• Michael Rutter, child psychiatrist, born 15 August 1933; died 23 October 2021
