Editorial: ‘The giant’s shoulders’: understanding Michael Rutter’s impact on science and society

The recent death of our colleague and friend Professor Sir Michael Rutter has quite rightly been greeted by an outpouring of gratitude and respect from distinguished commentators across the globe working in diverse fields of the basic, social and clinical sciences as well as from clinicians and policy makers. These have without exception highlighted his seminal role as a pioneer, perhaps The Pioneer, of the application of the scientific method to the study of child and adolescent mental health and disorder – the father of evidence-based Child Psychiatry and the most influential voice in the new field of Developmental Psychopathology (Stevenson, 2022). In this editorial, we will attempt to build on these commentaries. We will parse Mike’s scientific contributions to our field, in order to identify the personal characteristics and intellectual modus operandi that made him such a uniquely important figure, whose influence will resonate through the many fields he influenced for decades to come. We will also attempt something of a reframing of that contribution. Our thesis being that, although he never agitated for it politically or even stated it as a goal explicitly, Mike’s work was motivated by a desire for social reform and created the scientific catalyst for such reform to occur.

In making these observations, we will focus in particular on Mike’s writings published in the JCPP. Mike’s influence on and through our journal has been extraordinary in both its scale and scope. Indeed, Mike was a central player in the JCPP’s story of success and growth over the last 55 years. To coin a phrase from the mediation models Mike pioneered in our field – his influences have been both direct and indirect. He entered stage right in 1965, five years after our first issue was published. We are proud that, over the following 56 years, Mike trusted the JCPP with some of his most influential and impactful writings. It is a remarkable indication of the consistent impact of his work that Mike’s papers in the JCPP, taken on their own, had an H index of over 50 (51 papers cited more 50 times). Also remarkable is the scope of the work he published here – from major conceptual pieces on key psychopathological themes (Rutter, 1968, 2011, 2013), to rigorous new measures of assessment (Rutter, 1967), to state-of-the-art epidemiological studies (Maughan, Pickles, Hagell, Rutter, & Yule, 1996) and elegant empirical tests of hypotheses about the genetic and environmental origins of mental health and the factors that moderate their developmental course (Rutter & ERA Team, 1998; Rutter et al., 2007). His work covered a broad range of clinical topics including general patterns of common mental ill-health to specific clinical conditions such as autism, reading disorder, delinquency and ADHD. But even these, all taken together, do not come close to an estimation of Mike’s full contribution to the JCPP and through the JCPP to the field. We also need to add his indirect influences. For instance, nearly all of the authors of our most influential papers either trained or worked closely with Mike (the mentor effect) or were obviously profoundly influenced by his thinking and approach (the role model effect). Although it is impossible to quantify the scale of this sort of indirect influence on the progress and practice of a science – it is clear that Mike’s approach to science is baked into the core of the research fields that he was responsible, in large part, for founding. As we recently wrote in the ‘The Rutter Effect’ – an introduction to a special issue on Mike’s work in the JCPP – ‘The counter factual is unthinkable – if Rutter had not existed – scientific child psychiatry – at least as we know it now – would not have existed – his influence has been that profound.’ (Sonuga-Barke & Fearon, 2019). Although the sentiment of this quote is accurate as far as it goes it, in fact, underestimates the scope of his influence and his ability to transcend the disciplinary boundaries of child psychiatry to include social work, education, developmental psychology and clinical genetics.

Mike’s influence on and through our journal has been extraordinary in both its scale and scope. Indeed, Mike was a central player in the JCPP’s story of success and growth over the last 55 years.

But what are the core intellectual and scientific principles of his approach – which we might call the ‘Rutter School’? How were they able to transform what was a fragmented and speculative endeavour into a coherent and fully fledged science? Why do they remain so important for researcher’s today, even as new technologies promise a revolution in mental health science? In order to answer these questions, we advance the thesis that Mike was at heart, motivated by a desire to challenge received and socially engrained ways of thinking – albeit in a very British understated and modest way. In this sense, although never overtly a campaigner himself, he could be regarded as following in the long line of British social reformers inspired by the practical tenets of the Protestant religion – in his case Quakerism (Mike described himself as a non-theistic Quaker). These core values seemed to underpin his motivation to first focus on what he considered important matters with practical socio-cultural significance, and then use his science to get to the truth of that matter, even, or especially, if that involved challenging received thinking about the nature of childhood and the optimal conditions for mental health and development. He was equally at home challenging restrictive cultural stereotypes as he was debunking the grand psychodynamic theories of child development that dominated clinical and scientific thinking in the 1960s. Whatever his target, empirical evidence and scientific inference, rather than political rhetoric, were his weapons of choice. Perhaps his most notable accomplishments in this regard were his work on maternal deprivation which transformed the way the impact of motherhood and marriage on children’s mental health were understood, his debunking of the more extreme, and what he considered, dogmatic models of mother-child attachment (Rutter, 1979) and his work on autism as a genetic, rather than a socially determined, condition (e.g. refrigerator mums).

