Sex differences in friendships and loneliness in autistic and non-autistic children across development.
Natalie Libster, Azia Knox, Selin Engin and 3 others
PMID 36829214WHAT IT FOUND
Autistic and non-autistic children defined friendship similarly, but age predicted complexity: older children described dependability and intimacy, while younger ones focused on companionship.
All children who reported frequent loneliness had at least one friend, suggesting existing friendships may not prevent isolation.
Key findings
01Age, not diagnosis, predicted the complexity of friendship definitions; older children were more likely to include dependability and intimacy.
02Autistic and non-autistic children were equally likely to refer to companionship when defining friendship.
03Every autistic child who reported being frequently lonely also reported having at least one friend.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study only included children with spoken language and average to above-average IQ, so findings do not apply to minimally verbal or intellectually disabled autistic children. Data were secondary from a diagnostic assessment (ADOS), which limits the depth of information available about friendships and loneliness compared to a dedicated study. The question 'Do you ever feel lonely?' did not capture the frequency or type of loneliness (social vs. emotional) as well as a dedicated scale might. The sample was predominantly White (68%), limiting generalizability across racial and ethnic groups. Clinicians administering the ADOS varied in their use of follow-up questions, which may have influenced the richness of the children's responses.
Declared interests
Research support was provided by the U.S. Government (P.H.S.) and N.I.H. grants. The authors declared no competing interests.
The easy way to misread this
Do not assume that autistic children define friendship differently than their non-autistic peers. The study found no significant difference in how often autistic and non-autistic children referenced companionship, dependability, or intimacy when defining friendship once age and IQ were controlled for. The primary driver of complex friendship definitions was developmental age, not diagnosis.