Friendships and social participation as markers of quality of life of adolescents and adults with fragile X syndrome and autism.

All data came from mothers, not from the adolescents or adults themselves or from direct observation of social interactions. The study measured how often activities happened but not the quality of those interactions or the person's level of engagement. There was no comparison group of adolescents and adults without intellectual disability, so low participation cannot be judged against a same-age reference. The analysis used one wave of data, so it cannot show how friendships or social participation changed over time. Ethnic diversity was limited, especially in the fragile X group. The level of intellectual disability was not assessed, so differences in intellectual ability may partly explain group differences. The study did not record social skills interventions or supports, which could shape social participation. It cannot separate lack of opportunity, personal preference, and environmental factors as reasons for low participation. The groups differed in residential status and maternal marital status, which were controlled but may still influence outcomes.

The supplied text does not state author conflicts of interest. The publication types list NIH extramural and non-U.S. government research support.

Do not conclude that autism diagnosis alone causes fewer friendships. When behavior problems were added to the model, the group difference in mutual friendship was no longer significant, and friendships were rare in both groups.