When I speak to parents of children on the spectrum, one of the first questions I ask is, "Does he/she have friends?" The answer is a rough measure of many things: social skills, well-being, sense of connectedness and belonging, feeling happy in school, doing well academically, and being part of community and family.
Friendships are something parents worry about a lot because they are hard for children on the spectrum. Only a minority of children with autism have at least one reciprocal friendship. Over half have only limited peer relationships or relationships that are managed by parents, and about a quarter has no friendships at all.
Friendships are hard for adults, too. Almost half of adults on the spectrum report having no friends.
There is a popular myth that people with autism prefer to be alone. This has been debunked by much research, which showed that both children and adults with autism experience loneliness, even though they might understand it differently. Researchers have also found that many children and adults with autism have friendships that are not as rich or reciprocal as typical friendships. Having those types of friendships might help feel more belonging, but does not alleviate loneliness.
Some researchers also found that adults with autism can have a very rich and reciprocal relationship with one close friend, and less reciprocal relationships with friends who are not as close. Adults with autism also valued having a friendship in which they can take time off as needed.
We know that loneliness is a health risk. We also know that for children on the spectrum, there is a direct connection between their childhood friendships and how well they will do as adults. So, how can we help our children on the spectrum develop social skills that are needed to make and keep friends? Here are some ideas:
Socially-focused behavioral interventions, such as the Early Start Denver Model and Pivotal Response Training;
Relationship-based interventions, such as DIR/Floortime and Relationship Development Intervention (RDI);
Supported participation in extracurricular activities;
Direct social facilitation;
Curriculum-based social skills groups;
Social cognition training , i.e teaching theory of mind and perspective-taking (effective short-term, but does not maintain over time);
Playgroups;
Parent training to support social skills practice at home;
Peer-mediated interventions -- training typically developing peers to interact with children on the spectrum pulls them into the network of friendships and increases the number of children who consider them friends. This works best in natural settings (lunch, recess) rather than in specially created situations (lunch bunch).
Research shows that autistic children do best when their parents become involved and trained in teaching their children social skills. Request regular updates from your child's providers, both in public school and private providers. If possible, request training in how to work on the same goals that they are working on at home and in the community.
How can you help your child feel connected and less lonely:
For younger children, sign up for playgroups and extracurriculars;
For older children, school-based clubs and groups can be a good way to connect with peers;
Some schools are willing to create individualized buddy programs. For example, motivated typical peers can take turns sitting with your child at lunch. Or there can be a dedicated "buddy" from an older grade who would help your child with some aspects of school.
Network with other parents to arrange connections, playdates, and joint activities;
Many recreational community centers have adaptive programs . Check them out. Would your child like any of these?
Create a community for your child by intentionally building friendships with families in the community. This will create a lot of built-in social opportunities for your child;
Ask your child's teacher who your child tends to connect with at school and schedule playdates with these children;
Help your child get ready for playdates by planning activities, anticipating problems and making plans for problem-solving;
Think through where your child would have the best playdate. In your home, your child is the most comfortable and you have the most control over who is present and what is going on. In other people's homes, there will be a lot of novelty and also possible unexpected factors like other guests, pets, or sensory stimuli. On playgrounds there is a lot to do, but kids can also get distracted by other kids or gravitate to different activities. There is not one correct answer to what would work best for your child.
It's better to have a shorter successful playdate or activity than a longer one that goes sour;
Schedule playdates with one child rather than several friends;
Take advantage of afterschool activities and know that public afterschool programs have to provide supports for children with disabilities who are on IEPs;
Make your house a fun place where other children will have fun;
Use your child's strengths as a way to connect. If your child is very coordinated, he or she might connect with children who like active play. If your child is artsy, a craft project might work better;
Look beyond autism. There are many other families of kids with special needs who are looking for friends for their children. Find local opportunities to connect through your public school, your SEPAC, therapeutic centers, community organizations, and even through your pediatrician;
Low or moderate online gaming is associated with less loneliness;
As your child is growing up, gradually hand over the responsibility for managing friendships to him or her as much as possible. Teach your child how to maintain friendships, how to be a good host and a good guest, how to be a good sportsmanship, how to establish good reputation, and how to handle teasing, bullying, and arguments;
Be realistic about social goals for your child. Is your child going to socialize with family only, be a part of a structured group, have one friend, or have several friends? All these options are OK. There is no "right" way to socialize.
My observation from the years of working with autistic children is that making friends and maintaining friendships becomes more difficult as children get older. In preschool and even kindergarten, children tend to be forgiving. Social interactions are often play- and action-based. As children grow older, and especially for girls, there is more and more emphasis on verbal interaction in friendship. For both boys and girls, social expectations become higher and social rules become more complex. Children on the spectrum have an increasingly harder time managing this growing complexity. Friendships and even just social opportunities in middle and high school become harder to find.
With this in mind, start helping your child in this area as early as possible. The more connections they have in the earlier years, the more chances there are for some of them to become lasting and to be something that your child can rely on as years go by.