The nature of friendship in children with autism spectrum disorders: A systematic review

• Studies of friendship in children and adolescents with ASD were reviewed.
• All studies incorporated multidimensional perspectives of friendship.
• Children with ASD had fewer friends and less friendship reciprocation.
• Friendship quality and frequency of contact were lower for participants with ASD.
• Future research is needed on friendship satisfaction and friends’ perspectives.

This paper provides a systematic review of 24 studies that addressed the characteristics of friendship in school-age children with a diagnosis of autism spectrum disorder (ASD). The following questions were addressed: who are the participants, what methodologies have been employed, and what is our understanding of friendship in children with ASD. The results of this review indicate important differences in the manifestation of friendships in individuals with ASD as compared to typical children. While there is consistent evidence for several topographical differences in friendship characteristics, a number of gaps in our knowledge are evident. These include limited data on children who have intellectual disability, and on the perspective of nominated friends as well as circumscribed data on satisfaction with friendship relationships. In addition, there are a number of methodological limitations that restrict interpretation of extant research. Implications for future studies are discussed.