Mike’s faith in the power of scientific data to resolve social and clinical controversies never wavered. Although intensely interested in explanations and hypotheses, he apparently had little time for grand, and all encompassing, theories – seeing them more as a scientific reification of belief systems or dogma rather than the source of testable hypotheses. He made no claims to having an over arching Rutterian theory of child development, or developmental psychopathology – as did say Freud, Bowlby, Piaget and despite his own protestations to the contrary, Skinner? At the same time, he was about as far from a dust bowl empiricist as one could get. His work was always driven by the need to answer precisely defined questions through the testing of clearly specified and falsifiable predictions derived from hypotheses. Mike certainly had an uncanny and almost unique ability to identify questions of pivotal significance – that is, questions the answers to which would be extremely impactful and informative both clinically and scientifically. Some of this likely came from his genius for providing conceptual clarity to a field through his ability to draw important distinctions between, and boundaries around, scientific and clinical concepts. Indeed, some of his most important scientific contributions were made in this way. At the same time, much of it may have come from a practical intuition about what were the important scientific and clinical questions and how to address them. All of it was undoubtedly driven by a profound natural curiosity. Although his ‘theory’ of child development always remained implicit, there is little doubt that he had in his mind a very clear picture of the logical and empirical fundamentals of how development works and the rich array of potential mechanisms at play, which steered his scientific thinking and clinical practice. His 1990 book Developing Minds, co-authored with his wife Marjorie (Rutter & Rutter, 1992), remains an extraordinarily clear exposition of those fundamentals and is still one of the most accessible and definitive texts on child development ever written.

But the identification and the framing of novel and important research questions was only part of Mike’s distinctive form of practical scientific creativity. He was also a master at using novel designs to tease out the influence of different factors on a particular outcome. This was always followed up by painstaking post-hoc statistical testing and counter-factual logic to rule out competing explanations, increase confidence in his conclusions and/or strengthen inference of the causal role of one factor on another. Mike was a brilliant detective! His sleuth-like abilities were especially useful in studies where experimental control was not possible for ethical or practical reasons – for instance in the study of the impact of adversity. This was brilliantly exemplified in the English & Romanian Adoptees study (ERA), a study Mike established in 1990 at the request of the UK government to examine the needs of the young children who had been exposed to the brutally depriving institutions prior to the fall of the Communist regime in Romania and then adopted generous and heroic UK families (Rutter & ERA Team, 1998). Alongside his concern for the young people and families in the study, Mike immediately saw the natural experimental potential of such a study to first isolate, and then through judicious design, tease apart the impact of early adversity from other potential factors, including genetic factors. Largely due to his scientific presence of mind, the ERA study has transformed the way we think about the impact of early adversity on development.

Mike’s work was also marked by remarkable industry, drive and integrity – again qualities that probably had deep-seated roots in his core values. He also held his colleagues and collaborators to his own high standards. But it was his integrity which stood out in particular. He took science, and the respect for evidence very seriously, even as a moral imperative. On the one hand, this meant that he was quite willing to change his ideas when it became clear, after a thorough investigation, that they no longer could be reconciled with the evidence. On the other, he was very careful about the inferences he could and could not draw from his findings. For instance, he refused to draw conclusions about general child neglect from the ERA study of extreme neglect in institutions – despite the similarities that others may have seen. There was no spin or bluster with Mike and no attempt to go for the easy pay off or the low hanging fruit to get ahead.

We are entering a strange phase in the history of our field. Many of our colleagues, apparently taken by the increasing power of technology to collect and crunch enormous amounts data, now believe that the best route to scientific progress is through hypotheses-free inductive computational science. This is in many ways the obverse of the deductive approach at the heart of the Rutter School, with its emphasis on clinical grounding, conceptual clarity, the formation of intelligent and probing questions, the development and testing of hypotheses and predictions and careful drawing of inference about cause through counter-factual logic and targeted statistical testing. We jettison these principles, and the approach they underpin, at our peril.

Therefore as we say farewell to an extraordinary individual who built the foundations of our field, we remain hopeful that his legacy will stay with us for many years to come.

Edmund Sonuga-Barke has received consultancy from Neurotech Solutions, grant funding from QB-Tech and speaker fees from Takeda and Medice. He is the editor-in-chief of the Journal of Child Psychology & Psychiatry from whom he receives an honorarium. His research is supported by the Maudsley NIHR BRC, the ESRC, MRC and NIHR. Pasco Fearon is Deputy Editor in Chief of the Journal of Child Psychology and Psychiatry for which he receives an honorarium. His research is supported by the Wellcome Trust, Department for Education, ESRC, MRC and NIHR. Stephen Scott is the president of ACAMH and has no conflicts of interest to declare in relation to this editorial.

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