Colman Noctor: Critical need for autistic children to build friendships
Children Their World Across Them To society Need Streamlined Navigate Help Autistic Supports
‘On the spectrum’ is a phrase I have heard more in the recent past than I ever did in the 20 previous years of clinical experience.
It refers to children who are deemed to fit the criteria of the autistic spectrum.
Traditionally reserved for clinical professionals and child psychiatrists, the phrase is now part of the mainstream narrative and is used to describe people who appear to struggle more in a social and emotional context than most of their peers and have significant struggles with communication.
The exact figures for how many people in Ireland have an ASD (Autistic Spectrum Disorder) diagnosis are unclear, but I have seen a significant increase in this diagnosis in the number of children and young people in my clinic.
In a recent Oireachtas Committee meeting, it was said, “One in 65 people in Ireland is on the autism spectrum”.
International statistics are similar, with the Center for Disease Control and Prevention in the USA observing an increase in the prevalence of autism among children.
The CDC released two USA-based reports in 2021 which found that one in every 36 children has autism, a significant increase from one in 110 in 2006.
According to Dena Gassner, an autistic adult and adjunct professor at Towson University in Maryland, there is no ‘epidemic of autism’; instead, what we face is an epidemic of need.
As with any phenomenon where we see an exponential rise in the number of people presenting over a short period of time, a debate ensues.
On one side, people say the increase is due to an improvement in the general public’s awareness of the symptoms, resulting in more diagnoses.
While people on the other side say the significant increase in numbers highlights a new ‘catch-all’ diagnosis being given to those who do not seem to conform to societal ‘norms’ or expectations.
Whatever the reasons for the increasingly common diagnosis, it is critical to examine how we can respond and provide support for children with social, emotional and communication needs.
This is not just about providing prompt and accessible assessment services — autistic children also need streamlined supports across society to help them navigate their world.
Welcome developments include neurodiversity-friendly university campuses, a growing number of ASD education units in schools, and autism-friendly shops, cinemas and other public spaces.
However, there’s a critical need to support these children within their immediate social worlds.
Many children and young people I see report strong feelings of loneliness and disconnection. They tell me about feeling ‘different’, ‘misunderstood’ and ‘alone’.
Some with social and communication needs also report being victims of bullying and exclusion.
This highlights the need to create a space with supportive programmes for autistic children to develop relationships and friendships.
This is key to improving their overall well-being and journey through childhood and adolescence.
Most children I see who are ‘on the spectrum’ do not have reliable friendships and the subsequent loneliness and sense of disconnection from the world causes them great emotional difficulty.
Despite the efforts to create more inclusive cultures and increased awareness of autism among their peers, there remains a need to create spaces and opportunities for neurodivergent children to meet like-minded peers and form meaningful connections.
Providing support is not just about a crisis response — it's about being proactive and allowing ASD children to develop and grow.
Many ASD children suffer from depression and anxiety and the incidence of these conditions is far more likely among this cohort than the rest of the population.
Research by the Autism Research Institute in Massachusetts found that nearly 78% of children with ASD had at least one mental health condition compared to only 14.1% of children without ASD.
Children with ASD also had a higher prevalence of mental health conditions than children with intellectual disabilities or special health care needs.
The presence of friendships and strong relationships are crucial protective factors for mental health.
Instead of focusing on academic supports like spelling waivers and extra time allocations to complete exams, providing social and emotional support could be pivotal.
Promoting opportunities for friendships improves children’s experiences of managing emotions. By responding to the feelings of others, it improves their ability to negotiate and problem-solve.
There is a commonly held belief that ASD children do not enjoy social experiences and they regarded as being introverted.
However, most young ASD people I have met present as quite the opposite. They crave friendships but struggle to read the social cues.
Many have had a series of negative experiences when they have tried to connect with others in the past.
Australian-based online platform Raising Children Network says: "Autistic children and teenagers are usually keen on friendships, but they often need support to understand and learn skills for making and keeping friends.”
Its research found that initiatives that offer social skills improve children’s overall mental health.
Lesley Craig-Unkefer, an assistant professor at the University of Minnesota who developed social learning opportunities for young people with ASD, says the most important consideration is opportunity, given the unique nature of friendships: “With opportunities to interact and socialise, a community can be formed in which students with ASD and their typical peers can engage in mutual and reciprocal relationship.”
Working with young people has taught me that no matter what the neurodivergent label, loneliness makes it worse.
We need to create spaces where ASD children can meet, gather, and be given opportunities for social connection and friendships.
Busy mainstream schools are not meeting these children’s social needs, and perhaps they are not the optimum environments.
It’s time to think outside the box when providing support for ASD children.
Designing initiatives based on their interests that allow them to socialise, communicate and connect in a supportive environment might be a good place to start.
- Dr Colman Noctor is a child psychotherapist