A Spectrum of Understanding: A Qualitative Exploration of Autistic Adults' Understandings and Perceptions of Friendship(s)

Abstract

Background:

Previous research has often documented that friendship is an area of difficulty for autistic people, however this may be caused by a neurotypical understanding of friendship. The current study aimed at adopting a more inclusive account of friendship, involving an autistic participant group representing a range of genders and communication preferences while exploring the following question—What are autistic adults' perceptions of friendships?

Method:

Participants (n = 20) were interviewed using their preferred method of communication (speaking and non-speaking) during 2021–2022.

Results:

The results showed that three main themes emerged under an overarching theme of A Spectrum of Understanding: Identity with Others, Sharing Value, and Shared Presence. The inclusive approaches used in the current study allowed under-researched autistic groups such as non-speaking autistic people and autistic people who identify as non-binary to participate in meaningful research.

Conclusions:

The study offers a new perspective on the Double Empathy theory, suggesting it may be helpful to conceptualize it as a continuum of neuro-cultural learning rather than a distinctive binary centered on an autistic-allistic misunderstanding. Increased understanding of friendships in autistic groups will help to increase awareness of social belonging and support that can protect against poor mental health outcomes.

Community brief

Why is this an important issue?

For years, autistic perceptions of friendship have been viewed through a medicalized and neurotypical lens. Given the modern shifts away from a deficit-based medical model in autism research in response to the neurodiversity movement, it is important to understand autistic lived experiences as they are, rather than how neurotypical researchers think they ought to be.

What was the purpose of the study?

In this study, we are looking to better understand how autistic people themselves perceive and experience connections, such as friendship. Friendship is important for everyone, as it can provide a social support network and protect against poor mental health outcomes.

What did the researchers do?

The researchers interviewed 20 autistic people (including under-represented groups, such as trans, non-binary, and non-speaking autistic people) and asked about their perceptions of friendships.

What were the results of the study?

Three main themes emerged under an overarching theme of A Spectrum of Understanding. The three main themes are: (1) Identity with Others; (2) Sharing Value; and (3) Shared Presence. Identity with Others covers observations of friendships and being part of communities that value understanding while also encouraging learning to understand others. Sharing Value centers on how one feels within the friendship and how one values others. Finally, Shared Presence refers to the activities carried out within friendships that can help maintain these connections.

What do these findings add to what was already known?

The study offers a new perspective on the Double Empathy theory (Milton, 2012), which suggests that communication difficulties between autistic and allistic (i.e., non-autistic) are caused by mis-matched neurotypes. The current study extends this theory by considering neuro-cultural learning as part of a continuum, rather than a distinctive binary centered on an autistic-allistic misunderstanding.

What are potential weaknesses in the study?

Potential weaknesses in this study include the participant sample being from western countries; therefore, further research is needed to explore more intersectional facets, such as ethnicity and culture, in relationships and friendships. There was also a wide age range in the current sample, and future research may want to focus more on specific age groups to understand better how perceptions and experiences of friendships change across the lifespan.

How will these findings help autistic adults now or in the future?

The study offers a new perspective on the Double Empathy theory, highlighting the need to consider this as a continuum of understanding and learning and that misunderstandings can still take place in people of the same neurotype. The study also highlights how lockdowns during the COVID-19 pandemic have impacted relationships and that autistic people may need more support to tackle the adverse effects of isolation, given that friendships are valued by autistic people and protect against poor mental health outcomes. Overall, in contrast to a deficit-based perspective, this study shows that autistic individuals can have and maintain meaningful friendships with complex and nuanced conceptualizations, which ultimately center on the need to be/feel understood and to understand others. The researchers hope that this research will shed light on how friendships are perceived and experienced by autistic people, leading to increased awareness of social support needs, the importance of friendships for autistic individuals, and how further support is needed following the COVID-19 pandemic.