As a psychiatrist, I treat children with autism spectrum disorder (ASD) and know how much their parents struggle with adult friendships. Here's why that needs to change.

illustration of mother isolated from her friends in playground scene
Credit: Illustration by Kasia Bogdańska

Abigail G. is a mom of twin 15-year-old boys living in Montclair, New Jersey. One of her sons is smart and outgoing. The other, who has autism spectrum disorder (ASD), has a history of aggressive and disruptive behavior due to difficulty managing intense emotions and anxiety.

Having a child with autism changed everything for Abigail and her husband—including their ability to connect with their adult peers. "When the boys were young," she says, "we would entertain people, but never got a return invitation." For a family already overwhelmed by the day-to-day experience of caring for a son with autism, the lack of social interaction left scars. "We were told it was 'scary' to visit our house," says Abigail. She and her husband weren’t only mortified, but also hurt.

As a psychiatrist treating children with ASD, I've watched many families like Abigail's cope with the day-to-day demands of caring for a son or daughter with intense needs. But it's this other kind of stress coming from outside the home that often flies under the radar: friendships.

In an ideal world, parents form deep friendships with others whose kids are the same age as their own, and then watch their children mature together. Yet parents of children on the autism spectrum find that not only has their relationship with their child been recast, but the reverberations affect networks of extended family and friends.

Autism spectrum disorder is a neurological condition that shows itself in various ways. At the core it’s an alteration in the way a child can communicate and sustain social relationships. Depending upon the severity of the condition, an afflicted person may be non-verbal and aggressive (on the severe end) or of above-average intelligence but confused by social cues on the milder end. If we aren't directly touched by this disorder, chances are we know a family that grapples with it every day: The Centers for Disease Control and Prevention estimates that one out of every 59 children in America is on this spectrum.

How friendships are affected when parenting a child with ASD

Caring for a child with autism can impact almost every minute of every day and leave little time for friendships. "Therapy and appointments—all of a sudden you have a family that's pulled in so many different directions that maintaining social relationships can be difficult," says Kate Fiske, Psy.D, an associate clinical professor of psychology at Rutgers University.

But there are other reasons why ASD families may fail to connect with others or why longstanding bonds can fray, including stigma and inability to understand behavioral differences. Janet T. of Clifton, New Jersey, found that a simple trip to the supermarket with her son with ASD provoked an unwanted reaction: "I almost got into a verbal argument with another woman because my son was blocking her exit from an aisle. I tried to explain that he has a disability, but she dismissed me." Other moms encounter baffled—or annoyed—reactions when their child with ASD has a tantrum at a birthday party or other social event.

Another reason is as children age, new issues arise. Some parents of children with autism may live their lives in a perpetual grieving process as their children fail to attain expected developmental milestones, like forming friendships or dating. It can be exceedingly painful for these parents to socialize with well-meaning friends who discuss their children's accomplishments, such as grades or college acceptance. Suzanne Buchanan, Psy.D., executive director of the non-profit Autism NJ, adds that friends "might inadvertently say something that's upsetting or hit an emotional pain point. It frankly may not be worth the cost."

Melissa W., whose older son has autism, prefers to socialize with other families that have a child with special needs. "I think we're kind of a unique group. And I don't think you really, truly 'get it' unless you have been touched by it personally. It is a different life. We face different challenges when getting together with other families." Ditto for Abigail and her husband, who form friendships primarily with other families who have children with special needs so "no apologies are needed." Turning to others who "get it" can be comforting when life is a non-stop series of hurdles. There is no need for excuses or elaborate explanations.

Why keeping friendships is important

But I urge families—both with and without children with ASD—to consider maintaining at least some longstanding friendships, even with families unlike their own. Having long-term friends who know us well can enhance mood, counteract loneliness, and even aid physical health and longevity, according to the Harvard Study of Adult Development.

The appeal for a family with a child with ASD to maintain ties with other families like their own is undeniable. It is the bond forged via mutual support and shared information. But the support conveyed via non-verbal communication, the ability to vent and share stories and strategies can be accomplished in the company of any trusted friend.

It may be more difficult for families across the divide to find common ground after a diagnosis. But friends who are willing to make the effort to support a family with a child with ASD will learn valuable lessons in tolerance and empathy. Potential pitfalls can be negotiated with ample doses of knowledge, patience, flexibility, and humor.

Here are some tips:

  • Be sure to listen.
  • Avoid unsolicited advice, which may not fit the needs of the family at that time.
  • If a parent talks about wanting respite, ask about helping with household chores like laundry and cooking.
  • Offer to help drive siblings to activities or appointments.
  • Be flexible and understanding when your friend is not available to socialize because they are busy focusing on their child's needs.