Loneliness in autistic adults: A systematic review.
Kana Grace, Anna Remington, Brynmor Lloyd-Evans and 2 others
PMID 35257592WHAT IT FOUND
Autistic adults described wanting connection but finding social interaction exhausting and isolating.
Loneliness was not the same as being alone, so clinicians should not assume an autistic adult does not want contact.
Key findings
01Autistic adults wanted social connection, but social interaction could be difficult, and loneliness was described as different from being alone.
02In studies with non-autistic comparison groups, autistic adults had higher levels of loneliness.
03Having relationships was associated with lower loneliness, but social skills training findings were mixed, with a PEERS study reporting reduced loneliness and a replication not finding the same result.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The included studies mostly reported on autistic adults in young to middle adulthood, with average or above average intellectual and communicative abilities, so the findings may not apply to older adults or people with co-occurring intellectual or speech difficulties. Most loneliness measures were developed for the general population and had not been validated for autistic adults, so scores may not capture autistic experiences accurately. The review found associations, not causes, because most quantitative studies were correlational. Many studies used loneliness and social isolation interchangeably, although they may be different experiences. Only English language literature was included, and the review used broad questions and narrative synthesis, so some relevant work may have been missed. There was no additional autistic community involvement beyond the lead author being autistic.
Declared interests
The authors declared that they received no financial support for the research, authorship, or publication of the review.
The easy way to misread this
Do not conclude that social skills training reliably reduces loneliness. A study found lower loneliness after PEERS, but a replication did not find the same association, and most evidence is correlational.